Diagnosis and treatment of kidney cancer

Symptoms and treatment Who is at risk? Examination and diagnosis Treatment Schedule your appointment with us

Symptoms and treatment

In the early stages, kidney tumours cause no symptoms at all. The first sign that something may be wrong is often blood in the urine. This can also indicate other conditions of the urinary tract, but it is always a reason to see a doctor. In many cases the amount of blood is too small to be visible to the naked eye, which is why regular preventive check-ups at intervals appropriate to your age are so important.

Other symptoms of kidney tumours include a dull ache in the lower back, and less commonly fatigue, recurring fever, loss of appetite and unexplained weight loss.

Not all kidney tumours are malignant. Benign tumours include angiomyolipoma, oncocytoma and adenoma, while malignant tumours include carcinoma. Clinically, kidney tumours are divided into tumours of the renal parenchyma (epithelial tissue) and tumours of the pelvicalyceal system. Renal cell carcinoma of the parenchyma accounts for 85% of all malignant kidney tumours.

Who is at risk?

Malignant kidney tumours are a growing concern, accounting for 1 to 3% of all cancers in the general population. The likelihood of developing kidney cancer is up to twice as high in men as in women.

The highest number of cases occurs around the age of 60. Not all contributing factors are yet fully understood. Hereditary forms are rare, though a kidney ultrasound is recommended for anyone over the age of 40 with a family history of kidney cancer.

Smoking is among the most clearly established external risk factors, with kidney cancer occurring 1.5 to 2.5 times more frequently in smokers than in non-smokers. Obesity is also a recognised risk factor, and a diet high in animal fat may have a similarly unfavourable effect. An increased incidence of kidney cancer is also observed in clients with chronic kidney failure who are undergoing dialysis.

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Examination and diagnosis

In the vast majority of cases, ultrasound is the first examination used when a kidney tumour is suspected. If the scan confirms the presence of a tumour, the extent of the disease needs to be established, for which we use computed tomography (CT). To determine the most appropriate treatment approach, a chest X-ray is also taken, and in some cases a bone scintigraphy, a radionuclide examination that identifies areas of increased metabolic activity in the skeleton.

Treatment

Localised disease is usually treated with surgery alone, typically involving removal of the kidney and the regional lymph nodes in the abdominal cavity. In less advanced cases, it is sometimes possible to remove only the tumour itself. Advanced disease requires oncological treatment following surgical removal of the kidney.

Routine follow-up care after kidney removal for cancer includes clinical examination, chest X-ray, abdominal ultrasound, bone scintigraphy and laboratory tests.