Renal Cell Carcinoma

Overview

Renal cell carcinoma is a type of kidney cancer that starts in the lining of tiny filtering tubes within the kidney. The kidneys are two bean-shaped organs located on either side of the spine, below the ribs. They filter waste from the blood, help control fluid balance, and support blood pressure regulation.

Renal cell carcinoma is the most common type of kidney cancer in adults. It may be found when a person has symptoms, but it is also often discovered by chance during imaging tests performed for another reason. Some tumors grow slowly, while others may behave more aggressively. The approach to care depends on factors such as the size and location of the tumor, whether it has spread, the person’s general health, and kidney function.

For international patients, evaluation and treatment are usually planned by a multidisciplinary team, which may include specialists in urology, oncology, radiology, pathology, and, when needed, nephrology. The goal is to understand the disease accurately and choose an individualized treatment plan.

Symptoms

Renal cell carcinoma may not cause symptoms in its early stages. When symptoms do occur, they can be vague and may overlap with many non-cancer conditions. Possible symptoms include:

• Blood in the urine, which may appear pink, red, or dark
• Pain or discomfort in the side, back, or abdomen
• A lump or swelling in the side or abdomen
• Unexplained weight loss
• Persistent tiredness or weakness
• Loss of appetite
• Fever that does not have a clear cause
• High blood pressure or changes in blood test results related to kidney function

Having one or more of these symptoms does not mean a person has kidney cancer. However, persistent or unexplained symptoms should be assessed by a healthcare professional.

Causes and Risk Factors

The exact cause of renal cell carcinoma is not always known. Cancer develops when cells undergo changes that allow them to grow and divide in an uncontrolled way. In kidney cancer, these changes occur in kidney cells and may lead to the formation of a tumor.

Several factors may increase the risk of developing renal cell carcinoma. These include:

• Smoking or a history of smoking
• Excess body weight
• High blood pressure
• Long-term kidney disease or long-term dialysis
• Family history of kidney cancer
• Certain inherited genetic conditions
• Exposure to some workplace chemicals or industrial substances
• Older age
• Male sex

Many people with renal cell carcinoma have no clear risk factor. Having a risk factor also does not mean that cancer will develop. Risk factors are used to understand overall risk and guide appropriate medical assessment.

Diagnosis

Diagnosis begins with a medical history, physical examination, and review of symptoms. If kidney cancer is suspected or a kidney mass is found, the doctor may recommend tests to better understand the situation.

Common tests include blood and urine tests to assess kidney function, anemia, or other changes. Imaging tests are central to diagnosis and may include ultrasound, computed tomography, or magnetic resonance imaging. These tests help show the size, location, and features of a kidney mass and whether there are signs of spread to nearby tissues or other parts of the body.

In some cases, a biopsy may be recommended. During a biopsy, a small sample of tissue is taken for examination by a pathologist. A biopsy is not necessary for every kidney mass, as imaging and surgical findings may sometimes provide enough information for planning care. Additional imaging may be used for staging, which means determining how advanced the cancer is.

Treatment Options

Treatment for renal cell carcinoma depends on the stage of the disease, the size and location of the tumor, kidney function, and the person’s overall health and preferences. The care team will discuss the potential benefits, risks, and alternatives of each option.

For small tumors, active surveillance may be considered in selected patients, especially when the tumor appears slow-growing or when surgery carries higher risk. This involves regular monitoring with imaging and clinical review.

Surgery is a common treatment for localized renal cell carcinoma. In some cases, only the tumor and a small margin of surrounding tissue are removed, while preserving as much healthy kidney as possible. In other cases, removal of the entire kidney may be recommended. The surgical approach may be open, laparoscopic, or robot-assisted, depending on the tumor and the patient’s situation.

For patients who cannot have surgery, local treatments that destroy tumor tissue may be considered in selected cases. These techniques use extreme temperatures or other methods to target the tumor.

If renal cell carcinoma has spread beyond the kidney, treatment may include systemic therapies that work throughout the body, such as immunotherapy or targeted therapy. Radiation therapy may be used in certain situations, often to relieve symptoms or treat specific areas. Supportive care is also important and may help manage symptoms, maintain nutrition, support kidney function, and improve quality of life during treatment.

When to See a Doctor

A doctor should be consulted if there is blood in the urine, persistent pain in the side or back, unexplained weight loss, ongoing fever, unusual tiredness, or a new abdominal lump. These symptoms can have many causes, but they require medical assessment.

People with known risk factors, such as long-term kidney disease, a strong family history of kidney cancer, or an inherited condition associated with kidney tumors, should discuss appropriate monitoring with a healthcare professional.

Anyone who has already been diagnosed with renal cell carcinoma should seek medical advice promptly if symptoms worsen, new symptoms appear, or there are concerns during follow-up or treatment. Early evaluation helps the care team make informed decisions and provide appropriate support.