Kidney cancer, also known as renal cell carcinoma (RCC), is one of the top ten most common cancers in the United States. It originates in the kidneys—two bean-shaped organs responsible for filtering blood, removing waste, and producing urine. Early diagnosis dramatically improves outcomes, making awareness essential.
There are both malignant and benign types of renal masses. Although small renal masses can harbor kidney cancer in 80% of cases, benign renal masses do occur in ~20%. This could include oncocytomas, angiomyolipomas, multilocular cystic nephromas, benign complex renal cysts, maong others.
The majority of these small renal masses are low grade malignancies. The average growth rate is 3-5 mm per year, although the range can be from 0-15mm per year. Masses less than 3 cm have a small likelihood of metastasis on presentation (<1%). After tumors exceed 3 cm this rate increases somewhat and might be as high as 5% in masses over 4 cm. If your tumor is <3cm, it may be reasonable to watch the tumor for interval growth.
Incidence: Approximately 81,610 new cases of kidney cancer are expected in the U.S yearly.
52,360 in men
29,250 in women
Global View: Kidney cancer ranks among the top 15 cancers worldwide.
Age Factor: Most cases occur in individuals ages 50–70.
Smoking: Increases risk by up to 50%, especially for men.
Obesity: Linked to higher incidence due to hormonal and metabolic effects.
Family History: A genetic predisposition may increase risk.
Occupational Exposures: Contact with certain chemicals (e.g., asbestos, cadmium).
Often silent in early stages, but signs may include:
Blood in the urine (hematuria)
A persistent lump or mass in the abdomen
Lower back or flank pain (on one side)
Unexplained weight loss or fatigue
Fever not linked to infection
Note: Many kidney cancers are found incidentally during imaging for other reasons.
Clear Cell Renal Cell Carcinoma: ~75% of cases; often responsive to targeted therapies.
Papillary RCC: ~10–15%; has subtypes with varying behavior.
Chromophobe RCC: ~5%; generally slow-growing.
Collecting Duct & Medullary Carcinomas: Rare and more aggressive.
Wilms Tumor: Most common in children.
Upper Tract Urothelial Carcinoma: This is a different type of kidney cancer that originates from the urothelial lining of the kidney. It is treated differently from the more common renal call carcinoma described here.
Imaging: Ultrasound, CT scan, or MRI to visualize the tumor.
Urinalysis: To detect blood or abnormal cells.
Blood Tests: Assess kidney function and identify potential complications.
Biopsy: Sometimes used to confirm diagnosis.
Management depends on the size, stage, and type of tumor, as well as overall health:
Surgical Treatment:
Partial Nephrectomy: Removal of the tumor while preserving the kidney.
Radical Nephrectomy: Complete removal of the kidney (and surrounding tissue).
Laparoscopic or Robotic Surgery: Minimally invasive approaches for faster recovery.
Non-Surgical & Advanced Options:
Active Surveillance: In select cases with small, slow-growing tumors. This is a common option for tumors <3cm or with slow-growth kinetics.
Ablative Therapies: Cryoablation or radiofrequency ablation for small tumors.
Targeted Therapy: Drugs that block tumor growth pathways (used in cases of advanced disease with metastases)
Regular imaging and bloodwork are critical post-treatment to monitor for recurrence, especially within the first 3–5 years when the risk is highest.
I specialize in personalized care for kidney cancer, using the latest technology and evidence-based protocols. From early detection to advanced treatment, I will be with you every step of the way.
| Risk Group | Stage | Stage Description | Modality | Frequency | Duration |
|---|---|---|---|---|---|
| Low Risk | Stage I | Tumor ≤7 cm, confined to kidney (T1a/T1b), N0, M0 |
- Physical Exam - Creatinine, eGFR - Ultrasound or CT |
Annually | Up to 5 years |
| Moderate Risk | Stage I–II | Tumor >7 cm but confined to kidney (T2), N0, M0 |
- Physical Exam - CBC, Creatinine, LFTs - CT abdomen/pelvis ± Chest X-ray |
Every 6 months × 2 years, then annually |
5–10 years |
| High Risk | Stage II–III | Tumor invades fat or major veins (T3) or local nodes involved (N1) |
- Physical Exam - CBC, Creatinine, LFTs - CT chest/abdomen/pelvis |
Every 3–6 months × 3 years, then every 6–12 months |
10 years or lifelong |
| Node-Positive or Metastatic | Stage III–IV | Node-positive (N1) or distant metastasis (M1) |
- Physical Exam - CBC, Creatinine, LFTs - CT/MRI chest/abdomen/pelvis |
Every 3 months × 2 years, then every 6 months × 3 years, then annually |
Lifelong |
| Active Surveillance | — | Small tumors <4 cm (T1a) in unfit or unwilling patients |
- Physical Exam - Labs - Renal US, CT, or MRI |
Every 3–6 months initially, then annually |
Ongoing |
