About kidney cancer

What is the main type of kidney cancer?

Kidney cancer is cancer that starts in the cells of the kidney. Most kidney cancers are renal cell carcinoma (RCC), sometimes called renal cell adenocarcinoma. RCCs start in the cells lining the tiny tubes found in the nephrons.

In the early stages of RCC, the tumour is in the kidney only. Usually one kidney is affected, but in rare cases there is a tumour in both kidneys.

As the cancer grows, it can spread to areas near the kidney, such as the surrounding fatty tissue, veins, adrenal glands, lymph nodes, ureters or the liver. It may also spread to other parts of the body, such as the lungs, bones or brain.

Subtypes of renal cell carcinoma (RCC)

Clear cell

• makes up about 80% of RCC cases
• cancer cells look empty or clear

Papillary 

• makes up about 10–15% of RCC cases
• cancer cells are arranged in finger-like fronds

Chromophobe

• makes up about 5% of RCC cases
• cancer cells are large and pale

Other types of RCC

• make up about 5–10% of RCC cases
• include renal medullary carcinoma, collecting duct carcinoma, MiT family translocation RCC, sarcomatoid RCC and other very rare types

Are there other types of kidney cancer?

RCC is the most common type of kidney cancer, but there are other less common types:

Urothelial carcinoma (or transitional cell carcinoma) – This can begin in the ureter or in the renal pelvis, where the kidney and ureter meet. It is also known as upper tract urothelial cancer.

Wilms tumour (or nephroblastoma) – This type of kidney cancer is most common in younger children, but it is still rare. Visit Cancer Australia's Children's Cancer.

Secondary cancer – Very rarely, cancer can spread from a primary cancer somewhere else in the body to the kidney. This is known as secondary cancer (metastasis). This secondary cancer is not kidney cancer and it behaves more like the primary cancer.

How common is kidney cancer?

Each year about 4700 Australians are diagnosed with kidney cancer. Men are twice as likely as women to be diagnosed with kidney cancer. It is the sixth most common cancer in men and the tenth most common cancer in women (excluding non-melanoma skin cancers). It is more common in people over 50, but it can occur at any age.

The kidneys

The kidneys are two bean-shaped organs, each about the size of a fist. They are found deep inside your abdomen (belly), positioned near the middle of your back, on either side of the spine.

The kidneys are part of the body’s urinary system, which also includes the:

• ureters – tubes that take urine from the kidneys to the bladder
• bladder – a hollow sac that stores urine (wee) until you need to urinate
• urethra – a tube that takes urine from the bladder to outside the body.

An adrenal gland sits above each kidney. The adrenal glands produce a number of hormones. Although these glands are not part of the urinary system, kidney cancer can sometimes spread to them.

What the kidneys do

Filter blood – The main role of the kidneys is to filter and clean the blood. Blood flows through the renal artery into each kidney, where it is filtered through tiny networks of tubes called nephrons. The clean blood then flows out through the renal vein to the rest of the body.

Make urine – When the kidneys filter the blood, they remove excess water and waste products to make urine (wee or pee). The urine collects in an area of each kidney called the renal pelvis, and then flows through the ureters into the bladder.

Produce hormones – The kidneys also help your body control how much blood it needs. They do this by making hormones that regulate blood pressure and trigger the production of red blood cells.

The urinary system

Which health professionals will I see?

Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist such as a urologist. The specialist will arrange further tests. If kidney cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. During and after treatment, you will see a range of health professionals who specialise in different aspects of your care.

Health professionals you may see

• GP – assists you with treatment decisions and works in partnership with your specialists in providing ongoing care
• urologist – diagnoses and treats diseases of the urinary system, and the male reproductive system; performs surgery
• nephrologist – diagnoses and treats conditions that cause kidney (renal) failure or impairment; may be consulted by your urologist when planning surgery
• medical oncologist – treats cancer with drug therapies such as chemotherapy, targeted therapy and immunotherapy (systemic treatment)
• radiation oncologist – treats cancer by prescribing and overseeing a course of radiation therapy
• radiologist – analyses x-rays and scans; an interventional radiologist may also perform a biopsy under ultrasound or CT, and deliver some treatments
• nurse – administers drugs and provides care, information and support throughout your treatment
• cancer care coordinator – coordinates your care, liaises with other members of the MDT, and supports you and your family throughout treatment; care may also be coordinated by a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)
• social worker – links you to support services and helps you with emotional, practical and financial issues
• physiotherapist, exercise physiologist – help restore movement and mobility, and improve fitness and wellbeing
• occupational therapist – assists in adapting your living and working environment to help you resume usual activities after treatment
• dietitian – helps with nutrition concerns and recommends changes to diet during treatment and recovery
• psychiatrist, psychologist, counsellor – help you manage your emotional response to diagnosis and treatment
• palliative care specialist and nurses – work closely with the GP and cancer team to help control symptoms and maintain quality of life