What is a kidney tumor?
A kidney tumor is an abnormal growth within the kidney. The terms "mass," "lesion" and "tumor" are often used interchangeably. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common kidney lesion is a fluid-filled area called a cyst. Simple cysts are benign and have a typical appearance on imaging studies. They do not progress to cancer and usually require no follow-up or treatment. Solid kidney tumors can be benign, but are cancerous more than 80 percent of the time.
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The following are also types of kidney cancers:
- Squamous cell carcinoma
- Juxtaglomerular cell tumor (reninoma)
- Renal oncocytoma
- Bellini duct carcinoma
- Clear-cell sarcoma of the kidney
- Mesoblastic nephroma
- Wilms' tumor (usually diagnosed in children under 5)
- Mixed epithelial stromal tumor
- Smoking . If you smoke cigarettes, your risk for kidney cancer is twice that of nonsmokers. Smoking cigars may also increase your risk.
- Being male. Men are about twice as likely as women to get kidney cancer.
- Being obese. Extra weight may cause changes to hormones that increase your risk.
- Using certain pain medications for a long time. This includes over-the-counter drugs in addition to prescription drugs.
- Having advanced kidney disease or being on long-term dialysis, a treatment for people with kidneys that have stopped working.
- Having certain genetic conditions, such as von Hippel-Lindau (VHL) disease or inherited papillary renal cell carcinoma.
- Having a family history of kidney cancer. The risk is especially high in siblings.
- Being exposed to certain chemicals, such as asbestos, cadmium, benzene, organic solvents, or certain herbicides
- Having high blood pressure. Doctors don't know whether high blood pressure or medication used to treat it is the source of the increased risk.
- Being black. The risk in blacks is slightly higher than in whites. No one knows why.
- Having lymphoma. For an unknown reason, there is an increased risk of kidney cancer in patients with lymphoma.
SymptomsUnfortunately, kidney cancer does not have early symptoms but you should see your doctor if you notice the following:3
- Blood in your urine
- Lump in your abdomen
- Unexplained weight loss
- Pain in your side
- Loss of appetite
In some cases, kidney cancer causes related conditions called paraneoplastic syndromes. These syndromes occur in about 20 percent of kidney cancer patients and can occur in any stage, including cancers confined to the kidney. Symptoms from paraneoplastic syndromes include weight loss, loss of appetite, fever, sweats and high blood pressure. In many cases, the paraneoplastic syndrome improves or disappears after the cancer is removed.
DiagnosisIf a patient has symptoms that suggest kidney cancer, the doctor may perform one or more of the following procedures:
- Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
- Urine tests: Urine is checked for blood and other signs of disease.
- Blood tests: The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
- Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
- CT scan (CAT scan): An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. The patient may receive an injection of dye so the kidneys show up clearly in the pictures. A CT scan can show a kidney tumor.
- Ultrasound test: The ultrasound device uses sound waves that people cannot hear. The waves bounce off the kidneys, and a computer uses the echoes to create a picture called a sonogram. A solid tumor or cyst shows up on a sonogram.
- Biopsy: In some cases, the doctor may do a biopsy. A biopsy is the removal of tissue to look for cancer cells. The doctor inserts a thin needle through the skin into the kidney to remove a small amount of tissue. The doctor may use ultrasound or x-rays to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.
- Surgery: In most cases, based on the results of the CT scan, ultrasound, and x-rays, the doctor has enough information to recommend surgery to remove part or all of the kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope
- Removing the affected kidney (nephrectomy). Radical nephrectomy involves the removal of the kidney, a border of healthy tissue and the adjacent lymph nodes. The adrenal gland also may be removed. Nephrectomy can be an open operation, meaning the surgeon makes one large incision to access your kidney. Or nephrectomy can be done laparoscopically, using several small incisions to insert a video camera and tiny surgical tools. The surgeon watches a video monitor to perform the nephrectomy.
- Removing the tumor from the kidney (nephron-sparing surgery). During this procedure, also called partial nephrectomy, the surgeon removes the tumor and a small margin of healthy tissue that surrounds it, rather than removing the entire kidney. Nephron-sparing surgery can be an open procedure, or it may be performed laparoscopically. Nephron-sparing surgery may be an option if you have a small kidney cancer or if you only have one kidney. When nephron-sparing surgery is possible, it's generally preferred over radical nephrectomy since retaining as much kidney tissue as possible may reduce your risk of later complications, such as kidney disease and the need for dialysis.
Radiation Therapy (also called radiotherapy)