Kidney Cancer

Kidney (renal) cancer — usually renal cell carcinoma (RCC) in adults — is often found incidentally on an ultrasound or CT done for another reason. Early-stage RCC is often curable by surgery alone; advanced RCC is now treatable with targeted and immune therapies that have substantially improved survival.

Symptoms

• Often none in early stages — increasingly found incidentally on imaging.
• Blood in urine.
• Flank or back pain.
• Unexplained weight loss, fever, tiredness, anaemia.
• A palpable mass in the flank (late).
• Paraneoplastic syndromes — high calcium, high red-cell count, unexplained liver-test changes.

Risk factors

• Smoking.
• Obesity, high blood pressure.
• Long-term dialysis.
• Family history; genetic syndromes (VHL, HLRCC).
• Occupational — some chemicals (cadmium, trichloroethylene).

Evaluation

• Ultrasound is often first.
• Contrast CT or MRI characterises the mass.
• Biopsy — selected cases, particularly before systemic therapy.
• Staging scans.

Treatment

• Small, early tumours — partial nephrectomy (kidney-preserving surgery) or ablation.
• Larger/local tumours — radical nephrectomy (laparoscopic or robotic).
• Active surveillance — for small lesions in older or high-risk patients.
• Advanced/metastatic disease — targeted therapies (VEGF inhibitors) and immunotherapy (checkpoint inhibitors) have transformed outcomes; often used in combination.
• Hereditary kidney cancer — referral for genetic testing and family screening.
• Surveillance after treatment — regular imaging for several years.