Kidney cancer (also known as renal cell carcinoma or renal carcinoma for short) is a malignant tumor of the kidney. Approximately 2 to 3 percent of all malignant tumors in adults are kidney carcinomas. The average age of onset for renal carcinoma is around 65 to 70 years.
Kidney cancer is often discovered by chance through the use of imaging examinations for other reasons. In most cases, the tumor is still at an early stage. This increases the chances of recovery.
The causes of the development of a malignant tumor in the kidneys are not yet fully understood. However, there are known factors that increase the risk of kidney cancer. These include, for example
- Tobacco consumption,
- the use of certain painkillers,
- an existing kidney disease(chronic renal insufficiency),
- obesity and
- exposure to chemical substances such as asbestos, cadmium and solvents.
Hereditary factors can also play an important role in the development of cancer.
Initially, kidney cancer is barely noticeable, if at all. However, if the disease is already advanced, it can lead to pain in the kidney area and visible traces of blood in the urine.
Other symptoms may also occur, such as
- Weight loss,
- tiredness
- fever and
- night sweats.
Occasionally, a space-occupying structure, i.e. a lump or swelling, can also be felt in the flank area.
If metastases have formed, the symptoms depend mainly on the organ affected:

The location of the kidneys in the body and a view of kidney cancer tissue under the microscope © Dr_Microbe | AdobeStock
Kidney cancer does not initially cause any symptoms. Doctors therefore often find the first signs of kidney cancer by chance as a result of
However, some patients also go to the doctor because of blood in their urine or flank pain.
The diagnosis begins with a thorough medical history (patient questioning about risk factors). This is followed by a physical examination and a test for blood in the urine.
An ultrasound scan of the kidneys and abdomen and a contrast-enhanced computed tomography (CT) scan can confirm or rule out the initial suspicion. The CT scan also gives an indication of how far the renal cell carcinoma has already spread.
An MRI is usually ordered if vascular occlusion caused by the tumor is suspected.
An assessment of the tumor spread and the search for metastases is carried out using
of the skull.
Based on the diagnosis of kidney cancer and the spread of the tumor, the kidney cancer specialist can determine the stage.
- Early tumor stage: Smaller tumor that is localized(lymph nodes or adjacent tissue are not yet affected)
- Advanced stage: Infestation of the lymph nodes and/or formation of metastases
This assignment of the cancer to a stage plays a major role in the therapy and prognosis.
There are three treatment options available. Of these, kidney cancer surgery is the only curative (healing) option.
- Kidney cancer surgery: If the kidney carcinoma is removed, there is a chance of a complete cure. It may be necessary to remove part or even the entire kidney (so-called nephrectomy). The operations are performed using open surgery or a keyhole technique using laparoscopy or a robot.
- Chemotherapy: If the kidney carcinoma has not yet spread, kidney cancer specialists do not currently recommend chemotherapy after surgery(adjuvant chemotherapy). The results of clinical studies on neoadjuvant chemotherapy (chemotherapy before surgery) are still pending. However, if metastases have formed, drug therapy is required. Various drugs are available for this purpose, which must be administered according to a specific regimen.
- Radiotherapy: Renal cell carcinoma is relatively insensitive to radiotherapy. It is therefore not used curatively, but usually only palliatively, for example to treat pain.
Cold therapy (cryotherapy) and heat therapy
(radiofrequency ablation) are still in the
experimental stage. Long-term results are not yet available. Furthermore, a tissue sample from the tumor tissue (biopsy) is recommended before these forms of therapy.
Specialists in kidney cancer are oncologists. They work in an interdisciplinary team with specialists from other fields, such as
Patients with renal cell carcinoma should be treated in specialized clinics for kidney cancer. High quality kidney cancer treatment is guaranteed there. In addition, there is often the opportunity to benefit from the latest therapies by participating in clinical trials.
The prognosis depends above all
- the stage (I to IV) determined at diagnosis, and
- the histological subtype
and the histological subtype. The respective age of onset and other secondary diseases (comorbidities) can also favor or worsen the prognosis.
The more advanced the stage, the more difficult it is to treat kidney cancer and the less favorable the prognosis.
In Germany, the 5-year survival rate is between 65 and 75 percent. If metastases are already present, the average life expectancy is 24 to 30 months.
In principle, there are no specific recommendations for follow-up care after surgical removal of a tumor.
According to current guidelines, a risk profile can be created for each patient (low, medium, high). Follow-up care is carried out depending on the symptoms and the likelihood of metastasis.
Physical examinations, laboratory tests and new overview images are carried out at regular intervals.