Kidney cancer is a renal disease that begins in the kidneys. The urologists of Saint John’s Cancer Institute and Health Center develop personalized, effective treatment plans for kidney cancer.

About the Kidneys and Kidney Cancer

Our kidneys are the filters for our blood. They are located behind the abdominal organs, having one on each side of the spine. They not only remove waste but regulate our electrolytes. As part of the urinary tract, the main job of the kidneys is to make urine by removing waste and extra water before sending it into the bladder to be released from the body. Kidneys also help control blood pressure by producing a hormone called renin and help to make sure the body has enough red blood cells by making a hormone called erythropoietin.

kidney cancer ratio - men to women 2022
Kidney cancer affects men and women almost 2 to 1, or approximately 63% to 37%.

What is Kidney Cancer?

In adults, renal cell carcinoma is the most common type of kidney cancer.  If untreated, kidney cancer can spread to other parts of the body. Kidney cancer is also called renal cancer. It is one of the ten most common cancers in both men and women. In 2022, about 79,000 new cases of kidney cancer will be diagnosed consisting of about 50,000 men and 29,000 women, according to The American Cancer Society.  About 14,000 will die from the disease, consisting of about 9,000 men and 5,000 women.

Kidney cancer cells can spread through the lymph nodes and blood vessels, crossing into the lungs, bones, or liver. When this happens, cancer has metastasized (spread to other parts of the body), and new tumors may form in those parts of the body.

What are the two most common types of kidney cancers?

Renal Cell Carcinoma:

Renal Cell Carcinoma (RCC) is the most common type of kidney cancer that originates in the lining of the small tubes in the kidney that transport urine. RCC is the most common type of kidney cancer in adults, which is responsible for approximately 90–95% of all cases. About 9 out of 10 kidney cancers are renal cell carcinomas. About 54,000 Americans are diagnosed with renal cell carcinoma each year. Most are over 55 years old.

Cycts in the kidney
Kidney cysts are not a cancerous condition.

Transitional Cell Carcinoma:

Transitional Cell Carcinoma (TCC) is a more rare form of kidney cancer. It is also referred to as urothelial carcinoma. This cancer originates in the urothelial cells that line the inside of the bladder but can affect the ureters and kidney. About 5 to 10 of every 100 cancers in the kidney are transitional cell carcinomas, being the second most common cancer that affects the kidneys.

What are kidney cysts?

A kidney cyst is different than a kidney tumor, or cancer. Kidney cysts are small pouches of fluid that form on or in the kidneys. Though kidney cysts may impair function, they are not cancerous and rarely cause problems.

It’s not clear what causes simple kidney cysts. Simple kidney cysts aren’t the same as cysts that form with polycystic kidney disease.  They also differ from complex cysts, which need to be watched for changes that could be cancer.

Kidney Cancer Stages:

If you are diagnosed with kidney cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer development by how much of the disease is present and whether it has spread to other parts of the body. This helps doctors plan the best way to treat cancer.

4 stages of kidney cancer
In later stages of kidney cancer, cancer cells begin to invade other parts of the body.

Stage 1:

The tumor is 7 cm (2.75 inches) or smaller and found only in the kidney.

Stage 2:

The tumor is larger than 7 cm and found only in the kidney.

Stage 3:

The tumor can be any size but has spread to at least one nearby lymph node, or to nearby blood vessels.

Stage 4:

The tumor has grown through the outer layer of the kidney, or cancer cells have spread to lymph nodes, the lungs, the liver, bones, or other tissue.

What are the Symptoms and Risk Factors of Kidney Cancer?

Different cancers have different risk factors. Some risk factors, such as age and family history, are ones we cannot alter, while others we can change, such as quitting smoking.  Having one or more risk factors does not mean that kidney cancer is expected, while those who get the disease may have few or no risk factors.

Common kidney cancer symptoms

Kidney pain in the back
Persistent pain of the side and back may be caused by a kidney-related problem.
  • Blood in your urine, which may look rusty in color
  • Pain in your side that doesn’t go away
  • A lump or mass in your side or abdomen
  • Weight loss
  • Fever
  • Feeling very tired

If you experience blood in your urine or back pain, please see your physician right away to be evaluated.

Risk Factors

We have identified several key risk factors for this type of cancer:

  • Smoking: People who smoke have a higher risk of getting kidney cancer. The longer you smoke, the greater the risk.
  • Obesity: Being obese increases the risk of kidney cancer and other diseases.
  • High blood pressure: Having high blood pressure may increase the risk of kidney cancer.
  • Family history of kidney cancer: People with a family member who had kidney cancer have a slightly increased risk. Certain diseases that persist within families also increase the risk of kidney cancer. One is Von Hippel-Lindau syndrome, known as VHL. People with changes in the VHL gene face a greater risk for kidney cancer.

How is Kidney Cancer Diagnosed?

Our urologists diagnose and treat kidney cancer with the most advanced therapies available. We provide focused, personalized care with a team of specialists that will help you make informed decisions. In order to reach a diagnosis of cancer, we examine the details of the medical history and conduct a physical examination to be as accurate as possible. We’ll ask questions, make note of any symptoms you may have experienced, and factor in any other pertinent health information.

The following tests may be used to diagnose kidney cancer or to find out if it has spread:

kidney cancer - a comparison
Using magnetic resonance imaging (MRI), a normal kidney (left) compared to the kidney with a cancerous tumor (right).

Urine tests:

A lab test checks the urine for blood, cancer cells, and other signs of disease.

Blood tests:

A lab test checks your blood for several substances, including creatinine, which can indicate the kidneys are not functioning properly.

Ultrasound:

An ultrasound creates a picture of your kidney and nearby tissue and can reveal a kidney tumor.

CT scan:

An X-ray machine linked to a computer can show cancer in the kidneys, lymph nodes, or other tissue in the abdomen.

MRI:

A machine that uses magnetic resonance is used to make detailed pictures that can show cancer in the body, including smaller organs like kidneys, or lymph nodes.

IVP:

An injection of dye is used with an X-ray to detect a tumor or other problems.

Biopsy:

A sample of tissue is collected from the kidney by the doctor and is examined for cancer cells.

How do you treat Kidney Cancer?

Surgery is the most common treatment for people with kidney cancer. If a kidney is removed, the remaining kidney will need to do the work of both. Therefore, proper diet and nutrition are key to reducing the burden on the remaining kidney.  If your remaining kidney isn’t functioning well, you may need dialysis treatment while some people may need a kidney transplant.

The urologists at Saint John’s Health Center and Cancer Institute are experts in laparoscopic and robotic-assisted kidney cancer surgery.

Types of Kidney Cancer Surgery

Removing the entire kidney:

Removing the kidney is called a radical nephrectomy, which includes surgical removal of the adrenal gland. Lymph nodes in the area may also be removed.

Removing part of the kidney:

minimally invasive robot-assisted surgery - kidney
The tumor location and grade will indicate the type of treatment needed.

Removing part of the kidney is referred to as partial nephrectomy. The surgeon removes the tumor and part of the surrounding kidney tissue. This is performed either by a large incision or by laparoscopic surgery, which is minimally invasive.  Robotic surgery is a preferred method that reduces hospital stay time and patient recovery.

Cryosurgery

The surgeon inserts a tool through a small incision that freezes and kills the kidney tumor.

Laparoscopic surgery

Laparoscopic surgery is a minimally invasive technique involving robotics.  The urologist operates the robot remotely, which enhances the capability of the surgeon by performing similar techniques in less space. The doctors at Saint John’s Cancer Institute and Health center specialize in robotic kidney surgery using the da Vinci Surgical System. We utilized computerized imaging and an internal camera to direct the robot as it performs the procedure. This minimally invasive surgery means less blood loss and pain, and a faster recovery.

Kidney Treatment Innovation

Ceevra advanced 3D imaging for kidney surgery
Ceevra: Advanced, 3D visualization app for kidney cancer

Introducing Ceevra: Advanced Visualization for Kidney Cancer through Mobile 3D Imaging

Ceevra converts a patient’s standard black-and-white CT scan or MRI into a brilliant, interactive, multi-color 3D digital image that provides surgeons with finer detail and a true 3D visualization to help guide surgical decisions and the best approach for each patient.  The doctor can also view the patient’s 3D models in virtual reality using compatible VR headsets. This allows the oncologist to convey and resolve all the complexities of the surgery before work is performed.

Providence, Saint John’s Health Center was the first medical center in California to incorporate this groundbreaking technology into our standard practice for patients undergoing a partial or radical nephrectomy.

In a recent trial involving the use of 3-D virtual reality models, outcomes revealed a reduction in operation time, estimated blood loss, and length of hospital stay for kidney cancer patients.

Listen to Dr. Jennifer Linehan, Urologic Oncologist, discuss Ceevra 3D Imaging.

Other Kidney Cancer treatments Options

Radiofrequency Ablation:

A thin probe is used to deliver radio waves that generate heat to kill kidney cancer cells.

Radiation Therapy:

Radiation treatment (radiotherapy) uses X-rays to kill cancer cells. Though kidney cancers are not very sensitive to radiation, radiation is proven to disrupt the DNA of rapidly growing cells, therefore stopping cancer’s ability to continue to grow and thrive. Radiotherapy treatment for a kidney is often used to ease symptoms of kidney cancer, such as pain or bleeding caused by the cancer spread.

At the Saint John’s Cancer Institute, we also may use TomoTherapy®. This advanced radiation treatment delivery system uses computer image guidance during treatment to closely target kidney cancer. As a result, a higher dose of radiation can be safely applied to the tumor while preserving the healthy surrounding tissue.

Multidisciplinary Urology Team - Surgery Medical Oncology and Radiation
The multidisciplinary urology team at Saint John’s Health Center is ready to support you.
Targeted Therapy:

People with kidney cancer that has spread to other parts of the body may receive a type of drug called targeted therapy to shrink a kidney tumor or slow its growth. The drug usually is taken by mouth.

Chemotherapy:

This treatment uses anti-cancer drugs that are given intravenously, or by mouth, to reach all areas of the body. However, kidney cancer generally is resistant to chemotherapy, so it is not a standard treatment.

Biological Therapy:

People with kidney cancer that has spread may receive biological therapy. This treatment is meant to slow the growth of tumors or shrink them. The biological treatment is injected intravenously or under the skin.

How do Prevent Kidney Cancer?

Recommendations to lower your risk of kidney cancer include:

Quit smoking cigarettes and other tobacco products:

Smoking is responsible for a large percentage of cases of kidney cancer.

Maintain a healthy weight:

Obesity and high blood pressure are risk factors for kidney cancer and other diseases.

Avoid exposure to harmful substances:

Cadmium, industrial chemicals, and organic solvents found in the workplace may be a risk for kidney cancer.

If you have questions regarding kidney cancer treatment, or diagnosis, please call today. Click here to request an appointment.