Kidney (Renal) Cancer: Introduction
What is cancer?
Cancer is when cells in the body change and grow out of control. To help you understand what happens when you have cancer, let’s look at how your body works normally. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them, and die when your body does not need them any longer.
Cancer is made up of abnormal cells that grow even though your body doesn’t need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasis).
What is kidney cancer?
Cancer that starts in kidney cells is called kidney or renal cancer.
Understanding the kidneys
The kidneys are 2 bean-shaped organs. Each is about the size of a bar of soap. They sit in the body towards the middle to lower part of the back. There is 1 kidney on each side of the spine. The kidneys help filter waste and excess fluid from the blood. The liquid and waste is then sent as urine to the bladder through thin tubes called ureters. Urine then leaves the body through a tube called the urethra. The kidneys also help control blood pressure. And they help make sure there are enough red blood cells in the body.
When kidney cancer forms
A kidney is made up of many layers of cells. Kidney cancer can affect any one or all of these layers. The cancer can stop the kidneys from working normally. Kidney cancer may spread to other parts of the body. When cancer spreads, it’s called metastasis. The more cancer spreads (metastasizes), the harder it is to treat.
What are the different types of kidney cancer?
The main type of kidney cancer is called renal cell carcinoma (RCC). About 9 out of 10 kidney cancer tumors are this type. If you have this type of kidney cancer, you may have more than one tumor in one or both kidneys. These may be large by the time they are diagnosed. But most cases of kidney cancer are found before the cancer has spread to other organs.
There are different types of RCC. A healthcare provider called a pathologist identifies these types by looking at the cancer cells under a microscope. The types of RCC include:
Clear cell. This is the most common type of RCC. The cancer cells look pale or clear.
Papillary. This is the second most common type of RCC. This type of tumor has tiny fingerlike growths.
Chromophobe. This is a rare form of RCC. The cells are larger than other types of RCC.
Collecting duct. This is also a rare form of RCC. The cancer cells look like irregular tubes.
Unclassified. This includes tumors that have cells from more than 1 type of cancer. It also includes tumors with cells that don’t fit into the other categories.
Other types of kidney cancer
Other less-common types of kidney cancers include:
Transitional cell carcinoma. This is also known as urothelial carcinoma. It starts where the ureter and kidney meet. This area is called the renal pelvis. This type of kidney cancer can act and look like bladder cancer.
Wilms’ tumor. This cancer most always occurs in children. It's very rare in adults.
Renal sarcoma. This is a very rare type of kidney cancer. It begins in the blood vessels and connective tissue around the kidneys.
Kidney tumors that aren’t cancer
There are several types of kidney tumors that are not cancer (benign). These include renal cell adenoma, renal oncocytoma, and angiomyolipoma. These types of tumors may still affect kidney function and can cause pain and other symptoms. But the cells usually do not spread to other organs.
Talk with your healthcare provider
If you have questions about kidney cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer.
Kidney Cancer: Treatment Questions
Talking with healthcare providers about cancer can be overwhelming. It can be hard to take in all of the information. It helps to be prepared. Make a list of questions and bring them to your appointments. Write the answers down in a notebook. Make sure you ask how the treatment will change your daily life, including your diet, and how you will look and feel after treatment. Ask how successful the treatment is expected to be, and what the risks and possible side effects are.
You may also want to ask a friend or family member to come with you. He or she can take notes and write down the answers, and also ask questions you may not think of. You can also ask your healthcare provider if you can record the conversation.
Below are some questions to ask during your appointments.
Deciding on a treatment
What kind of kidney cancer do I have?
What is the grade and stage of my cancer?
Has the cancer spread anywhere else in my body?
What are the treatment choices?
What treatment do you think is best for me?
What are the goals of the treatment you are recommending?
What is the success rate of this treatment for my type and stage of kidney cancer?
What is the life expectancy for someone with my stage of cancer receiving this treatment?
Are there any clinical trials that I can apply for?
Getting ready for treatment
What is the length of the treatment period?
How long will each treatment take?
Where do I have to go for the treatment?
Who will give me the treatment?
Does someone need to go with me during treatments?
Can I take my other medicines during treatment?
Coping during treatment
What side effects should I expect?
How long will side effects last?
Are there side effects that I need to call you about?
How do I reach you after hours and on weekends?
What can I do to ease the side effects?
Should I change my diet? What foods can't I eat?
Will I be able to go to work and be around my family?
Are there support groups nearby that I can join?
How will I feel after the treatment?
What type of follow-up will I need after treatment?
How will we know if treatment worked?
Kidney Cancer: Your Chances for Recovery (Prognosis)
What is a prognosis?
Prognosis is the word your healthcare team may use to describe your chances of recovering from cancer. Or it may mean your likely outcome from cancer and cancer treatment. A prognosis is a calculated guess. It’s a question many people have when they learn they have cancer.
Making a choice
The decision to ask about your prognosis is a personal one. It’s up to you to decide how much you want to know. Some people find it easier to cope and plan ahead when they know their prognosis and the statistics for how well a treatment might work. Other people find statistics confusing and frightening. Or they might think statistics are too general to be useful.
A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. For instance, a favorable prognosis (which means you’re likely going to do well) can change if the cancer spreads to key organs or doesn’t respond to treatment. An unfavorable prognosis can change, too. This can happen if treatment shrinks and controls the cancer so it doesn’t grow or spread.
What goes into a prognosis
When figuring out your prognosis, your doctor will consider all the things that could affect the cancer and its treatment. Your doctor will look at risk estimates about the exact type and stage of the cancer you have. These estimates are based on what results researchers have seen over many years in thousands of people with the same type and stage of cancer.
If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. This means you’re expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. It’s important to keep in mind that a prognosis states what’s likely or probable. It is not a prediction of what will definitely happen. No doctor can be fully certain about an outcome.
Your chance of recovery depends on:
The type and location of the cancer
The stage of the cancer
Your overall health
Your treatment decisions
Understanding survival rates
Survival rates show how many people live for a certain length of time after being told they have cancer. The rates are grouped for people with certain types and stages of cancer. Many times, the numbers used refer to the 5-year or the 10-year survival rate. That’s how many people are living 5 years or 10 years after diagnosis. The survival rate includes people at these different stages:
People who are cancer-free or cured
People who have few or no signs or symptoms of cancer
People who are getting cancer treatment
What are the survival rates for kidney cancer?
Here are the 5-year survival rates for kidney cancer, according to the American Cancer Society:
Overall, the 5-year survival rate for people with kidney cancer is about 74%.
For people whose cancer is found when it is only in the kidney, the 5-year survival rate is about 93%.
If kidney cancer has spread to nearby tissues or organs or the regional lymph nodes, the 5-year survival rate is about 66%.
If the cancer has spread to a distant part of the body, the 5-year survival rate is about 12%.
Talking with your healthcare provider
You can ask your healthcare provider about survival rates and what you might expect. But remember that statistics are based on large groups of people. They can't be used to say what will happen to you. No two people are exactly alike. Treatment and how well people respond to treatment vary.