Kidney cancer is a type of cancer that starts in the cells in the kidney.

The two most common types of kidney cancer are renal cell carcinoma (RCC) and urothelial cell carcinoma (UCC) of the renal pelvis. These names reflect the type of cell from which the cancer developed.

The different types of kidney cancer (such as RCC and UCC) develop in different ways, meaning that the diseases have different long-term outcomes, and need to be staged and treated in different ways.

RCC is responsible for approximately 80% of primary renal cancers, and UCC accounts for the majority of the remainder.

Overall five-year survival rates in the United States are 73%.

In addition to renal cell carcinoma and renal pelvis carcinoma, other, less common types of kidney cancer include:

Squamous cell carcinoma
Juxtaglomerular cell tumor (reninoma)
Renal oncocytoma
Bellini duct carcinoma
Clear-cell sarcoma of the kidney
Mesoblastic nephroma
Wilms’ tumor, usually is reported in children under the age of 5.
Mixed epithelial-stromal tumor

Rarely, some other types of cancer and potentially cancerous tumors that more usually originate elsewhere can originate in the kidneys. These include:

Clear cell adenocarcinoma
Transitional cell carcinoma
Inverted papilloma
Renal lymphoma
Carcinoid tumor of the renal pelvis

Cancer in the kidney may also be secondary, the result of metastasis from primary cancer elsewhere in the body.

The most common signs and symptoms of kidney cancer are a mass in the abdomen and/or blood in the urine (or hematuria).

Other symptoms may include tiredness, loss of appetite, weight loss, high temperature, and heavy sweating, and persistent pain in the abdomen.

However, many of these symptoms can be caused by other conditions, and there may also be no signs or symptoms in a person with kidney cancer, especially in the early stages of the disease.

Factors that increase the risk of kidney cancer include smoking, which can double the risk of the disease, regular use of NSAIDs such as ibuprofen and naproxen, which may increase the risk by 51% or may not; obesity, faulty genes, a family history of kidney cancer, having kidney disease that needs dialysis; being infected with hepatitis C, and previous treatment for testicular cancer or cervical cancer.

There are also other possible risk factors such as high blood pressure, which are being investigated.

Kidney cancer originates in the kidney in two principal locations: the renal tubule and the renal pelvis. Most cancers in renal tubule are renal cell carcinoma and clear cell adenocarcinoma. Most cancers in the renal pelvis are transitional cell carcinoma.

Treatment for kidney cancer depends on the type and stage of the disease. Surgery is typically the mainstay of treatment and it usually doesn’t involve chemotherapy and radiotherapy, as kidney cancers often do not respond to these treatments.

If the cancer has not spread, it will usually be removed by surgery.

Sometimes this involves removing the whole kidney, which is called nephrectomy but most tumors are amenable to partial nephrectomy which is removing only the kidney tumor and preserving the remaining normal kidney.

Unfortunately, surgery is not always possible – for example, the patient may have other medical conditions that prevent it, or the cancer may have spread around the body and doctors may not be able to remove it.

There is currently no evidence that body-wide medical therapy after surgery where there is no known residual disease, that is, adjuvant therapy, helps to improve survival in kidney cancer.

If the cancer can’t be cured with surgery, sometimes doctors may use other techniques such as cryotherapy (freezing the tumor away) or radio-frequency ablation (burning the tumor away). However, these are not yet used as standard treatments for kidney cancer.

Immunotherapy has the potential to induce complete remissions or durable partial remissions in some patients, although it works in only about 10 to 15% of patients.

In Wilms’ tumor (a type of kidney cancer that affects children), chemotherapy, radiotherapy, and surgery are the accepted treatments, depending on the stage of the disease when it is diagnosed.

The majority of kidney cancers reported in children are Wilms’ tumors. These tumors can begin to grow when a fetus is still developing in the uterus, and may not cause problems until the child is a few years old.

Wilms’ tumor is most common in children under the age of 5, but can rarely be diagnosed in older children or in adults. It is still not clear what causes most Wilms’ tumors. The most common symptoms are swelling of the abdomen and blood in the child’s urine.

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