Spotlight on kidney cancer

The kidneys are two bean-shaped organs, each about the size of a fist and are part of the renal system. They are located just below the rib cage, one on each side of your spine. Kidneys perform many crucial functions including filtering blood, removing waste as urine and the creation of hormones that help produce red blood cells.

In 2020 it is estimated:

4,100+

diagnoses

of kidney cancer in Australia

2.9%

of all newly diagnosed cancers in Australia

men

are almost twice as likely to be diagnosed as women

What is kidney cancer?

Kidney cancer generally refers to renal cell cancer, which develops in the lining of the small tubes in the kidney. There is usually just a single tumour in one kidney, but sometimes there may be more than one tumour, or tumours in both kidneys. Kidney cancer can be subdivided into several different types, based on the appearance of the cancer cells under a microscope as well as other genetic factors. About 90% of kidney cancers are renal cell cancer, and the most common subtype is clear cell renal cancer.

Other types of kidney cancers include:

Urothelial cancer of the renal pelvis and ureter starting in either the ureter (the long tube that connects the kidney to the bladder) or the renal pelvis (the top part of the ureter, where it connects to the kidney). The renal pelvis and ureters are lined with transitional cells, which can develop into cancer cells. These cancers behave more like bladder cancers than kidney cancers and are treated like bladder cancer. Wilms tumours usually occur in children rather than adults; about 90% of kidney cancers in children are Wilms tumours. These tumours are often not detected until they are quite large, but most are found before they have spread to other organs.

Renal sarcomas, which are rare, begin in the blood vessels or other types of tissue in the kidney.

Other types of tumours in the kidneys are benign – that is, they do not spread (metastasise) to other parts of the body.

Kidney cancer has become increasingly more commonly diagnosed and survival rates continue to improve. This cancer is the 7th most diagnosed cancer in Australia and in 2020 it is estimated there will be 4,193 new cases of kidney cancer diagnosed (2,755 males and 1,438 females). Kidney cancer is rare in people under 40 but risk does increase with age. Also, men are almost twice as likely to be diagnosed with kidney cancer as women.

Spotlight on kidney cancer

In 2020, it is estimated there will be 917 deaths from kidney cancer (616 males, 301 females) and the fiveyear survival rate for Australians diagnosed with kidney cancer is 79%, although most people with kidney cancer localised only to the kidney can be cured.

Kidney cancer symptoms

Most people with kidney cancer have no symptoms. Many are diagnosed with the disease when they see a doctor for a different reason.

Symptoms may include: •blood in the urine (haematuria);

• pain or a dull ache in the side or lower back that is not due to an injury; •a lump in the abdomen;

•rapid, unexplained weight loss; •constant tiredness;

•fever not caused by a cold or flu. If you are experiencing some of these symptoms, please see your doctor.

Causes of kidney cancer

The causes of kidney cancer are not known, but factors that put some people at higher risk include:

Obesity – Excess body fat may alter certain hormones that can lead to kidney cancer.

Smoking – Up to one-third of all kidney cancers are thought to be related to smoking. People who smoke have almost twice the risk of developing kidney cancer as non-smokers.

High blood pressure – Whether it is caused by another medical condition or due to being overweight, high blood pressure increases the risk of kidney cancer.

Kidney failure – People with end-stage kidney disease have an increased risk of developing kidney cancer. Family history – People who have family members with kidney cancer, especially a sibling, are at a greater risk.

Inherited conditions – About 3–5% of kidney cancers occur in people with particular inherited syndromes, such as von Hippel-Lindau disease, BirtHogg-Dubé syndrome, and hereditary papillary RCC.

Exposure to toxic substances at work – After regular exposure to certain chemicals, such as arsenic, cadmium or some metal degreasers, the risk of kidney cancer may be higher.

Treatment options

Treatment will depend on the type of kidney cancer, the stage of the cancer and your general health. The main treatment for kidney cancer is surgery alone or with radiotherapy and will depend on the stage of the cancer. All treatment has benefits and side effects, which need to be discussed with your cancer care team. Treatment for kidney cancer is provided by a multidisciplinary team, comprising a group of doctors and other health professionals with expertise in kidney cancer. This team will regularly meet and discuss the patient’s medical history, organise appropriate tests, assess the test results, and together determine the most appropriate treatment care plan.

Clinical trials

One treatment option is taking part in a clinical trial. A trial will help confirm whether novel medicines are safe and effective to introduce as new treatment for kidney cancer. During a trial your health and progress is monitored extremely closely and as a participant in a trial you may also gain access to a treatment option that is not yet available to the wider public.

If you have already had one or more forms of cancer treatment and are looking for a new treatment option, there are clinical trials for you to consider. Or, if you have just been diagnosed with cancer, the time to think about joining a trial is before you have any treatment. Read more about the ANZUP kidney cancer trials on page 50.

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