Introduction
Kidney cancer is more common in men than in women, with the risk of developing the condition in men (by age 85) 1 in 49, with the risk in women being 1 in 94. The commonest type is renal cell carcinoma (85% of kidney cancer diagnoses) and in most cases of kidney cancer, only one kidney is affected, but very rarely it may affect both.
Renal cell carcinoma develops in the lining of the kidney tubules, whereas the other main type, urothelial carcinoma or 'transitional cell carcinoma' develops outside the kidney itself in the area where urine collects before going into the bladder. It is not as common, and is the same type of cancer that can affect the bladder.
The majority of masses that are seen on the kidney are malignant, however there are numerous other types of kidney masses. These include:
- Cysts
- Angiomyolipomas
- Oncocytoma
- Metastases
- Xanthogranulomatous pyelonephritis
Causes
There are a number of risks factors for the development of kidney cancer. Some of these include:
- Smoking
- Long term pain medication use (or misuse), especially those containing phenacetin (removed from all medication in Australia in the 1970s)
- Family history - especially Hippel-Lindau disease and hereditary papillary renal cell carcinoma
- Gender - men are more likely to develop the condition than women
- Obesity
- High blood pressure
- Acquired renal cysts from chronic renal failure
Symptoms
Kidney cancer often has no symptoms in the early stages. Where symptoms appear, they may include the following:
- Haematuria (blood in the urine)
- Development of a lump in the abdomen
- Persistent pain in the side or lower back
- Anaemia
- Tiredness
- Appetite loss
- Unexplained weight loss
- Fever (where cold or flu is not present)
Tests / Diagnosis
Once the doctor has completed a review of the medical history and symptoms and conducted a physical examination, the following tests may be recommended to confirm the diagnosis:
- Urine test / Urinalysis
- Blood test(s)
- Liver function tests
- Scans - these may include ultrasound and CT scan, x-ray (chest) and nuclear medicine scan
- Biopsy - this is via a 'core needle biopsy'
Treatment
Kidney cancers are predominantly managed surgically by the removal of the kidney with or without the ureter which connects the kidney to the bladder.