Kidney cancer most commonly refers to renal cell carcinoma. Risk factors include smoking, obesity, high blood pressure, chronic kidney disease, and inherited syndromes. Many tumors are found incidentally on imaging. Diagnosis relies on ultrasound and contrast CT or MRI; biopsy is used selectively. Localized tumors are treated surgically (partial or radical nephrectomy), while advanced disease is managed with targeted therapies and immune checkpoint inhibitors. Radiation and embolization are used for palliation and local control. Prognosis depends on stage and tumor biology.

What is kidney cancer?

Kidney cancer occurs when cells in the kidney grow out of control and form tumors. The most common type is renal cell carcinoma (RCC), which arises from the lining of the kidney's small filtering tubules. Clear cell is the single largest subtype of RCC; other subtypes include papillary and chromophobe. Wilms tumor is a distinct, fast-growing kidney cancer of early childhood.

Who is at risk?

Risk factors include cigarette smoking, obesity, high blood pressure, chronic kidney disease (including dialysis), and certain inherited syndromes such as von Hippel-Lindau (VHL) disease. Men develop kidney cancer more often than women, and most cases are diagnosed in middle-aged and older adults. Many cases are now detected incidentally on imaging done for other reasons.

Symptoms and spread

Many people have no symptoms early on. When present, symptoms can include blood in the urine (hematuria), flank or abdominal pain, a palpable mass, unintended weight loss, fever, or fatigue. When kidney cancer spreads, the most common sites are the lungs, bones, liver, brain, and nearby lymph nodes.

How kidney cancer is diagnosed

Ultrasound, contrast-enhanced CT of the abdomen and pelvis, and MRI (when CT is contraindicated or to evaluate venous involvement) are the main imaging tests used today. A chest CT is commonly done to check for lung spread. Image-guided percutaneous biopsy is increasingly used when tissue confirmation will influence management (for example, before ablation or systemic therapy), but it is not always required prior to surgery.

Treatment options

Local disease

Surgery remains the cornerstone of cure for localized kidney cancer. Partial nephrectomy (removing only the tumor and a rim of normal tissue) is preferred for most small tumors to preserve kidney function. Radical nephrectomy (removing the entire kidney and surrounding tissue) is used for larger or centrally located tumors. Minimally invasive approaches - laparoscopic and robotic surgery - are common.

Ablation (cryoablation or radiofrequency ablation) is an option for small tumors in patients who are not surgical candidates.

Advanced or metastatic disease

Since the mid-2000s, systemic therapy options have changed dramatically. Targeted agents that inhibit VEGF and mTOR pathways and immune checkpoint inhibitors (PD-1/PD-L1 and CTLA-4 antibodies) are now central to treatment. Combination regimens (immune checkpoint inhibitor plus a tyrosine kinase inhibitor or dual immunotherapy) are commonly used in first-line metastatic care. High-dose interleukin-2 and interferon are now rarely used and reserved for select cases.

Radiation is typically used for palliation (for painful bone metastases or brain lesions), but stereotactic radiation can also control limited metastatic sites.

Other measures

Renal artery embolization can provide symptom relief in specific situations. Supportive care to manage anemia, blood pressure, and kidney function is important throughout treatment.

Outlook

Prognosis depends mainly on stage at diagnosis, tumor subtype, and the patient's overall health. Advances in systemic therapy have improved outcomes for many people with advanced RCC, but early detection and appropriate surgical management remain key for cure.

Some subtype and epidemiology percentages and specific approvals were updated; see verification todos.

  1. Confirm current percentage breakdown of RCC subtypes (clear cell vs others) in contemporary epidemiology sources.
  2. Verify the most recent approvals and guideline recommendations for adjuvant and first-line systemic therapies (for example, pembrolizumab adjuvant approval and current preferred combination regimens).
  3. Update precise median age at diagnosis and male:female incidence ratio from current cancer registry data.

FAQs about Kidney Cancer

What are the most common types of kidney cancer?
The most common is renal cell carcinoma (RCC), with clear cell being the single largest subtype. Other RCC subtypes include papillary and chromophobe. Wilms tumor is a separate entity seen in children.
How is kidney cancer usually found?
Many cases are detected incidentally on imaging (ultrasound, CT or MRI) performed for other reasons. Symptoms, when present, include blood in the urine, flank pain, or an abdominal mass.
When is a kidney biopsy needed?
A percutaneous biopsy is helpful when the result will change management - for example, before ablation or when systemic therapy is considered. It is not always required before surgical removal.
What are current treatments for advanced kidney cancer?
Modern systemic treatments include targeted therapies (VEGF and mTOR inhibitors) and immune checkpoint inhibitors. Combinations of these drug classes are commonly used first-line for metastatic disease.
Can localized kidney cancer be cured?
Yes. Surgical removal of the tumor (partial or radical nephrectomy) can cure many localized kidney cancers. Outcomes depend on tumor stage, subtype, and patient health.