There are several types of kidney cancer, which usually affect one kidney.

• Renal cell carcinoma (RCC) This is the most common type of kidney cancer, accounting for about 90% of cases.¹
• Wilms tumour This usually occurs in children but is very rare.
• Urothelial carcinoma, also called transitional cell carcinoma This usually begins where the kidney and ureter (the tube that carries urine to the kidney) meet. 
  

Kidney cancer may not cause symptoms in the early stages. Later stage symptoms may include:

• blood in the urine
• dark or rusty brown urine
• frequent urinating during the night
• unexplained fatigue
• unexplained rapid weight loss
• a lump in the abdomen
• unexplained fever
• pain in the flank or back

Having any of these symptoms doesn’t necessarily mean you have kidney cancer, but you should see your doctor for a check-up.

There is no clear reason for kidney cancer developing. However, some factors appear to increase the risk. These include:

• smoking¹
• family history of kidney cancer²
• being overweight³
• high blood pressure⁴
• exposure to workplace chemicals, including arsenic and benzene⁵

Having any of these risk factors doesn’t mean you will develop kidney cancer, but you should see your GP if you are worried.

If you are found to have kidney cancer, your doctor will give you details about how far your cancer has progressed. Kidney cancer is commonly staged with the TNM system, which is used to show how advanced the cancer is. These letters stand for:

• Tumour: Your doctors will measure the size of the tumour and how much it has grown
• Nodes: Refers to whether cancer has spread to lymph nodes
• Metastasis: Refers to whether cancer has spread to other parts of the body

Treatment for kidney cancer will depend on how advanced it is. Your doctor may recommend a watch-and-wait approach if you have a small tumour that isn’t aggressive. This involves monitoring your kidneys with regular ultrasounds or scans, but no treatment is given unless necessary. If the tumours are larger or more aggressive, recommended treatments may include:

• immunotherapy
• radiation therapy
• surgery
• targeted therapy

Kidney cancer doesn’t usually respond well to chemotherapy, so it isn’t a standard treatment.

General side effects include:

• fatigue
• nausea
• coughing
• skin rashes or itching
• diarrhoea
• low blood pressure
• high fevers

Side effects may include:

• discomfort or swelling around the treatment area
• tiredness and lethargy for a few weeks after you finish
• nausea
• diarrhoea

Most of these side effects will ease soon after treatment is finished. However, your team will discuss any long-term considerations with you, depending on the tumour type.

If you have part of or a whole kidney removed, your remaining kidney usually does the work of both. Your surgeon will talk to you about any risks before surgery. General side effects of kidney surgery include:

• pain and swelling
• wound infection
• kidney failure

General side effects include:

• nausea
• fatigue
• mouth sores
• loss of appetite
• cough
• changes in your voice.

References

1. Tobacco smoking, body mass index, hypertension, and kidney cancer risk in central and eastern Europe. https://www.nature.com/articles/6604761
   
2. Family history of cancer and renal cell cancer risk in Caucasians and African Americans. British Journal of Cancer volume 102, pages1676–1680 (2010). https://www.nature.com/articles/6605680
3. Obesity and Kidney Cancer. https://pubmed.ncbi.nlm.nih.gov/27909903/
4. Hypertension and risk of renal cell carcinoma among white and black americans. Epidemiology. 2011 Nov; 22(6): 797–804. doi: 10.1097/EDE.0b013e3182300720. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188386/
5. Renal cell carcinoma and occupational exposure to chemicals in Canada. https://pubmed.ncbi.nlm.nih.gov/12063361/