Kidney cancer: information & kidney cancer specialists

Kidney cancer (also known as renal carcinoma or renal cell carcinoma) is a malignant tumor disease of the kidney. If it is detected early and operated on professionally, it can be cured. Symptoms usually only appear at an advanced stage. Chemotherapy is mainly considered for metastases; radiotherapy is not very important in therapy.

Here you will find further information as well as selected clinics and specialists for kidney cancer.

Frequency of kidney cancer

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.

Causes of kidney cancer

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.

Symptoms of kidney 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:

• Bone metastases: Bone pain,
• Metastases in the lungs: cough and shortness of breath,
• Metastases in the liver: increased liver values withjaundice,
• Brain metastases: neurological deficits.

The location of the kidneys in the body and a view of kidney cancer tissue under the microscope © Dr_Microbe | AdobeStock

Diagnosis of kidney cancer

Kidney cancer does not initially cause any symptoms. Doctors therefore often find the first signs of kidney cancer by chance as a result of

• magnetic resonance imaging (MRI ),
• a computer tomography (CT) or
• a sonography of the abdomen (abdominal ultrasound).

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

• MRI,
• skeletal scintigraphy and
• CT of the skull

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.

Treatment of kidney cancer

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.

Specialists in kidney cancer are oncologists. They work in an interdisciplinary team with specialists from other fields, such as

• nephrologists,
• surgeons from the field of oncological surgery and urologists.
• urologists.

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.

Prognosis for kidney cancer

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.

Aftercare following kidney cancer surgery

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.