1. Smokers are two times more likely to develop this disease
2. Obesity is linked to about one third of renal cell carcinomas
3. High blood pressure and its treatments (diuretic medications)
4. Patients on dialysis or who are on immunosuppressant drugs after a kidney transplant
5. Radiation
6. Environment, including people who work in steel plants or who are exposed to cadmium, asbestos, trichloroethylene, aniline dyes or heavy metals.
7. People who have had bladder cancer are more likely to develop kidney cancer, and vice versa.
8. Age – people over 40 are more likely to develop kidney cancer
9. Gender – men are almost twice as likely as women to be diagnosed

Factors that may decrease the risk of developing kidney cancer include:

1. Maintaining a normal body weight
2. A diet that is high in fruits and vegetables, especially in bananas and root vegetables such as carrots
3. Maintaining normal blood pressure
4. Limited exposure to environmental toxins

Genetic Link

People who have developed Von Hippel-Lindau disease or papillary renal cell carcinoma, both inherited disorders, are at higher risk of kidney cancer.

About three per cent of kidney cancer patients have inherited a damaged gene that will make it likely the cancer will also be found in their second kidney.



Detection and Diagnosis

The signs of kidney cancer include blood in the urine, chronic back pain, unintentional weight loss, intermittent fever, general fatigue, and a mass in the kidney area. Abnormalities in the kidney suspicious for kidney cancer may be detected on other exams such as investigations for gall stones or kidney stones or other abdominal disorders.

In children, doctors are most likely to detect a growth during an abdominal examination.  The most common form of childhood kidney cancer, called Wilms’ tumour, usually has no other symptoms.

Diagnosis usually begins with a physical exam where the doctor checks for high blood pressure and signs of tumours.  They will order urine and blood tests to see how well the kidneys are working.

Doctors may use an ultrasound, a CT scan or an MRI to get a more detailed image of the internal organs.

A biopsy is the only way to be sure it’s cancer, but a solid tumour is often removed without a biopsy because the needle could spread the cancer.



Treatment

Treatment options for kidney cancer include surgery, chemotherapy, immunotherapy and radiation therapy, sometimes in combination depending on the progression of the disease.

Surgery for kidney cancer usually involves nephrectomy or removal of the entire organ including the adrenal gland, adjacent lymph nodes and surrounding “normal” tissue, but new research shows that removal of just the tumour, or nephron-sparing surgery, produces similar survival rates and offers less chance of subsequent renal failure in selected cases.  A laparoscopic procedure may also be an option instead of the traditional open surgery.  It involves the insertion of a tiny camera through a small incision, the surgeon then makes several small additional incisions to perform the operation.

An arterial embolization involves injecting a special material to block the main blood vessel leading to the kidney.  That deprives the tumour of oxygen.

Chemotherapy administered in a pill form has recently been shown to be of value in the treatment of patients with disease that has spread beyond the kidney. It is now used prior to immunotherapy in most cases.

Immunotherapy uses drugs such as interferon or interleukin-2 to stimulate the body’s immune system to fight the cancer.  Immunotherapy is most effective when used in combination with surgery.

Radiation therapy, concentrated beams of high-energy X-rays, is sometimes used alone or in combination, both as an addition to surgery and as an alternative treatment when surgery is not an option.  It is sometimes used in kidney cancer to relieve the pain when the cancer has spread to the bones.


Links:

 National Comprehensive Cancer Network (U.S.) guide to treatment decisions with links to other sites
 The Kidney Foundation of Canada
 Kidney Cancer Canada
 Canadian Cancer Society

Factors Affecting Prognosis

Survival is very much related to the stage of cancer when it is diagnosed. Almost 90 per cent of kidney cancer patients are still alive after five years if the cancer was discovered before it spread. Overall, almost two thirds of kidney cancer patients survive that long.

Learn more

Support for kidney cancer patients

• Psychosocial and spiritual support, Edmonton,
  Cross Cancer Institute
  • Phone: (780) 432-8703 or 8704
• Psychosocial and spiritual support, Calgary,
  Holy Cross site of the Tom Baker Cancer Centre 
  • Phone: (403) 355-3207
• Compassion House

How you can help

• Volunteer
• Raise Funds:  Alberta Cancer Foundation

Other Resources

  Canadian Cancer Society
  American Society of Clinical Oncology