Renal cell carcinoma is a type of kidney cancer in which the cancerous cells are found in the lining of very small tubes (tubules) in the kidney.

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in people 50 - 70 years old, and typically affects men.

The exact cause is unknown.

Risk factors include:

• Dialysis treatment
• Family history of the disease
• Genetics
• Smoking
• Von Hippel-Lindau disease (a hereditary disease that affects the capillaries of the brain)

• Abdominal pain
• Abnormal urine color (dark, rusty, or brown)
• Back pain
• Blood in the urine
• Emaciated, thin, malnourished appearance
• Enlargement of one testicle
• Flank pain
• Swelling or enlargement of the abdomen
• Unintentional weight loss of more than 5% of body weight

• Constipation
• Cold intolerance
• Excessive hair growth in females
• Paleness
• Vision abnormalities

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. About one-third of patients have spreading (metastasis) at the time of diagnosis.

Palpation of the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. Men may have a varicocele in the testicles. (A varicocele that is only on the ride side is especially suspicious.)

Tests include:

• Complete blood count (CBC)
• IVP
• Kidney x-ray
• Liver function tests
• Renal arteriography
• Serum calcium
• SGPT (also called ALT) and alkaline phosphatase
• Ultrasound of the abdomen and kidney
• Urine cytology
• Urine test

The following tests may be performed to see if the cancer has spread:

• Abdominal CT scan
• Abdominal MRI
• Bone scan
• Chest x-ray

Surgical removal of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder or surrounding tissues or lymph nodes.

Radiation therapy does not usually work for renal cell carcinoma and, therefore, is not often used. Hormone treatments may reduce the growth of the tumor in some cases.

Chemotherapy is generally not effective for treating renal cell carcinoma. The drug interleukin-2 is effective, but toxic to patients. Other chemotherapy drugs have been used, but survival rates are short.

Current therapies include sorafenib (Nexavar), sunitinib (Sutent), and temsirolimus (Torisel). The biologic drug bevacizumab (Avastin) has also been used.

A cure is unlikely unless all of the cancer is removed with surgery.

You can ease the stress of illness by joining a support group whose members share common experiences and problems. See cancer - support group and kidney disease - support group.

The outcome depends on the degree of cancer spread. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

• Hypertension
• Spread of the cancer

Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

US Food and Drug Administration. FDA Approves New Treatment for Advanced Kidney Cancer. Rockville, MD: National Press Office; December 20, 2005. Press Release P05-107.

Kidney Cancer. NCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network. 2008. Accessed June 10, 2008.