Kidney cancer, also known as renal cell carcinoma (RCC), is the most common form of cancer reported by adults. It occurs when kidney cells begin to multiply abnormally; consequently, a mass (tumour) develops, either remaining inside the kidney or possibly metastasizing to distant body sites.
This guide will help you understand all about the aspects related to kidney cancer, including the causes, risk factors, how kidney cancer is diagnosed and staged, modern treatment modalities such as immunotherapy and targeted therapy, and the options available to those diagnosed with kidney cancer.
The kidneys are critical organs that:
People typically live a full, active, and healthy life with one working kidney, which is an important consideration when determining treatment for kidney cancer.
There isn’t one single known cause of renal cell carcinoma, but several factors increase risk.
A small percentage of kidney cancers are inherited. Genetic conditions associated with RCC include:
If cancer occurs at a younger age, affects both kidneys, or multiple family members, genetic testing may be recommended.
Many kidney cancers are asymptomatic and found incidentally. When symptoms occur, they may include:
Not everyone will experience symptoms, especially in early stages.
Diagnosis is based on tests such as:
PET scans are used selectively when other scans are unclear.
These help assess kidney function and overall health.
A biopsy may be used mainly in:
In early-stage disease, biopsy isn’t always necessary if surgery is already planned.
Staging helps determine appropriate treatment.
| Stage | Summary |
| Stage I | Tumor ≤7 cm, limited to kidney |
| Stage II | Tumor >7 cm, still within kidney |
| Stage III | Spread to nearby vessels or lymph nodes |
| Stage IV | Spread beyond kidney or to distant organs |
Early-stage disease generally has the best outcomes.
Treatment depends on stage, health status, tumour type, and kidney function.
Surgery is the main treatment:
Modern approaches may include robotic or minimally invasive surgery to reduce recovery time.
Treatment typically requires:
Robotic surgery may be feasible depending on tumour location and surgeon expertise.
Some patients are at higher risk of recurrence even after successful surgery. These patients may benefit from adjuvant immunotherapy.
This therapy is considered when pathology suggests a high likelihood of recurrence.
At this stage, cancer has spread beyond the kidney.
Surgery may still be helpful if the kidney tumour is causing:
Otherwise, treatment usually starts with systemic therapy.
Doctors may use a scoring system (IMDC criteria) to guide treatment planning.
Immunotherapy has been one of the most successful forms of treatment in recent years for patients diagnosed with renal cell carcinoma.
These are a few examples of the types of immunotherapy drugs available to help treat RCC:
Targeted therapies block signals that help cancer grow or develop new blood vessels.
Some examples of targeted therapies used in RCC:
A patient who receives combination therapy may have the best response to their treatment.
| Approach | Example |
| Immunotherapy + Immunotherapy | Nivolumab + Ipilimumab |
| Immunotherapy + Targeted Therapy | Pembrolizumab + Axitinib, Pembrolizumab + Lenvatinib, Nivolumab + Cabozantinib
|
The combination of the above therapies is now widely used as first line therapies.
It is another option for patients who are symptomatic; however, doctors may choose to regularly monitor their kidney cancer rather than treating it immediately (for slowly-growing cancers).
Unfortunately, traditional chemotherapy is not effective for most types of kidney cancer and is not frequently used.
The follow-up care will likely include:
Many patients are able to continue with their regular activities while being treated.
