Kidney Cancer

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Symptoms, Diagnosis & Risk Factors

Dr. Scott Tykodi describes the risk factors and symptoms of kidney cancer

Kidney cancer is often undiscovered until the later stages for a few reasons:

  • These cancers can become quite large before they cause pain or other symptoms;
  • Kidneys are deep inside the body, so small kidney tumors cannot be seen or felt during a physical exam;
  • There are no recommended screening tests for people who are not at increased risk for the disease; and
  • The symptoms of kidney cancer are often caused by other, benign, diseases.

Symptoms may include blood in the urine, low back pain on one side, a mass or lump on the side or lower back, tiredness (fatigue), loss of appetite, weight loss, recurrent fevers not associated with colds or flu, and swelling of the ankles and legs.

You should tell your doctor if you have any of these symptoms.

Diagnosis

Doctors may use several tests to diagnose kidney cancer, including a biopsy, genetic tests, and imaging scans. Blood tests may be useful for providing prognostic (potential outcome) information.

A biopsy is a procedure that involves removing a small amount of tissue for examination under a microscope by a pathologist. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The pathologist identifies the type of cell involved in the kidney cancer, which is important in planning treatment.

Genetic tests look for gene mutations in your DNA. If you have family members (direct blood relatives) who were diagnosed with kidney cancer, especially at a younger age, or if they’ve been diagnosed with a genetic condition that is a risk factor for kidney cancer (see risk factors below), your doctor may recommend that you consider genetic testing.

Imaging tests look at the inside of the body. They may be used to help find out whether a suspicious area is cancerous, to determine if the cancer has spread (metastasized), and to help determine if treatments have been effective. The most common imaging tests used for kidney cancer are sonogram, IVP, CT scan, or MRI scan.

  • Ultrasound (or ultrasonography, sonogram) uses sound waves to produce images of internal organs. This type of imaging can help determine if a kidney mass is solid or filled with fluid.
  • Intravenous pyelogram (IVP) uses a dye that is injected into the patient’s bloodstream to highlight the kidney, urethra, and bladder when an X-ray is taken. The picture produced can show changes in these organs and in the nearby lymph nodes.
  • Computed tomography (CT) scan creates a three-dimensional picture of the inside of the body with an X-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.
  • Magnetic resonance imaging (MRI) uses magnetic fields to produce detailed images of the body. A contrast medium may be injected into a patient’s vein to create a clearer picture.

Blood tests check the number of blood cells, electrolytes, and enzyme levels.  These tests may identify abnormalities caused by kidney cancer.

Risk Factors

Risk factors for kidney cancer include:

  • Age. The risk of kidney cancer increases as you age. Kidney cancer is uncommon in people younger than age 45. It occurs most often in people 55 and older; with an average age of 64 at diagnosis.
  • Sex. Renal cell carcinoma (RCC) is about twice as common in men as in women.
  • Smoking. Smokers are twice as likely to get kidney cancer as nonsmokers.
  • Obesity and diet. Being overweight, having a high-fat diet increases the risk of getting kidney cancer.
  • Exposure to certain environmental substances, including asbestos, cadmium (a trace metal), or organic solvents
  • Genetic and hereditary factors, including having kidney disease or a family history of cancer
  • High blood pressure
  • Race. For reasons that are unclear, African Americans have a slightly high rate of RCC.

Five inherited diseases result from a faulty gene that makes a person more susceptible to kidney cancer: von-Hippel Lindau syndrome, Birt-Hogg-Dube syndrome, Hereditary papillary RCC, and Hereditary leiomyomatosis and RCC syndromes. People with Lynch syndrome may also be at greater risk for kidney cancers.