OHSU

Types of Kidney Cancer

Renal Cell Carcinoma

Renal cell carcinoma is the most common form of kidney cancer.

If you have kidney cancer, you might have seen blood in your  urine, noticed a swelling on your side or had pain in your side. Unfortunately, many kidney cancers have no signs or symptoms, and are not found until they become very large. Currently, there are no laboratory tests that detect kidney cancer. Some warning signs include:

  • Blood in your urine (even under a microscope)
  • Discomfort in your side or back that will not go away
  • Feeling tired
  • Losing your appetite
  • Losing weight loss without dieting
  • Having abnormal blood counts

Many patients never have any symptoms, and cancer is diagnosed when they are examined or tested for something else or at a regular doctor visit. Most  kidney tumors are discovered this way.

To determine if you have kidney cancer, your doctor will do imaging studies. These include ultrasound, which can tell solid tumors from cysts (tumors filled with fluid). You will also have a CT scan, which is considered the best test for finding kidney tumors, or an MRI if you cannot have a CT. An MRI can be used look for tumors in the kidney’s blood vessels. A bone scan can determine whether the kidney cancer has spread to the bones, and arenal (kidney) scan can tell your doctor how well the kidneys are functioning. You might also have blood tests to look for problems with kidney function or with your liver.

Transitional Cell Cancer

A second type of kidney cancer is called transitional cell cancer. This type of cancer is very similar to bladder cancer. It can involve the kidney or the ureters, the tubes that empty the kidney and drain urine to the bladder.  These cancers are relatively rare, affecting approximately 4,000 people in the United States each year. Exposure to tobacco smoke and working in the chemical and petroleum industries raises your risk of transitional cell cancer. Because people with transitional cell cancer often have bladder cancer, your doctor will do a test called cystoscopy to examine your bladder.

Your doctor will work with you to determine the best treatment depending on your age and general health. Surgery to remove the cancerous kidney, ureter and other tissue is the most common treatment for transitional cell cancer. Depending on your age, health, the location of the tumor and whether it has spread, your doctor may be able to remove just the ureter or do endoscopic surgery to remove only the tumor. For most patients, removal of the kidney, ureter and other tissue is the most effective cancer treatment.

Kidney Cancer Stages

Staging is the process of determining how much cancer you have and where it exists. All cancers are assigned a stage before treatment. This helps doctors determine the best treatment for you and how well it is likely to work. Your doctor might do a CT or MRI scan, X-ray, bone scan, blood tests or other tests to stage your cancer.

Stages of renal cell cancer:

  • Stage I: Cancer is only in the kidney. The tumor is seven centimeters in diameter or less. 
  • Stage II: Cancer is only in the kidney, but the tumor is larger than seven centimeters..
  • Stage III: The tumor in the kidney may be any size, but it has grown outside the kidney. There may be cancer in the blood vessels near the kidney, or in the adrenal gland next to the kidney.
  • Stage IV: The tumor has spread outside the kidney, or cancer has spread to one or more lymph nodes near the kidney, or both. Cancer might have spread to other organs in the body, such as the lungs, liver, brain or bones.

Your cancer stage, age and general health will help your doctor determine the best treatment for you.

Most patients with kidney cancer benefit from surgery. You might have a radical nephrectomy, which involves removing the whole kidney and the tissues that surround it, or a partial nephrectomy, (which removes only the area of the kidney that contains cancer.. If your other kidney is healthy, removing one kidney probably will not affect your body’s ability to remove waste. Many people can live healthy lives with only one kidney. If your other kidney does not work wellI, you have tumors in both kidneys, only have one kidney or the tumor is small, your doctor will probably do a partial nephrectomy. Other new treatment options are freezing (cryotherapy), heating (radiofrequency ablation) and radiation (stereotactic radiosurgery). Your doctor will tell you if one of these options could be right for you.

Our doctors do open (traditional incision) and minimallyinvasive (robotic and laparoscopic) surgeries for kidney cancer. In laparoscopic and robotic surgery, your doctor will do surgery with a camera and instruments inserted through small holes in the skin. Open and minimally invasive surgery have advantages and disadvantages. Talk with your doctor and multidisciplinary care team to decide which option is best for you. 

Your adrenal gland, which sits above the kidney, may or may not be removed, depending on your  situation. Your doctor may also remove the lymph nodes around the kidney or leave them in place. Your doctor and other members of your multidisciplinary care team can talk with you about these treatment options.

Some patients may benefit from chemotherapy after surgery.

Chemotherapy might work if you have an advanced tumor or your cancer has spread to the lymph nodes or other areas. Several new drugs are available for kidney cancer. Your doctor will help you choose the best treatment option to treat your cancer.