Kidney Cancer Symptoms Are Often Silent—Do You Have the ‘Big Three’ Risk Factors?
Plus, discover new treatment options that are improving outcomes for cancer patients
On the list of medical terms we’d rather never hear, cancer is at the top. But when it comes to fighting it, knowledge is incredibly powerful. Here, top doctors share the risk factors and symptoms of kidney cancer, plus reveal cutting-edge treatments proven to help combat and even potentially cure this “silent” disease.
What is kidney cancer?
It’s more common in men than women, with men accounting for roughly 60 percent of cases and women about 40 percent.
About 90 percent of kidney cancers are renal cell carcinoma, making it by far the most common type, says Thomas E. Hutson, DO, Pharm.D, chief of the Hematology Oncology Division in the Department of Internal Medicine at the Texas Tech University Health Sciences Center (TTUHSC) School of Medicine.
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“The second most common is renal pelvis carcinoma, which is a type of urothelial cancer [that starts in the kidney]. Other cancers can also occur in the kidney, including lymphoma and neuroendocrine tumors, and the kidney can be a site where cancers from other parts of the body, such as breast cancer, spread.”
While anyone can develop kidney cancer, awareness is crucial—whether you’re tracking your own risk factors or following real-life stories like soap and Great American Family channel star Cameron Mathison’s recent diagnosis and recovery journey.
Kidney cancer is on the rise
In the United States, roughly 75,000 cases of renal cell carcinoma are diagnosed each year, and this number is increasing annually, observes Dr. Hutson. “There are also geographical differences in incidence. For example, renal cell carcinoma appears to be more common in people of Northern European descent, though it can occur in other populations.”
Kidney cancer symptoms are ‘silent’
The most common way kidney cancer is found is actually not through symptoms like blood in the urine, a mass or pain, reveals Steven Campbell, MD, PhD, Chair and Professor of Urology at West Virginia University School of Medicine. “Most cases are discovered incidentally, either during imaging for unrelated medical issues or when patients have very nonspecific complaints that lead to evaluation.”
A patient with a history of lung cancer, for example, might come in for a follow-up CT scan to monitor their lungs, he continues. “Sometimes, part of the kidney is captured in the scan, and a mass is detected completely by accident, with no symptoms at all.”
There are no routine screenings for this disease
One of the challenges with kidney cancer is that, unlike some other common cancers, we don’t have a reliable screening test or biomarker, adds Eric A. Singer, MD, MA, MS, FACS, FASCO, urologic oncologist and Professor of Urology and Bioethics at The Ohio State University College of Medicine.
“For instance, women have mammograms to screen for breast cancer, and both men and women undergo colonoscopies to screen for colon cancer. But there’s no routine screening test or blood test for kidney cancer.”
Still, kidney tumors are being detected earlier
It’s important to note that not all kidney tumors or masses are cancer, he points out. “But typically, anyone with a solid, ‘enhancing’ kidney mass should be evaluated. Enhancing means that during imaging—such as a CT scan or MRI—a contrast agent is injected through an IV to help the radiologist see structures inside the body more clearly.
Kidney tumors that enhance, or become brighter, after contrast is administered are the ones we’re most concerned about, because this can indicate kidney cancer.”
Indeed, imaging technology has come so far that what was once called the “terrible triad” of more advanced kidney cancer symptoms—blood in the urine, flank pain and an abdominal mass—is largely a thing of the past, adds Dr. Singer.
“Most people no longer present this way because we’re able to detect kidney tumors much earlier. For many reasons, it’s less common for patients to have very large kidney masses, but it still does happen.”
3 risk factors for kidney cancer
Here, Dr. Campbell notes three big risk factors that can increase your odds of developing kidney cancer. Fortunately, they can be managed through healthy lifestyle changes like eating a balanced diet and staying active:
- Smoking (Discover simple strategies to help you quit.)
- Obesity
- Hypertension (high blood pressure)
That said, the exact cause of kidney cancer remains unknown in most cases, notes Dr. Hutson, who points out a few additional factors that increase the risk of the disease:
- Exposure to petroleum products and insecticides, like Agent Orange
- Acquired renal cysts in patients with end-stage renal disease
- Certain occupational links (The International Firefighters Association recognizes kidney cancer as an occupationally-associated cancer due to their routine and unavoidable exposure to hazardous carcinogens in their line of work.)
4 kidney cancer treatment options
A biopsy can be performed to determine if a mass is cancerous. “For small masses, there’s about a 70 to 80 percent chance that it is malignant,” reveals Dr. Singer, adding that this means there’s a 20 to 30 percent chance it’s not cancer, which is pretty good odds. “If I had a 20 percent chance of winning the lottery, I’d probably play a lot more often.”
If it does turn out to be malignant, the main treatment for localized kidney cancer is surgery, says Dr. Campbell. “That’s either what we call a radical nephrectomy, where we remove the whole kidney, or a partial nephrectomy, where we operate and remove the tumor and a small rim of normal kidney right around it and we save as much as possible of the remaining kidney.”
Other treatments for kidney cancer include:
Active surveillance
“When it comes to a small renal mass, we have options like surveillance—just watching to see if it’s going to change or grow over time,” says Dr. Singer, noting that most kidney tumors are very slow growing.
Ablation
Sometimes, for patients with small tumors (less than 4 cm), an interventional radiology doctor can do a percutaneous—through the skin—procedure called ablation, where they freeze or heat the tumor to destroy it, reveals Dr. Singer. High-dose radiation can also be used in select cases, he adds.
Histotripsy
“We have a new technology called histotripsy, which uses sound waves to create micro bubbles in the tumor cells, destroying them by causing them to pop,” says Dr. Singer, explaining that this technology has only recently been tested in kidney cancers and is currently awaiting FDA approval.
Immunotherapy
For the roughly 20 percent of kidney cancers that are metastatic—or have spread to other parts of the body—immunotherapy is the main treatment. These drugs are typically given every three weeks and work by activating the immune system, helping the body recognize and fight the cancer cells, explains Dr. Campbell.
The other main treatment for metastatic kidney cancer is targeted therapy. “Kidney cancer is interesting because the most common type secretes substances that stimulate blood vessel growth, a process called angiogenesis.
Essentially, the cancer tricks the body into growing more blood vessels, increasing blood flow to the tumor. These medications, called angiogenesis inhibitors, block those substances that turn on the blood vessels,” which in essence cuts off its food supply.
Kidney cancer outcomes are improving
“While for most patients advanced kidney cancer is still incurable, when I first went into the field, they would only live an average of one year,” says Dr. Campbell. “Now they quite often will live three to four years. And many of them will live much longer than that—some eight to 10 years, and a small percentage will essentially get cured by these medications.”
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