What is Kidney Cancer?

Kidney cancer (also called renal cancer) is a type of cancer that starts in the kidneys, which are two bean-shaped organs responsible for filtering blood and producing urine. It develops when abnormal cells in the kidney grow uncontrollably and form a tumour, which can spread (metastasize) to other parts of the body.

What are the symptoms of Kidney Cancer?

Common Symptoms

1. Blood in urine (Haematuria)

• Most frequent symptom; urine may appear pink, red, or cola-colored.
  2. Persistent pain in the side or back
• Usually below the ribs and not related to injury.
  3. Lump or mass in the abdomen or side
• Can sometimes be felt during a physical examination.

Other Possible Symptoms

• Unexplained
• Loss of appetite
• Fatigue
• Persistent fever (not due to infection)
• Anaemia (low red blood cell count)

Advanced Stage Symptoms

• Swelling in legs or ankles
• Shortness of breath
• Bone pain (if cancer spreads)
• High blood pressure (due to kidney involvement)
• Night sweats

Paraneoplastic Syndromes(Caused by hormones produced by tumour)

• Hypercalcaemia (high calcium levels → nausea, confusion)
• Polycythaemia (increased red blood cells)
• Liver dysfunction (Stauffer syndrome)

How to detect Kidney Cancer?

1. Medical History & Physical Exam

• Ask about symptoms (blood in urine, pain, weight loss).
• Palpate abdomen to check for masses.

2. Imaging Tests

These are the main tools to identify kidney tumours:

• Ultrasound

• Non-invasive, can detect masses in kidneys.
  • CT Scan (Computed Tomography)
• More detailed, helps determine size, location, and whether cancer has spread.
  • MRI (Magnetic Resonance Imaging)
• Used if CT cannot be done (e.g., contrast allergy) or for better soft tissue detail.
  • Intravenous Pyelogram (IVP)
• Older test, less commonly used now.

3. Laboratory Tests

• Urinalysis: To detect blood or abnormal cells.
• Blood tests: Kidney function tests, anaemia check, calcium levels.

4. Biopsy

• Sometimes done to confirm diagnosis before treatment.
• Can be performed with CT-guided needle biopsy.
• Not always necessary if imaging is clear and surgery is planned.

5. Staging Tests

• To check if cancer has spread beyond the kidney:

• Chest X-ray or CT (lungs)
• Bone scan (if bone pain)
• PET scan (in some cases)

What are the available treatments for Kidney Cancer?

1. Surgery (Primary Treatment for Localized Kidney Cancer)

• Radical nephrectomy: Removal of the entire kidney, often including nearby tissues and lymph nodes.
• Partial nephrectomy: Removal of only the tumour and a small margin of healthy tissue; preserves kidney function.
• Ablative therapies (for small tumours or patients who can’t undergo surgery):
• Cryoablation (freezing tumour)
• Radiofrequency ablation (heating tumour)

2. Targeted Therapy

• Used for advanced or metastatic kidney cancer.
• Drugs block blood supply to tumour or specific cancer pathways.
• Examples:
• Tyrosine kinase inhibitors (TKIs): Sunitinib, Pazopanib, Axitinib
• mTOR inhibitors: Everolimus, Temsirolimus
• VEGF inhibitors: Bevacizumab

 3. Immunotherapy

• Boosts immune system to attack cancer.
• Checkpoint inhibitors (e.g., Nivolumab, Pembrolizumab) are approved for Advanced Renal Cell Carcinoma.
• Sometimes combined with targeted therapies.

4. Radiation Therapy

• Not commonly used as primary treatment because kidney cancer is often resistant.
• Used mainly for palliative care to relieve symptoms like bone pain or brain metastases.

5. Active Surveillance

• For small tumours or patients with other health issues.
• Regular monitoring with imaging instead of immediate treatment.