Cancer of the kidneys, also known as renal cancer, is often curable when detected early. However, some patients may not be diagnosed until the tumor is large or has metastasized (spread to other organs) and becomes difficult to treat. Most kidney cancers are renal cell carcinomas. In children, the most common type of kidney cancer is called Wilms tumor. This Patient Page is based on one published in the July 7, 2004, issue of JAMA.
Kidney cancers most commonly occur in adults older than 50 years.
Men are twice as likely as women to have kidney cancers.
Cigarette smoking increases the risk of developing kidney cancer.
Obesity has been linked to as much as 20% of kidney cancers.
Von Hippel–Lindau syndrome, Birt-Hogg-Dubé syndrome, hereditary papillary renal cell carcinoma, hereditary leiomyomatosis, and renal cell cancer syndrome are some genetic conditions associated with kidney cancer.
In many cases, the diagnosis of kidney cancer is made in the absence of symptoms, during testing for unrelated medical conditions. In some patients, especially those with more advanced cancer, the following signs and symptoms may be present:
Hematuria (blood in the urine)
Abdominal or low back pain unrelated to injury
Mass in the flank (lower side)
Constitutional symptoms (fever, unintentional weight loss, fatigue)
Anemia (low red blood cell count)
High blood pressure
Leg or ankle swelling
In addition to a detailed medical history, physical examination, and laboratory blood testing, tests used to diagnosis kidney cancer may include a computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound. Percutaneous biopsy (using a needle to obtain small samples of tissue) may help distinguish cancer from other diseases. A chest x-ray and bone scan may be used to detect metastatic disease. Additional testing may be needed before treatment for kidney cancer.
The best treatment may depend on a patient's age, life expectancy, and overall health in addition to the size and spread of the cancer. Surgical removal of the tumor only (partial nephrectomy) may cure patients with small kidney cancers and lower the risk of kidney disease. In some patients with larger tumors, removal of the entire kidney (radical nephrectomy) may be necessary to cure the cancer. Active surveillance (observation with periodic imaging) or ablation (using high energy to destroy cancer cells) may be an option for certain patients. Immunotherapy (boosting the body's immune system) or targeted therapy (oral medications that help block tumor growth) may benefit some patients with advanced kidney cancers. Experimental treatments may be available to patients who volunteer for clinical trials (medical research studies). Palliative treatment (to reduce symptoms, not to try to cure) with surgery or radiation therapy (x-ray treatments) may be offered to treat pain caused by advanced or metastatic kidney cancers.
American Cancer Society www.cancer.org
National Cancer Institute www.cancer.gov
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA 's Web site at www.jama.com.
Sources: American Cancer Society, National Cancer Institute
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
Janet M. Torpy, Cassio Lynm, Robert M. Golub. Kidney Cancer. JAMA. 2011;306(2):226. doi:10.1001/jama.2011.867