Table of ContentsView AllTable of ContentsFrequent SymptomsSymptoms of MetastasesRare SymptomsComplicationsWhen to See Your Healthcare ProviderFrequently Asked QuestionsNext in Kidney Cancer GuideHow Kidney Cancer Is Diagnosed and Staged
Table of ContentsView All
View All
Table of Contents
Frequent Symptoms
Symptoms of Metastases
Rare Symptoms
Complications
When to See Your Healthcare Provider
Frequently Asked Questions
Next in Kidney Cancer Guide
The signs and symptoms of kidney cancer that alert people and their healthcare providers to its presence have changed dramatically in recent years. In the past, the classic triad of flank pain, blood in the urine, and a mass in the flank were most common.
Today, the most common symptoms of kidney cancer are anemia, fatigue, weight loss, loss of appetite, and a fever.
In addition, the spread of kidney cancer to other parts of the body (metastatic disease) gives the first warning signs of the disease (such as a cough or bone pain) in 30 percent of people.
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In the earliest stages of kidney cancer, there are usually few symptoms, and many diagnoses are now made based on lab and imaging studies before symptoms occur.
Anemia
Anemiais currently themost commonpresenting symptom of kidney cancer, and is present in one third of people diagnosed. The kidneys make a protein called erythropoietin, which stimulates production of red blood cells in the bone marrow (in a process called erythropoiesis). With kidney cancer, anemia occurs because of chronic blood loss through the urine.
Blood in the Urine
Blood in the urine(hematuria) is a common symptom of kidney cancer, occurring at some time in one-fifth of people who are diagnosed.
That said, only about 10 percent of people now have the classic triad symptoms ofblood in the urine, flank pain, and a flank mass at the time of diagnosis, and when these are present, the tumor has usually already spread (metastasized).
Urine may be obviously bloody (referred to as “gross hematuria”), moderate, and causing only a pink tinge to the urine, or may be microscopic, so that it is only seen on aurinalysis.
Flank Pain
Pain may occur in the back, side, or abdomen, and can vary from a subtle ache to a sharp, stabbing pain. Pain in the flank that occurs without an obvious injury should always be investigated.
Roughly 40 percent of people with kidney cancer experience pain at some time during the course of their disease, but flank pain is becoming less common as the presenting symptom of the disease.
Kidney Pain
Flank Mass (Back, Side, or Abdomen)
Unintentional Weight Loss
Unintentional weight lossis a common symptom of kidney cancer.It is defined as the loss of 5 percent or more of body weight over a 6-month to 12-month period of time.
For example, a loss of 10 pounds in a 200-pound man over a 6 month period of time that occurs without a change in diet or exercise would be considered unexpected or unintentional weight loss.
In addition to kidney cancer, there are a number of serious conditions associated with this symptom, and people should always see their healthcare provider if they lose weight without trying.
Fatigue
Fatigue also occurs commonly in people diagnosed with kidney cancer.Cancer fatigue, unlike ordinary tiredness, can be profound and usually worsens over time. It’s not the kind of fatigue that improves with a good night of sleep or a good cup of coffee.
Cachexia
Loss of Appetite
Loss of appetite, with or without cachexia or weight loss, is a common symptom of kidney cancer. People may note that they are just not hungry, or, instead, may feel full rapidly while eating.
Fever
A fever (a temperature over 100.4 degrees F) is a common symptom of kidney cancer.The fever may be continuous, or it may come and go, but occurs without any obvious signs of infection. A fever that does not have an explanation (fever of unknown origin) always deserves a visit to your healthcare provider.
High Blood Pressure
The kidneys produce hormones that play an important role in regulating blood pressure. Persistent high blood pressure may be a symptom of kidney cancer. In turn, persistent high blood pressure can lead to further kidney damage.
Swelling in the Ankles and Legs
The kidneys also play a very important role in regulating fluid balance (and electrolytes) in the body. Kidney cancer (and other kidney diseases) can interfere with this regulation, leading to fluid retention that is observed as swelling in the feet, ankles, and legs.
Flushing
Flushing, or episodes in which the skin becomes red, along with a feeling of warmth (or even burning) of the face, neck, or extremities, is a potential symptom. There are several possible cancerous (malignant) causes of cutaneous flushing, one of which is kidney cancer.
It’s very important to mention the possible symptoms of kidney cancer that has spread (metastasized) to other regions of the body, as symptoms related to these metastases are the presenting symptoms for 20 to 30 percent of people diagnosed with the disease.
Over 30 percent of people have metastases at the time of diagnosis. Kidney cancer most often spreads to the lungs, bones, and brain, and can lead to the following symptoms.
Cough
Apersistent coughis the most common symptom ofcancer spread to the lungs. Other symptoms that may occur include wheezing,coughing up blood, or pain in the chest, shoulder, or back.
Shortness of Breath
Shortness of breathis a common symptom of kidney cancer, both as a symptom of a cancer that has spread to the lungs and due to anemia. Early on, shortness of breath may occur only with activity, and can easily be dismissed as due to being out of shape, weight gain, or aging.
Bone Pain
The bones are the second most common site of kidney cancer metastases (after the lungs). Bone pain from metastases can be severe, and is usually not associated with any form of injury. Sometimes the first sign of cancer is a fracture in the area of weakened bone.
There are a few uncommon but unique symptoms associated with kidney cancer.
Varicocele
A varicocele is an enlarged vein (varicose vein) that occurs in the scrotum or testicle. Symptoms may include swelling, pain, and shrinkage of the testicle. Most often occurring on the right side, a varicocele related to kidney cancer does not go away when a person lies down.
Paraneoplastic Symptoms
There are a number of complications that may occur due to kidney cancer. At times, these may occur even before diagnosis, but most often are found when the tumor is advanced. They may occur due to the tumor itself, due totreatmentsof the tumor, or due to metastatic disease.
Keep in mind that most people do not experience all of these complications, and many people do not experience any of these. They are discussed here so that people can be empowered in their health care and aware of potential concerns.
Gross Hematuria
Urine that is frankly bloody occurs less often as a first symptom of kidney cancer, but happens eventually for one-fifth of people.It can be very frightening to suddenly urinate large amounts of blood, but prompt treatment can usually control the bleeding.
Pleural Effusion
When kidney cancer spreads to the lungs or the lining of the lungs, it may cause the build-up of fluid between the membranes lining the lungs (thepleura). When cancer cells are present, this is referred to as amalignant pleural effusion. Sometimes a large amount of fluid (several liters) accumulates, causing significant shortness of breath.
A procedure called a thoracentesis involves placing a fine needle through the skin on the chest wall and into the pleural cavity to withdraw fluid. Pleural effusions frequently recur and can be treated with either an indwelling pleural catheter (a shunt that allows for continuous drainage of the fluid) or a procedure in which an irritating substance (talc) is placed between the membranes, causing them to scar together so that fluid can no longer accumulate (pleurodesis).
Pathological Fractures
Bone pain may be an early symptom of kidney cancer when metastases are present. When cancer infiltrates the bone, it weakens the bone and may result in fractures with minimal or no trauma. These are referred to aspathologic fractures.
When kidney cancer spreads to the lower spine, microfractures in the spine may lead to a collapse of the vertebrae and press on nerve roots, causing spinal cord compression. This may lead to weakness of the legs along with loss of bladder and bowel control, and is a medical emergency.
Bone metastases from kidney cancer tend to be very destructive, requiring careful attention to pain, potential fractures and nerve compression, hypercalcemia (high blood calcium due to a breakdown of bone), and more. Fortunately, there are a variety of treatments available today that can reduce these complications.
As discussed earlier, the kidneys play an important role in regulating blood pressure. Kidney cancer may result in persistent high blood pressure, and sometimes blood pressure that is very difficult to control (malignant hypertension).
Hypercalcemia
An elevated level of calcium may occur in the blood, both due to a paraneoplastic syndrome and due to the breakdown of bone with bone metastases. A high blood calcium level with cancer (hypercalcemia) may lead not only to symptoms such as nausea, but severe muscle weakness, confusion, coma, and even death.That said, it is treatable as long as it is diagnosed.
High Red Blood Cell Count
Liver Insufficiency
Kidney cancer may affect the liver both through the spread of the cancer as well as part of a paraneoplastic syndrome. Since the liver filters the blood, as does the kidney, the combination of liver and kidney dysfunction can result in the accumulation of toxins in the blood, leading to confusion, personality changes, mood changes, and more.
Treatment Complications
Treatments for kidney cancer may include removing part or all of the kidney. This is a major surgical procedure and can result in heart events, a stroke, pulmonary embolism (a clot breaking off in the leg and traveling to the lungs), pneumonia, or injuries during surgery, such as to the liver, spleen, pancreas, or bowel.Infection in the abdomen and bleeding may also occur.
Surgery is more challenging if the tumor extends to the inside of the renal vein, and often requires a surgeon who specializes in vascular disease (such as a heart surgeon) to remove the cancer. Surgery has improved, and complications are much fewer than in the past, especially with the less invasive surgical options now available, such as laparoscopicnephrectomy(removal of the kidney through small incisions in the abdomen and special instruments).
If you are undergoing this surgery, trust your healthcare team and be sure to voice any concerns or questions you may have.
Renal Failure
Since surgery often consists of removing a kidney, or at least part of a kidney, this leaves only one functioning kidney behind. In addition, some of the treatments used for kidney cancer, as well as medications, may place stress on the remaining kidney, leading tokidney failure. If kidney failure occurs, dialysis may be needed (or a kidney transplant, if it is an early stage kidney cancer).
If you have any of the symptoms mentioned above, it’s important to see your healthcare provider. Most of the symptoms of kidney cancer have many potential causes, but there are other serious reasons you could be having these symptoms as well.
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Symptoms are our body’s way of signaling that something is wrong. Rather than fearing and ignoring them, take action to find out why they’re occurring so that you can obtain appropriate and timely treatment. Talk to your healthcare provider and ask questions. If you still don’t have answers, consider getting a second opinion.
What Is Kidney Cancer?
14 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.Larkin JM, Pyle LM, Gore ME.Fatigue in renal cell carcinoma: the hidden burden of current targeted therapies. Oncologist. 2010;15(11):1135-46. doi:10.1634/theoncologist.2010-0078Dowd AA, Ibrahim FI, Mohammed MM.Renal cell carcinoma as a cause of iron deficiency anemia. African Journal of Urology. 2014;20(1):25-27. doi:10.1016/j.afju.2013.11.001Ueda K, Suekane S, Chikui K, et al.Successful treatment of erythropoietin-producing advanced renal cell carcinoma after targeted therapy using sunitinib: Case report and review of the literature. Mol Clin Oncol. 2013;1(1):112-116. doi:10.3892/mco.2012.5Shephard E, Neal R, Rose P, Walter F, Hamilton WT.Clinical features of kidney cancer in primary care: a case-control study using primary care records. Br J Gen Pract. 2013;63(609):e250-5. doi:10.3399/bjgp13X665215Marzec K, Mailhot T, Perera P.Ultrasound detection of a renal mass in a patient with flank pain and hematuria. West J Emerg Med. 2013;14(2):123-6. doi:10.5811/westjem.2012.8.12595Signs and Symptoms of Kidney Cancer. American Cancer Society.Penet MF, Bhujwalla ZM.Cancer cachexia, recent advances, and future directions. Cancer J. 2015;21(2):117-22. doi:10.1097/PPO.0000000000000100Walter FM, Rubin G, Bankhead C, et al.Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer. 2015;112 Suppl 1:S6-13. doi:10.1038/bjc.2015.30Leslie SW, Sajjad H, Siref LE.Varicocele. Treasure Island, Fl: StatPearls Publishing.Seccareccia D.Cancer-related hypercalcemia. Can Fam Physician. 2010;56(3):244-6, e90-2.Keohane C, Mcmullin MF, Harrison C.The diagnosis and management of erythrocytosis. Bmj. 2013;347(nov18 1). doi:10.1136/bmj.f6667Surgery for Liver Cancer. American Cancer Society.American Cancer Society.What causes kidney cancer?American Cancer Society.Survival rates for kidney cancer.Additional ReadingAmerican Society of Clinical Oncology. Cancer.Net.Kidney Cancer Signs and Symptoms.Lara, Primo N., and Eric Jonasch.Kidney Cancer Principles and Practice. Springer International Publishing.Umer, M., Mohib, Y., Atif, M., and M. Nazim.Skeletal Metastasis in Renal Cell Carcinoma: A Review.Annals of Medicine and Surgery (London). 27:9-16.Sadeghian, A., Rouhana, H., Oswald-Stumpf, B., and E. Boh.Etiologies and Management of Cutaneous Flusihng: Malignant Causes.Journal of the American Academy of Dermatology. 2017. 77(3):405-414.
14 Sources
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.Larkin JM, Pyle LM, Gore ME.Fatigue in renal cell carcinoma: the hidden burden of current targeted therapies. Oncologist. 2010;15(11):1135-46. doi:10.1634/theoncologist.2010-0078Dowd AA, Ibrahim FI, Mohammed MM.Renal cell carcinoma as a cause of iron deficiency anemia. African Journal of Urology. 2014;20(1):25-27. doi:10.1016/j.afju.2013.11.001Ueda K, Suekane S, Chikui K, et al.Successful treatment of erythropoietin-producing advanced renal cell carcinoma after targeted therapy using sunitinib: Case report and review of the literature. Mol Clin Oncol. 2013;1(1):112-116. doi:10.3892/mco.2012.5Shephard E, Neal R, Rose P, Walter F, Hamilton WT.Clinical features of kidney cancer in primary care: a case-control study using primary care records. Br J Gen Pract. 2013;63(609):e250-5. doi:10.3399/bjgp13X665215Marzec K, Mailhot T, Perera P.Ultrasound detection of a renal mass in a patient with flank pain and hematuria. West J Emerg Med. 2013;14(2):123-6. doi:10.5811/westjem.2012.8.12595Signs and Symptoms of Kidney Cancer. American Cancer Society.Penet MF, Bhujwalla ZM.Cancer cachexia, recent advances, and future directions. Cancer J. 2015;21(2):117-22. doi:10.1097/PPO.0000000000000100Walter FM, Rubin G, Bankhead C, et al.Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer. 2015;112 Suppl 1:S6-13. doi:10.1038/bjc.2015.30Leslie SW, Sajjad H, Siref LE.Varicocele. Treasure Island, Fl: StatPearls Publishing.Seccareccia D.Cancer-related hypercalcemia. Can Fam Physician. 2010;56(3):244-6, e90-2.Keohane C, Mcmullin MF, Harrison C.The diagnosis and management of erythrocytosis. Bmj. 2013;347(nov18 1). doi:10.1136/bmj.f6667Surgery for Liver Cancer. American Cancer Society.American Cancer Society.What causes kidney cancer?American Cancer Society.Survival rates for kidney cancer.Additional ReadingAmerican Society of Clinical Oncology. Cancer.Net.Kidney Cancer Signs and Symptoms.Lara, Primo N., and Eric Jonasch.Kidney Cancer Principles and Practice. Springer International Publishing.Umer, M., Mohib, Y., Atif, M., and M. Nazim.Skeletal Metastasis in Renal Cell Carcinoma: A Review.Annals of Medicine and Surgery (London). 27:9-16.Sadeghian, A., Rouhana, H., Oswald-Stumpf, B., and E. Boh.Etiologies and Management of Cutaneous Flusihng: Malignant Causes.Journal of the American Academy of Dermatology. 2017. 77(3):405-414.
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.
Larkin JM, Pyle LM, Gore ME.Fatigue in renal cell carcinoma: the hidden burden of current targeted therapies. Oncologist. 2010;15(11):1135-46. doi:10.1634/theoncologist.2010-0078Dowd AA, Ibrahim FI, Mohammed MM.Renal cell carcinoma as a cause of iron deficiency anemia. African Journal of Urology. 2014;20(1):25-27. doi:10.1016/j.afju.2013.11.001Ueda K, Suekane S, Chikui K, et al.Successful treatment of erythropoietin-producing advanced renal cell carcinoma after targeted therapy using sunitinib: Case report and review of the literature. Mol Clin Oncol. 2013;1(1):112-116. doi:10.3892/mco.2012.5Shephard E, Neal R, Rose P, Walter F, Hamilton WT.Clinical features of kidney cancer in primary care: a case-control study using primary care records. Br J Gen Pract. 2013;63(609):e250-5. doi:10.3399/bjgp13X665215Marzec K, Mailhot T, Perera P.Ultrasound detection of a renal mass in a patient with flank pain and hematuria. West J Emerg Med. 2013;14(2):123-6. doi:10.5811/westjem.2012.8.12595Signs and Symptoms of Kidney Cancer. American Cancer Society.Penet MF, Bhujwalla ZM.Cancer cachexia, recent advances, and future directions. Cancer J. 2015;21(2):117-22. doi:10.1097/PPO.0000000000000100Walter FM, Rubin G, Bankhead C, et al.Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer. 2015;112 Suppl 1:S6-13. doi:10.1038/bjc.2015.30Leslie SW, Sajjad H, Siref LE.Varicocele. Treasure Island, Fl: StatPearls Publishing.Seccareccia D.Cancer-related hypercalcemia. Can Fam Physician. 2010;56(3):244-6, e90-2.Keohane C, Mcmullin MF, Harrison C.The diagnosis and management of erythrocytosis. Bmj. 2013;347(nov18 1). doi:10.1136/bmj.f6667Surgery for Liver Cancer. American Cancer Society.American Cancer Society.What causes kidney cancer?American Cancer Society.Survival rates for kidney cancer.
Larkin JM, Pyle LM, Gore ME.Fatigue in renal cell carcinoma: the hidden burden of current targeted therapies. Oncologist. 2010;15(11):1135-46. doi:10.1634/theoncologist.2010-0078
Dowd AA, Ibrahim FI, Mohammed MM.Renal cell carcinoma as a cause of iron deficiency anemia. African Journal of Urology. 2014;20(1):25-27. doi:10.1016/j.afju.2013.11.001
Ueda K, Suekane S, Chikui K, et al.Successful treatment of erythropoietin-producing advanced renal cell carcinoma after targeted therapy using sunitinib: Case report and review of the literature. Mol Clin Oncol. 2013;1(1):112-116. doi:10.3892/mco.2012.5
Shephard E, Neal R, Rose P, Walter F, Hamilton WT.Clinical features of kidney cancer in primary care: a case-control study using primary care records. Br J Gen Pract. 2013;63(609):e250-5. doi:10.3399/bjgp13X665215
Marzec K, Mailhot T, Perera P.Ultrasound detection of a renal mass in a patient with flank pain and hematuria. West J Emerg Med. 2013;14(2):123-6. doi:10.5811/westjem.2012.8.12595
Signs and Symptoms of Kidney Cancer. American Cancer Society.
Penet MF, Bhujwalla ZM.Cancer cachexia, recent advances, and future directions. Cancer J. 2015;21(2):117-22. doi:10.1097/PPO.0000000000000100
Walter FM, Rubin G, Bankhead C, et al.Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer. 2015;112 Suppl 1:S6-13. doi:10.1038/bjc.2015.30
Leslie SW, Sajjad H, Siref LE.Varicocele. Treasure Island, Fl: StatPearls Publishing.
Seccareccia D.Cancer-related hypercalcemia. Can Fam Physician. 2010;56(3):244-6, e90-2.
Keohane C, Mcmullin MF, Harrison C.The diagnosis and management of erythrocytosis. Bmj. 2013;347(nov18 1). doi:10.1136/bmj.f6667
Surgery for Liver Cancer. American Cancer Society.
American Cancer Society.What causes kidney cancer?
American Cancer Society.Survival rates for kidney cancer.
American Society of Clinical Oncology. Cancer.Net.Kidney Cancer Signs and Symptoms.Lara, Primo N., and Eric Jonasch.Kidney Cancer Principles and Practice. Springer International Publishing.Umer, M., Mohib, Y., Atif, M., and M. Nazim.Skeletal Metastasis in Renal Cell Carcinoma: A Review.Annals of Medicine and Surgery (London). 27:9-16.Sadeghian, A., Rouhana, H., Oswald-Stumpf, B., and E. Boh.Etiologies and Management of Cutaneous Flusihng: Malignant Causes.Journal of the American Academy of Dermatology. 2017. 77(3):405-414.
American Society of Clinical Oncology. Cancer.Net.Kidney Cancer Signs and Symptoms.
Lara, Primo N., and Eric Jonasch.Kidney Cancer Principles and Practice. Springer International Publishing.
Umer, M., Mohib, Y., Atif, M., and M. Nazim.Skeletal Metastasis in Renal Cell Carcinoma: A Review.Annals of Medicine and Surgery (London). 27:9-16.
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