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If you or someone you know has just been diagnosed with kidney cancer, this short, simple guide can help. Find information on kidney cancer here.

What is kidney cancer?

Cancer can start any place in the body. Kidney cancer starts in the kidney. It starts when cells in the kidney grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.

Kidney cancer cells can sometimes spread to other parts of the body, such as the lungs or bones, and grow there. When cancer cells do this, it’s called metastasis. Even if kidney cancer spreads to the bones (or any other place), the cancer cells there are still kidney cancer cells.

The kidneys

Ask your doctor to use this picture to show you where the cancer is.

The kidneys

You have 2 kidneys. They are bean-shaped and about the size of a fist. They clean waste out of your blood and make it into urine. They also help control your blood pressure and help make sure you have enough red cells in your blood.

Types of kidney cancer

There are many types of kidney cancer. Some are very rare. The most common kind is called renal cell cancer (RCC). There are also different types of RCC and knowing what type you have helps your doctor know what treatment you need. Your doctor can tell you more about the type you have.

Questions to ask about your diagnosis

• Why do you think I have cancer?
• Is there a chance I don’t have cancer?
• Would you please write down the kind of cancer you think I might have?
• What will happen next?

How does the doctor know I have kidney cancer?

Kidney cancers usually don't cause any signs or symptoms, but sometimes they might. Symptoms of kidney cancer may be:

• Blood in the urine
• Low back pain on one side (not from a hit or fall)
• A lump on the side or lower back
• Feeling tired
• Losing weight, if you’re not trying to lose weight
• Fever that’s not from a cold and that doesn’t go away

If your doctor thinks you might have kidney cancer, they will ask you questions about your health and  examine you. More tests might be done as well. Here are some of the tests you may need:

Urine tests: Your urine will probably be checked in the lab to see if there are blood or cancer cells in it.

Blood chemistry tests: These tests can sometimes show changes in the blood levels of certain chemicals that can happen with kidney cancer. The tests can also give an idea of how well your kidneys are working.

Complete blood count (CBC): This test measures the number of blood cells in your blood, like white blood cells, red blood cells, and platelets. People with kidney cancer often have low red blood cell counts (anemia).

CT scan (CAT scan): It uses x-rays to make detailed pictures of your insides. It can show how big a kidney tumor is, as well as if the cancer has spread.

MRI: This test uses radio waves and strong magnets instead of x-rays to make detailed pictures of the inside of the body. MRI isn’t done as often as CT scans for kidney cancer, but it can be helpful in some situations.

Ultrasound: This test uses sound waves and their echoes to make pictures of the inside of the body. This test can help show if a kidney growth is solid or filled with fluid. (Kidney cancers are more likely to be solid.) If a kidney biopsy is needed, ultrasound can be used to guide a needle into the lump to take out some cells for testing.

Chest x-ray: X-rays may be done to see if the cancer has spread to your lungs. But more often this can be seen on a CT scan instead.

Bone scan: A bone scan can help show if the cancer has spread to your bones. This test isn’t done unless there’s a reason to think the cancer might have spread, such as if you’re having bone pain.

Kidney biopsy: In a biopsy, the doctor takes out a small piece of an abnormal area to check it for cancer cells. For most cancers, a biopsy is the only way to tell for sure if you have cancer. But a biopsy isn’t always needed to tell if you have kidney cancer. X-rays or scans are sometimes enough.

In the most common type of biopsy, known as a needle biopsy, the doctor inserts a thin, hollow needle into the tumor to remove a piece of it. There are other types of biopsies as well. Ask your doctor what kind you might need. Each type has risks and benefits. The choice of which type to use depends on your own case.

Grading kidney cancer

The cancer cells in the biopsy sample will be graded, based on how abnormal they look. Kidney cancers are graded 1 through 4. Grade 1 kidney cancers look a lot like normal kidney cells, and they tend to grow slowly. Cancer cells that look very different from normal cells are given a higher grade (up to 4) and tend to grow faster. Ask the doctor to explain the grade of your cancer and if it might affect which treatment is best for you.

Questions to ask about tests for kidney cancer

• What tests will I need to have?
• Who will do these tests?
• Where will they be done?
• Who can explain them to me?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How advanced is my cancer?

If you have kidney cancer, the doctor will want to find out how far it has spread. This is called the stage of your cancer. It describes the growth of the cancer in the kidney, as well as if it has spread to nearby organs or to places farther away. The stage can be used to help decide what type of treatment is best for you.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more advanced cancer that has spread away from the kidney. Be sure to ask the doctor about the cancer stage and what it means.

If you have stage 4 kidney cancer, you might also be put into a risk group (low, intermediate, or high), based on certain factors. This might affect your treatment options, as people in higher risk groups often need more intense treatment.

Questions to ask about kidney cancer staging

• Do you know the stage and grade of my cancer?
• If not, how and when will you find out the stage and grade?
• Would you explain to me what these mean in my case?
• What will happen next?

What kind of treatment will I need?

There are many ways to treat kidney cancer. The treatment plan that’s best for you will depend on:

• The stage and grade of your cancer
• The chance that a type of treatment will cure the cancer or help in some way
• Your age and overall health
• Your feelings about the treatment and the side effects that come with it

Surgery for kidney cancer

Surgery is used to treat most kidney cancers. The surgeon might remove the whole kidney or only the part that contains the cancer, and there are different ways to do each surgery. Talk to your doctor about how the surgery will be done.

Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. If you have side effects after your surgery, let your cancer care team know. They should be able to help you with any problems that come up.

Tumor ablation for kidney cancer

Tumor ablation destroys the tumor without taking it out by surgery. It might be an option for some people, such as those who aren’t healthy enough to have surgery.

There are many ways to do this, such as heating the tumor with radio waves or microwaves, freezing the tumor, or creating an electric field inside the tumor. Talk to your cancer care team about the planned treatment and what you can expect.

Radiation treatments for kidney cancer

Radiation uses high-energy rays (like x-rays) to kill cancer cells. It’s sometimes used to treat kidney cancer in people who can’t have surgery, but other treatments might be tried first. It can also be used to treat small tumors in other parts of the body.

Radiation is aimed at the kidney from a machine outside the body. This is called external beam radiation. The treatment is a lot like getting an x-ray.

Side effects of radiation treatments

Side effects depend on the type of radiation that’s used and where it’s aimed. The most common side effects of radiation are:

• Skin changes and hair loss where the radiation is given (redness or skin peeling like a sunburn)
• Feeling sick to your stomach or having diarrhea, if the radiation is aimed at your belly
• Feeling very tired

Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect.

Immunotherapy for kidney cancer

Immunotherapy is treatment that boosts your own immune system to help attack cancer cells. Some types of immunotherapy can be used to treat kidney cancer. These drugs are given into a vein.

Side effects of immunotherapy

Immunotherapy can cause different side effects, depending on which drug is used. These drugs might make you feel tired, sick to your stomach, or cause fever, chills, and rashes. Most of these problems go away after treatment ends. Some less common side effects can be more serious.

There are ways to treat most of the side effects from immunotherapy. If you have side effects, tell your cancer care team so they can help.

Targeted drugs for kidney cancer

These drugs target some of the gene or protein changes inside cancer cells. These drugs are often part of the treatment for more advanced kidney cancers. Some come as pills that you take at home, while others are given through a vein.

Side effects of targeted drugs

Side effects of these drugs depend on which one is used. Many of these drugs can make you feel sick to your stomach and cause low blood counts. They can also cause high blood pressure and skin changes of the hands and feet. These side effects usually go away after treatment ends.

There are ways to treat most of the side effects caused by targeted drugs. If you have side effects, talk to your cancer care team so they can help.

Chemo for kidney cancer

Chemotherapy (chemo) is the use of drugs to fight cancer. The drugs may be given into a vein or taken as pills. Chemo doesn’t tend to work well for kidney cancer, but it may be tried if other treatments don’t work.

Side effects of chemo

Chemo can make you feel tired, sick to your stomach, or cause your hair to fall out. But these problems tend to go away after treatment ends.

There are ways to treat most chemo side effects. If you have side effects, be sure to tell your cancer care team so they can help.

Clinical trials

Clinical trials are research studies that test new drugs or other treatments in people. They often compare standard treatments with others that may be better.

If you’d like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital takes part in clinical trials. See Clinical Trials to learn more.

Clinical trials are one way to get the newest cancer treatment. They are the best way for doctors to find better ways to treat kidney cancer. If your doctor can find one that might be right for you, it’s up to you whether to take part. And if you do sign up for a clinical trial, you can always stop at any time.

What about other treatments that I hear about?

When you have kidney cancer, you might hear about other ways to treat the cancer or treat your symptoms that are not standard medical treatments. These treatments may be vitamins, herbs, special diets, or other things. You may wonder about these treatments.

Some of these might be helpful, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.

Questions to ask about kidney cancer treatment

• What are my treatment choices?
• What treatment do you think is best for me? Why?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• How soon do I need to start treatment?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment?
• What’s the goal of these treatments?
• What should I do to be ready for treatment?
• Is there anything I can do to help the treatment work better?
• What side effects could I have from these treatments?
• What can I do about side effects that I might have?
• Is there a clinical trial that might be right for me?
• What about special vitamins or diets that friends tell me about? How will I know if they are safe?
• What’s the next step?

What will happen after treatment?

You’ll be glad when treatment is over. But can be hard not to worry about the cancer coming back. Even when cancer never comes back, it’s normal to worry about this.

For years after treatment ends, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back. At first, your visits may be every few months. Then, the longer you’re cancer-free, the less often you will need to go.

Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.

You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.