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Category: Nephrology | Oncology

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Renal cell carcinoma overview

Published: July 07, 2009. Updated: July 07, 2009

Renal cell carcinoma, a form of kidney cancer that involves cancerous changes in the cells of the renal tubule, is the most common type of kidney cancer in adults.

Epidemiology of renal cell carcinoma

Renal cell carcinoma affects about three in 10,000 people, resulting in about 31,000 new cases in the US per year. Every year, about 12,000 people in the US die from renal cell carcinoma. It is more common in men than women, usually affecting men older than 55.

Causes of renal cell carcinoma

Why the cells become cancerous is not known. A history of smoking greatly increases the risk for developing renal cell carcinoma. Some people may also have inherited an increased risk to develop renal cell carcinoma, and a family history of kidney cancer increases the risk.

People with von Hippel-Lindau disease, a hereditary disease that affects the capillaries of the brain, commonly also develop renal cell carcinoma. Kidney disorders that require dialysis for treatment also increase the risk for developing renal cell carcinoma.

Symptoms of renal cell carcinoma

The first symptom is usually blood in the urine. Sometimes both kidneys are involved. The cancer metastasizes (spreads) easily, most often to the lungs and other organs, and about one-third of patients have metastasis at the time of diagnosis.

Symptoms of renal cell carcinoma

  • Blood in the urine
  • Abnormal urine color (dark, rusty, or brown)
  • Flank pain
  • Back pain
  • Abdominal pain
  • Weight loss, more than 5% of body weight
  • Emaciated, thin, malnourished appearance
  • Enlargement of one testicle
  • Swelling or enlargement of the abdomen

Additional symptoms that may be associated with this disease:

  • Vision abnormalities
  • Paleness
  • Excessive hair grown (females)
  • Constipation
  • Cold intolerance

Complications of renal cell carcinoma

  • Hypertension
  • Metastasis (spread) of the cancer

Treatment of renal cell carcinoma

Surgical removal of all or part of the kidney (nephrectomy) is recommended. This may include removal of the bladder or surrounding tissues or lymph nodes. Radiation therapy is not commonly used for treatment of renal cell carcinoma because it is usually not successful. Hormone treatments may reduce the growth of the tumor in some cases. Medications such as alpha-interferon and interleukin have been successful in reducing the growth of some renal cell carcinomas, including some with metastasis. Chemotherapy may be used in some cases, but cure is unlikely unless all the cancer can be removed with surgery.

Prognosis of renal cell carcinoma

The outcome varies depending on the amount of metastasis. The five-year survival rate is around 60 percent to 75 percent if the tumor is in the early stages and has not spread outside the kidney. If it has metastasized to the lymph nodes, the 5-year survival is around 5 percent to 15 percent. If it has spread to other organs, the 5-year survival at less than 5 percent.

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