Quick answer

What is kidney cancer?

Kidney cancer usually starts in the lining of the small tubes inside the kidney. The most common type is renal cell carcinoma. Early kidney cancer often has no symptoms — blood in urine, a lump in the side, or persistent back pain may appear as it grows. Diagnosis uses ultrasound, CT, and sometimes biopsy. Treatment depends on stage — surgery is the main curative option for localised disease; advanced cases may need targeted drugs or immunotherapy.

Kidney cancer — often silent until found

Kidney cancer develops when cells in the kidney grow abnormally. The most common type is renal cell carcinoma (RCC), which starts in the lining of the small tubes that filter blood. Around 13,000 people are diagnosed in the UK each year — it is more common in people over 60 and in men.

Because early kidney cancer rarely causes symptoms, many cases are discovered incidentally during scans for unrelated problems.

Symptoms to watch for

Blood in urine — visible pink, red, or brown urine, or found on dipstick testing — is the most recognised symptom. Other signs include:

  • Persistent pain in the side or back below the ribs
  • A lump or swelling in the side of the abdomen
  • Unexplained weight loss
  • Fatigue and loss of appetite
  • High temperature and night sweats in advanced disease

These symptoms can have many other causes — but blood in urine always needs investigation.

Risk factors

  • Smoking — doubles risk
  • Obesity
  • High blood pressure
  • Long-term dialysis
  • Family history or genetic syndromes — von Hippel-Lindau disease
  • Workplace exposure to certain chemicals — cadmium, asbestos

Diagnosis pathway

  1. Urine tests — blood, protein, infection
  2. Ultrasound — initial kidney imaging
  3. CT scan with contrast — defines tumour size, location, and spread
  4. MRI — alternative or additional imaging in some cases
  5. Biopsy — not always required; scan appearance may be sufficient
  6. Chest CT — checks for lung metastases
  7. MDT discussion — multidisciplinary team plans treatment

Staging and types

Stage I to III — cancer confined to the kidney or nearby lymph nodes.

Stage IV — spread to distant organs — lungs, bones, liver, brain.

Renal cell carcinoma — ~85% of cases.

Transitional cell carcinoma — starts in the renal pelvis or ureter — treated more like bladder cancer.

Wilms tumour — rare childhood kidney cancer.

Treatment

Localised kidney cancer

Partial nephrectomy — removes the tumour and preserves remaining kidney tissue — preferred when feasible.

Radical nephrectomy — removes the entire kidney, surrounding fat, and sometimes the adrenal gland.

Ablation — radiofrequency or cryotherapy for small tumours in patients not fit for surgery.

Active surveillance — monitoring very small, slow-growing tumours in selected elderly or frail patients.

Advanced kidney cancer

Targeted therapy — drugs blocking blood vessel growth to the tumour.

Immunotherapy — helps the immune system attack cancer cells.

Cytoreductive nephrectomy — removing the primary kidney tumour before systemic treatment in selected metastatic cases.

After treatment

Regular follow-up scans monitor for recurrence. If one kidney is removed, the remaining kidney usually compensates — but kidney function is monitored. See chronic kidney disease if kidney function is reduced.

Stopping smoking and maintaining a healthy weight support recovery and reduce risk of second cancers.

Common questions

What are the early signs of kidney cancer?
Early kidney cancer often causes no symptoms. When symptoms appear, the most common are blood in urine (visible or microscopic), persistent pain in the side or back below the ribs, a lump or swelling in the side, and unexplained weight loss or fatigue. Some cancers are found on scans done for other reasons.
What causes kidney cancer?
The exact cause is unknown. Risk factors include smoking, obesity, high blood pressure, long-term dialysis, certain genetic conditions such as von Hippel-Lindau disease, and a family history of kidney cancer. It is more common in men and people over 60.
How is kidney cancer diagnosed?
Initial tests include urine analysis and ultrasound of the kidneys. CT scan with contrast is the main imaging test — it shows tumour size and whether cancer has spread. Biopsy is not always needed — surgery may proceed based on scan appearance. Staging uses TNM system — tumour size, lymph nodes, metastases.
Is kidney cancer curable?
Localised kidney cancer (stage I to III) is often curable with surgery — partial nephrectomy removes the tumour while preserving kidney function; radical nephrectomy removes the whole kidney. Advanced metastatic disease is not usually curable but targeted drugs and immunotherapy can control it and extend life.
Will I lose my kidney?
Not always. Partial nephrectomy — removing only the tumour — is preferred when possible, especially if you have one kidney, chronic kidney disease, or tumours in both kidneys. Your surgeon discusses the best approach based on tumour size and location.
What is the treatment for advanced kidney cancer?
Systemic treatments include targeted therapies such as sunitinib, pazopanib, and cabozantinib, and immunotherapy combinations such as nivolumab plus ipilimumab. Treatment is guided by a specialist oncology team based on cancer type and your overall health.
Can I prevent kidney cancer?
You cannot prevent all cases, but stopping smoking, maintaining a healthy weight, keeping blood pressure controlled, and eating a balanced diet reduce risk. There is no routine UK screening programme for kidney cancer in the general population.

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