Kidney cancer, also known as renal cell carcinoma (RCC), is the most common type of kidney cancer in adults. It begins when abnormal kidney cells grow uncontrollably, forming a tumour that may remain localised or spread to other parts of the body.
This guide helps patients and caregivers understand causes, risk factors, diagnosis, staging, and treatment options for kidney cancer — including modern treatments such as immunotherapy and targeted therapy.
Your kidneys are essential organs responsible for:
Most people can live normally with one functioning kidney, which is important when planning kidney cancer treatment.
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:
✔ Imaging
PET scans are used selectively when other scans are unclear.
✔ Blood & Urine Tests
These help assess kidney function and overall health.
✔ Kidney Biopsy
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.
Stages 1 & 2: Localised Kidney Cancer (Curable Stage)
Surgery is the main treatment:
Modern approaches may include robotic or minimally invasive surgery to reduce recovery time.
Stage 3 Kidney Cancer
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.
Stage 4 (Metastatic Kidney Cancer)
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 helps your immune system recognise and attack cancer cells. It is one of the most successful modern treatments for kidney cancer.
Common immunotherapy drugs:
Targeted therapies block signals that help cancer grow or develop new blood vessels.
Examples include:
Some patients respond best to combination therapy:
| Approach | Example |
| Immunotherapy + Immunotherapy | Nivolumab + Ipilimumab |
| Immunotherapy + Targeted Therapy | Pembrolizumab + Axitinib, Pembrolizumab + Lenvatinib, Nivolumab + Cabozantinib |
These combinations are now common first-line treatments.
Active Surveillance (“Watchful Waiting”)
For slow-growing kidney cancer in patients without symptoms, doctors may choose regular monitoring rather than immediate treatment.
Is Chemotherapy Used?
Traditional chemotherapy is not effective for most kidney cancers and is rarely used.
Living With Kidney Cancer
Follow-up care may include:
Many patients continue everyday activities throughout treatment.
Lead and Senior Consultant - Medical Oncology and Haematology
Consultant Medical and Hemato Oncologist
