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Symptoms
Causes
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Next in Renal Cell Carcinoma Guide
Renal cell carcinoma is a type of kidney cancer. This type of cancer can produce a variety of symptoms, including pain, fatigue, and blood in the urine. Risk factors include smoking, obesity, toxin exposure, and a family history of renal cell cancer.
The noticeable effects of renal cell carcinoma typically begin as the cancer reaches an advanced stage. You may need to have a number of diagnostic tests to identify the cause of your symptoms because renal cell carcinoma has such vague effects. Once a diagnosis is made, treatment may involve surgery, radiation, and chemotherapy.
This article covers the causes and symptoms of renal cell carcinoma, along with how it is diagnosed, staged, and treated.
Symptoms of Renal Cell Cancer
There are many different effects that can occur as the result of renal cell carcinoma. This cancer starts in the kidney, and it can also metastasize (spread) to other areas in the body.
The first symptoms of renal cell carcinoma can vary. You may experience some of the effects, but you are unlikely to experience all of them.
Symptoms of renal cell carcinoma can include:
Any of these symptoms can occur if your cancer is only in your kidney, and you can also expect to experience these effects if the cancer spreads.
Impaired Kidney Function
With renal cell carcinoma, your kidney function can be impaired. This may cause specific physical signs, including:
Symptoms of Cancer Spread
Renal cell cancer might not produce symptoms until it spreads outside your kidney—what’s calledmetastatic renal cell cancer.
Paraneoplastic Effects
Sometimes renal cell carcinoma can cause an effect described asparaneoplastic syndrome. This may occur if the tumor produces hormones or other substances that affect distant parts of the body.
For example, renal cell carcinoma can causeataxia(a severe problem with balance) if the tumor produces immune cells that attack the cerebellum (the part of the brain that controls balance).
Paraneoplastic effects can occur even while the tumor is very small.
What Causes Renal Cell Cancer?
Renal cells are a type of cell in the kidneys. Renal cell carcinoma usually involves only one kidney, but it can affect both kidneys. Thekidneysare organs that balance fluids and chemicals in the body. Your kidneys filter your blood to remove waste material. They produce urine, which contains the wastes that your body doesn’t need.
There are a number of risk factors associated with renal cell carcinoma. Smoking and exposure to toxic chemicals are considered the leading causes of this type of cancer.
Obesity, hypertension, and diabetes are considered risk factors, although it isn’t completely clear why or how these conditions may lead to renal cell carcinoma.
Medications that are metabolized and detoxified in the kidneys, such as non-steroidal anti-inflammatory medications (NSAIDS) are also associated with renal carcinoma.
Toxin Exposure
Experts suggest that certain chemicals are nephrotoxic—meaning they damage the kidneys. Chemicals such as industrial materials and pesticides can harm the kidneys.
When the kidneys become damaged, the renal cells may heal, but they can also undergo a cancerous transformation. It may take months of toxin exposure before renal cell carcinoma develops.
Genetics
How Renal Cell Carcinoma Spreads
Renal cell carcinoma can spread from the kidney to other areas of the body. It can enlarge within the kidney and grow into the adrenal glands, which are adjacent to the kidneys. Adrenal glands are small organs that make and release hormones. Each kidney has one adrenal gland located right above it.
Cancer cells can also enter into the bloodstream or the lymphatic vessels, spreading to other areas of the body. The cancer can then grow in other organs, such as the lungs, bones, or brain, causing serious harm to these areas.
How Cancer Metastasizes
Renal Cell Carcinoma Diagnosis
Often, renal cell carcinoma is identified on an imaging test. It can be seen before any symptoms occur (when a test is done for another medical reason). Additional testing, such as blood tests, a biopsy, or a search for metastatic lesions is usually needed.
If you have any of the symptoms of renal cell carcinoma, your medical team will evaluate them with a medical history, physical examination, and diagnostic tests.
Your medical history will include questions about your symptoms, your smoking history, and environmental chemical exposures, as well as your medications and any other illnesses or conditions that you have.
Your physical examination will include an abdominal examination, which can identify tenderness or enlargement of your kidneys. Your medical team will check your blood pressure.
Blood Tests
The symptoms associated with renal cell cancer are vague, and they can also be signs of many different medical conditions. Your healthcare providers may order a complete blood count (CBC) or electrolyte levels. These tests often give your medical team an idea about your overall health.
If you have anemia or erythrocytosis, your CBC will show an altered red blood cell count. If your kidneys are starting to fail, your electrolyte levels (such as calcium, phosphorus, or magnesium) may be altered.
What Your CBC Results Mean
Urine Test
A urinalysis (UA) test is a simple test that involves analysis of your urine. The fluid sample can be analyzed with a microscopic evaluation. Your medical team can assess your urine to see if there is blood, protein, or cancer cells—all of which are signs of renal cell cancer.
Kidney failure may cause a change in the concentration of electrolytes in your urine.
Additionally, other illnesses can be diagnosed with a UA. Diabetes often results in excess glucose in the urine. Kidney or bladder infections often cause an increase in white blood cells. The infectious organisms that cause these infections can often be identified in the urine as well.
An Overview of Urinalysis (U/A)
Imaging
Imaging tests, such as X-ray, computerized tomography (CT), ultrasound, or magnetic resonance imaging (MRI) can be used to obtain a picture of your kidney.
If there is a concern about metastatic cancer, your medical team may also obtain imaging tests to look at other areas of your body. Abone scancan be used to identify lesions in the bones.
Often, imaging tests can differentiate between cancer and other conditions, such as infections, traumatic injuries, cysts, and inflammation. When there is uncertainty about the lesion, or whenever more detailed information is needed, a biopsy may be the next step.
What Is Cystic Renal Cell Carcinoma?
Biopsy
You may need to have a biopsy of your kidney. This is an interventional surgical procedure in which your healthcare providers would take a sample of kidney tissue (usually with a very thin needle) so that it can be examined under a microscope.
With a biopsy, your healthcare providers can evaluate whether a growth in your kidneys is an infection, an inflammatory lesion, or cancer. A biopsy can also determine the type of cancer and the aggressiveness of the cancer (often described as cancer grade). Identifying your disease and type of cancer under a microscope is very important in planning the right medical treatment.
What to Expect When Having a Biopsy
Staging and Grading
Your tumor will be given a stage and a grade.These designations are used to help your medical team with planning your treatment. Tumor grading is a description of how aggressive the tumor is andhow quickly it is expected to grow and spread.
Grading is based on a combination of factors, including the microscopic appearance of the tumor, and its size and location. The tumor stage describes how far the tumor has grown or spread in the body.
Renal Cell Carcinoma Tumor StagesStage 1: The tumor is only in the kidney and it is smaller than 7 centimeters (cm) in size.Stage 2: The tumor is only in the kidney and it is larger than 7 cm in size.Stage 3: The tumor has spread beyond the kidney to adjacent areas, such as the adrenal gland.Stage 4: the tumor has spread beyond the kidney and adjacent structures to at least one other area of the body.
Renal Cell Carcinoma Tumor Stages
Stage 1: The tumor is only in the kidney and it is smaller than 7 centimeters (cm) in size.Stage 2: The tumor is only in the kidney and it is larger than 7 cm in size.Stage 3: The tumor has spread beyond the kidney to adjacent areas, such as the adrenal gland.Stage 4: the tumor has spread beyond the kidney and adjacent structures to at least one other area of the body.
There are anumber of treatmentsused for renal cell carcinoma. These include having the tumor surgically removed, radiation therapy to shrink the tumor, and therapies such as chemotherapy, immunologic therapy, and/or targeted therapy to kill tumor cells.
Additionally, you receive symptomatic treatment that helps relieve the effects of your tumor.
Surgery
You may need to have your tumor removed from your kidney or haveyour whole kidney removed. Surgery may also be used to remove metastatic lesions from elsewhere in your body.
There are several types of kidney surgery used for removal of renal cell carcinoma:
You can survive with only one kidney. If both kidneys are damaged or removed, however, you would need to have dialysis.
Dialysisis a procedure that involves filtration of your blood so that waste material can be removed from your body. If your kidneys are absent or are not functional, you would need to have dialysis several times per week.
Radiation
Radiation therapy is a treatment that uses powerful rays to destroy tumor cells. You can have radiation directed towards the cancer in your kidneys and/or towards metastatic lesions in other areas of your body.
Depending on your situation, you might have radiation therapy before or after surgical resection of your tumor.
Chemotherapy, Immunologic Therapy, Targeted Therapy
Medications approved for treatment of renal cell carcinoma include:
Keytruda (pembrolizumab) is a monoclonal antibody that is given along with other targeted therapies such as Inlyta (axitinib) or Lenvima (lenvatinib) to treat renal cell carcinoma.
Keytruda is approved for the adjuvant treatment of adults with renal cell carcinoma at risk of recurrence after nephrectomy or following nephrectomy and resection of metastatic lesions. Adjuvant therapies help keep cancer from returning.
All of these medications are powerful, and they may produce serious side effects during your treatment and recovery.
Symptomatic Treatment
In addition to treatments that are aimed at shrinking or removing your tumor, you may also require medical care to alleviate the effects of the tumor. For example, you may receive a blood transfusion if your red blood cells are extremely low.
You may be given anti-hypertensive medication to manage your blood pressure. And, if you have lost weight due to your cancer, you may need treatment to help increase your appetite. Your healthcare provider may also prescribe vitamins, minerals, proteins, or other supplements to help maintain your body’s nutritional needs.
Summary
Renal cell carcinoma is a type of kidney cancer that may cause a variety of symptoms, including abdominal pain, flank pain, and blood in urine. Imaging tests, lab analyses, and biopsies are typically involved in its diagnosis. Treatment options may include surgical tumor removal, chemotherapy, and radiation, as well as treatments for specific symptoms.
Because there are several known risk factors of renal cell carcinoma that are related to lifestyle habits—such as smoking, obesity, and toxin exposure—it is especially important that you avoid these risks if you have a family history of renal cell carcinoma.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Risk factors for kidney cancer.American Cancer Society.Treating kidney cancer.American Cancer Society.Kidney cancer signs and symptoms.UCLA.Don’t ignore these symptoms of kidney cancer.Darwesh K.Paraneoplastic syndrome case presented as nystagmus and ataxia.Cureus. 2024 Feb;16(2):e55153. doi:10.7759/cureus.55153Bruinsma FJ, Jordan S, Bassett JK, et al.Analgesic use and the risk of renal cell carcinoma - finding from the Consortium for the Investigation of Renal Malignancies (CONFIRM) study.Cancer Epidemiol. 2021 Dec;75(1):102036. doi:10.1016/j.canep.2021.102036National Cancer Institute.Von Hippel-Lindau disease (PDQ)-health professional version.American Cancer Society.Tests for kidney cancer.Radadia KD, Rivera-Núñez Z, Kim S, Farber NJ, Sterling J, Falkiewicz M, et al.Accuracy of clinical nodal staging and factors associated with receipt of lymph node dissection at the time of surgery for nonmetastatic renal cell carcinoma. Urol Oncol. 2019 Sep;37(9):577.e17-577.e25. Epub 2019 Jul 5. doi:10.1016/j.urolonc.2019.06.003National Cancer Institute.Renal Cell Cancer Treatment (PDQ®)–Patient Version.Brown JT, Bilen MA.Management of metastatic renal cell carcinoma: The complexity of choice. EBioMedicine. 2019 Sep 6. pii: S2352-3964(19)30571-7. [Epub ahead of print] doi:10.1016/j.ebiom.2019.08.049Food and Drug Administration.Keytruda label.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Risk factors for kidney cancer.American Cancer Society.Treating kidney cancer.American Cancer Society.Kidney cancer signs and symptoms.UCLA.Don’t ignore these symptoms of kidney cancer.Darwesh K.Paraneoplastic syndrome case presented as nystagmus and ataxia.Cureus. 2024 Feb;16(2):e55153. doi:10.7759/cureus.55153Bruinsma FJ, Jordan S, Bassett JK, et al.Analgesic use and the risk of renal cell carcinoma - finding from the Consortium for the Investigation of Renal Malignancies (CONFIRM) study.Cancer Epidemiol. 2021 Dec;75(1):102036. doi:10.1016/j.canep.2021.102036National Cancer Institute.Von Hippel-Lindau disease (PDQ)-health professional version.American Cancer Society.Tests for kidney cancer.Radadia KD, Rivera-Núñez Z, Kim S, Farber NJ, Sterling J, Falkiewicz M, et al.Accuracy of clinical nodal staging and factors associated with receipt of lymph node dissection at the time of surgery for nonmetastatic renal cell carcinoma. Urol Oncol. 2019 Sep;37(9):577.e17-577.e25. Epub 2019 Jul 5. doi:10.1016/j.urolonc.2019.06.003National Cancer Institute.Renal Cell Cancer Treatment (PDQ®)–Patient Version.Brown JT, Bilen MA.Management of metastatic renal cell carcinoma: The complexity of choice. EBioMedicine. 2019 Sep 6. pii: S2352-3964(19)30571-7. [Epub ahead of print] doi:10.1016/j.ebiom.2019.08.049Food and Drug Administration.Keytruda label.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Risk factors for kidney cancer.American Cancer Society.Treating kidney cancer.American Cancer Society.Kidney cancer signs and symptoms.UCLA.Don’t ignore these symptoms of kidney cancer.Darwesh K.Paraneoplastic syndrome case presented as nystagmus and ataxia.Cureus. 2024 Feb;16(2):e55153. doi:10.7759/cureus.55153Bruinsma FJ, Jordan S, Bassett JK, et al.Analgesic use and the risk of renal cell carcinoma - finding from the Consortium for the Investigation of Renal Malignancies (CONFIRM) study.Cancer Epidemiol. 2021 Dec;75(1):102036. doi:10.1016/j.canep.2021.102036National Cancer Institute.Von Hippel-Lindau disease (PDQ)-health professional version.American Cancer Society.Tests for kidney cancer.Radadia KD, Rivera-Núñez Z, Kim S, Farber NJ, Sterling J, Falkiewicz M, et al.Accuracy of clinical nodal staging and factors associated with receipt of lymph node dissection at the time of surgery for nonmetastatic renal cell carcinoma. Urol Oncol. 2019 Sep;37(9):577.e17-577.e25. Epub 2019 Jul 5. doi:10.1016/j.urolonc.2019.06.003National Cancer Institute.Renal Cell Cancer Treatment (PDQ®)–Patient Version.Brown JT, Bilen MA.Management of metastatic renal cell carcinoma: The complexity of choice. EBioMedicine. 2019 Sep 6. pii: S2352-3964(19)30571-7. [Epub ahead of print] doi:10.1016/j.ebiom.2019.08.049Food and Drug Administration.Keytruda label.
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Bruinsma FJ, Jordan S, Bassett JK, et al.Analgesic use and the risk of renal cell carcinoma - finding from the Consortium for the Investigation of Renal Malignancies (CONFIRM) study.Cancer Epidemiol. 2021 Dec;75(1):102036. doi:10.1016/j.canep.2021.102036
National Cancer Institute.Von Hippel-Lindau disease (PDQ)-health professional version.
American Cancer Society.Tests for kidney cancer.
Radadia KD, Rivera-Núñez Z, Kim S, Farber NJ, Sterling J, Falkiewicz M, et al.Accuracy of clinical nodal staging and factors associated with receipt of lymph node dissection at the time of surgery for nonmetastatic renal cell carcinoma. Urol Oncol. 2019 Sep;37(9):577.e17-577.e25. Epub 2019 Jul 5. doi:10.1016/j.urolonc.2019.06.003
National Cancer Institute.Renal Cell Cancer Treatment (PDQ®)–Patient Version.
Brown JT, Bilen MA.Management of metastatic renal cell carcinoma: The complexity of choice. EBioMedicine. 2019 Sep 6. pii: S2352-3964(19)30571-7. [Epub ahead of print] doi:10.1016/j.ebiom.2019.08.049
Food and Drug Administration.Keytruda label.
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