Kidney cancer is one of the 10 most common cancers in the UK. Known medically as renal cancer, it is more common in men than women and it’s rare in people under the age of 50. You have two kidneys, one on either side of your tummy (your flanks) and slightly to the back. Their job is critical in keeping us alive - they balance up the salts (sodium, potassium and chloride) in our blood and excrete out any excess in urine. They filter out toxins into the urine and balance out fluids by making the urine more concentrated or more watery, depending on what we need. Signs that might alert you to a problem in the kidneys are blood in the urine or a lump in one of your flanks. It’s confirmed with blood tests, urine tests and scans.
As with many cancers, there aren’t often any clear symptoms in the early stages and kidney cancer is often identified through tests looking for something else. Symptoms of kidney cancer include blood in your urine, a lump or swelling on the abdomen and a mild but persistent pain in the lower back or side. You may have an anaemia or a poor renal function on bloods taken for another reason. You may get other non-specific symptoms like weight loss, back pain, loss of appetite and feeling tired and lethargic, but these can point to any number of conditions and cancers.
It’s often difficult to determine a specific cause for kidney cancer. Certain factors increase your risk. There are ones you can’t control, such as certain genetic conditions, like tuberous sclerosis, or if a close family member has renal cancer. Kidney disease increases the risk, especially if you require dialysis for kidney failure, or you have conditions that lead to kidney disease, such as high blood pressure and type 1 diabetes. Thyroid cancer is also a risk factor. And you can’t control your age or gender – being over 50 and male are risk factors. There are lifestyle factors that you do have control of: smoking and obesity are two significant factors. Certain pain medication, especially long-term reliance on over-the-counter pain medication, can increase your risk. If you think you are at increased risk, you can discuss with your doctor. If you have been diagnosed with kidney disease, it’s important to keep up with the invites to monitor this, via weight and blood pressure checks and blood tests.
You should see your doctor with any concerning symptoms such as blood in your urine or abdominal lumps and bumps. They will ask about your symptoms, your family history and check any other medical conditions or medications. They will examine your abdomen, looking for any pain or swelling. They will ask you for a urine sample looking for any simple signs of kidney disease or damage, and also to exclude any urine infection. They will do a set of bloods, particularly looking at how well the kidney is performing, the urea and electrolytes (known by doctors as “U’s and E’s”), and to assess any anaemia from the full blood count. Further tests may include an ultrasound scan of the kidneys, ureters and bladder. If there is an immediate concern for kidney cancer, your doctor will refer you urgently to a kidney specialist called a urologist. They may perform a cystoscopy, which is where a thin tube with a camera is passed into your urinary tract to look at your bladder and take samples of the tissue or they may perform a CT scan gain more information.
As with all cancers, treatment depends on the type of kidney cancer (renal cell carcinoma is the most common), the size of a tumour, whether it has spread to other areas and how fit you are overall. Surgery is the main treatment for most people, to remove either a section or the whole of the affected kidney. Medications that help stop the growth and spread of cancer (called biological therapies) can be initiated and radiotherapy can also be undertaken with high energy radiation. Other treatments such as cryotherapy (using freezing) or radiofrequency ablation (using heat) may be appropriate, where they are designed to destroy cancer cells. Embolisation is another option, where the blood supply to the cancer is disrupted. Most people want to know whether they will survive a particular cancer. This is a tricky question, as so much depends on an individual’s risk factors, age and general health, and on the type of tumour, how far advanced it is and whether it has spread. As a general impression, 80% survive to a year or more, 65% survive to 5 years or more.