Kidney (Renal) Cancer

What is renal cell carcinoma (RCC)?

Renal cell carcinoma is the most common form of kidney cancer amongst adults. It is the 10th most common cancer in Australia. It is most common in males between the ages of 50 and 70 years.

What is transitional cell cancer (TCC)?

The next most common cancer of the kidney is transitional cell cancer (TCC), which is a cancer of the internal lining of the kidney. It can also affect the tube or ureter that carries urine down to the bladder.

What are the most common symptoms associated with RCC?

Tumours of the kidney are classically associated with painless haematuria or blood in the urine. The tumours may be associated with pain in the back or groin but are often found incidentally when ultrasounds and CT scans are performed for other reasons. With larger tumours there may be fever, weight loss or tiredness.

How is the diagnosis of RCC or TCC made?

The diagnosis is usually made via a CT scan of the kidneys, although MRI can also be used. Occasionally a biopsy is required, but usually a diagnosis can be made on the basis of imaging characteristics, and this will guide surgical excision.

How is it determined if the kidney cancer has spread?

A CT scan of the abdomen and pelvis and chest is usually performed. A chest x-ray may be sufficient in some situations, and a bone scan is needed if there are symptoms such as bone pain.

How is renal cancer treated?

Renal cancer is treated with removal of the whole kidney or part of the kidney. The usual method of removal of the kidney is laparoscopic nephrectomy, which is performed by keyhole techniques. For large tumours (greater than 12-14cm) it may be necessary to perform open surgery. For smaller cancers, it may be more sensible to remove part of the kidney in a procedure called partial nephrectomy. Partial nephrectomy can be performed with keyhole, keyhole robotic or open surgery techniques depending on the size and location of the tumour as well as individual patient factors.

What is robotic partial nephrectomy?

Robotic partial nephrectomy is a keyhole procedure using robotic instruments controlled by the surgeon to more easily perform the otherwise complex procedure of removing part of a diseased kidney. Your surgeon will explain the risks, benefits and limitations of this procedure if it is an option for your treatment.

How long is the hospital stay after surgery?

The usual postoperative stay after laparoscopic nephrectomy is 3 days, and up to 6 days for open surgery. Normal recovery of activities can be expected 2 to 4 weeks after laparoscopic surgery although heavy lifting should be delayed for a few weeks longer because of the risk of hernia.

Do all kidney cancers need to be removed?

Some renal cancers usually less than 3cm in size can be observed, particularly in elderly patients, and do not need to be removed unless they cause problems or continue to grow. These cancers will be watched by means of regular ultrasound or CT scan imaging. In addition some small cancers can be treated with other methods such as radiofrequency ablation, which heats and kills the tumour cells.

Are other treatments required after nephrectomy or partial nephrectomy?

In most circumstances surgery is all that is required. Sometimes when the cancer is already advanced, treatment with cancer drug therapy may be required either before or more commonly after the surgery. Patients will be referred to a medical cancer doctor, an oncologist, for this treatment.

What is the prognosis for kidney cancer?

Small, earlier diagnosed RCCs are associated with near normal life expectancy in many cases. Advanced cancers are associated with higher death rates but some patients can survive for many years when surgery is combined with cancer drug therapy.