Symptoms, Stages, and Modern Treatment Methods of Kidney Cancer

Kidney cancer is a serious health issue that occurs when kidney cells, which form our body's essential filtering system, multiply uncontrollably. Often progressing silently in its early stages, this disease is usually discovered by chance during routine health check-ups or scans performed for different complaints. Thanks to the innovative surgical methods and targeted medications offered by modern medicine, treatment success is quite high in early-diagnosed cases.

• Most kidney cancers originate from the cells lining the tiny tubules that form urine.
• The disease usually shows no symptoms in its initial stages; bleeding in the urine is the most common first sign.
• Smoking, obesity, and uncontrolled high blood pressure are the most fundamental risk factors in the development of the disease.
• Imaging methods such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) play a critical role in the diagnostic process.
• Surgery is the gold standard in treatment; robotic and laparoscopic methods significantly speed up the patient's recovery process.

What is Kidney Cancer?

Our kidneys are vital, bean-shaped organs, roughly the size of a fist, located on either side of our lower back. Their most fundamental task is to purify the blood from harmful waste and toxins, ensuring these substances are expelled from the body through urine. They also have critical functions such as maintaining fluid balance, regulating blood pressure, and secreting hormones that support red blood cell production.

The uncontrolled and aggressive multiplication of cells as a result of disruptions in their genetic structure prevents the organ from performing its normal function. These cellular accumulations grow over time to form a kidney tumor. Abnormal growths developing anywhere in the body are generally called a mass. If this growth occurs in the kidney tissue, it is medically referred to as a mass in the kidney.

Not all masses detected in the kidney are malignant (cancerous). A significant portion of small-sized masses are benign, but as the mass size increases, the probability of it being malignant increases. The most common type is Renal Cell Carcinoma, which originates from the lining of the kidney's filtering tubes. While this type of cancer sometimes appears as a single mass, it can rarely be seen as multiple foci in the same kidney or simultaneously in both kidneys.

Causes and Risk Factors

Although the exact cause of kidney cancer is not clearly known in every patient, it is proven that mutations in the DNA of the cells initiate this process. There are various environmental, genetic, and lifestyle-related risk factors that increase the likelihood of contracting the disease. Being aware of these risk factors provides a great advantage in preventing or catching the disease early.

• Smoking: Individuals who smoke have twice the risk of developing kidney cancer compared to non-smokers. The risk increases in direct proportion to the amount and duration of smoking.
• Obesity: Excess weight changes the hormonal balance in the body, putting pressure on kidney cells and potentially triggering the cancerous process.
• High Blood Pressure (Hypertension): Continuously high blood pressure wears down the kidney vessels and tissue. Risk factors like high blood pressure and diabetes deeply affect not only your kidneys but also your eye vessels. Therefore, it is of great importance for patients in the risk group to have regular retina screenings at our Eye Diseases department to protect holistic health.
• Advanced Age and Gender: The disease is generally seen more frequently in individuals aged 50 and over. It is about twice as common in men as in women.
• Kidney Failure and Dialysis: In advanced-stage kidney patients who have been receiving dialysis treatment for a long time, the risk of cyst formation and cancer development in the kidneys increases.
• Occupational Exposure: Long-term unprotected contact with chemical substances such as cadmium, asbestos, and some organic solvents increases the risk.
• Genetic Predisposition: A family history of kidney cancer or hereditary diseases like Von Hippel-Lindau syndrome significantly increases the genetic risk.

What Are the Symptoms of Kidney Cancer?

The most insidious aspect of the disease is that it usually gives no signs in its early stages. When the tumor is small within the kidney tissue, patients feel completely healthy. However, as the mass grows, begins to press on surrounding tissues, or reaches the urinary tract, kidney cancer symptoms gradually begin to appear.

• Blood in the Urine (Hematuria): This is the most common symptom. The urine color may be pink, red, or cola-colored. Sometimes the bleeding is too little to be seen with the naked eye and is only detected in a microscopic urine test.
• Persistent Side and Back Pain: A dull, continuous pain felt just below the ribs, on the side of the lower back, or in the back. Unlike pain caused by injury or strain, this pain does not go away with rest. The complaint of flank pain can sometimes be confused with passing a kidney stone. To better understand this distinction, you can also review our article titled Golden Rules to Avoid Kidney Stone Pain and What Your Urine Color Tells You.
• Swelling or Mass in the Abdominal Area: A hard mass can be felt on the side of the abdomen by patients or physicians.
• Unexplained Weight Loss and Loss of Appetite: Experiencing rapid and significant weight loss even though you are not on a diet.
• Continuous Fatigue (Lethargy): A state of extreme exhaustion caused by cancer cells consuming body energy or the development of anemia.
• Unexplained High Fever: Recurrent fever attacks lasting for days without an infection or cold.

Diagnostic Methods and Stages of the Disease

When patients present with suspicious symptoms or a mass is discovered by chance during routine health screenings, various methods are used to make a definitive diagnosis and determine the extent of the disease.

Imaging Methods and Biopsy

The first step is usually a simple, painless, and radiation-free ultrasound scan. An ultrasound helps distinguish whether the mass in the kidney is an innocent fluid-filled cyst or a solid tumor. If a solid mass is detected, medicated (contrast-enhanced) Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) is requested for detailed examination. These methods clearly show the exact size of the mass, its location within the kidney, and whether it has spread to surrounding tissues.

While a biopsy (taking a tissue sample) is essential for a definitive diagnosis in many types of cancer, imaging methods in kidney tumors usually provide such clear information that surgical planning can be started directly. However, if the mass is very small, the patient's surgical risk is high, or it is suspected that a different type of cancer has spread to the kidney, a biopsy can be taken from the tumor with a fine needle under local anesthesia.

Stages of Cancer

The stage of the disease is the most decisive factor in creating a treatment plan. Kidney cancer is generally divided into four stages:

Stage 1: The tumor is smaller than 7 centimeters and is completely confined within the kidney tissue. There is no spread to surrounding tissues or lymph nodes. It is considered an early diagnosis, and this is the stage with the highest treatment success.

Stage 2: The tumor is larger than 7 centimeters but has still not spilled outside the kidney. Its borders are distinct.

Stage 3: Cancer cells have spread to the fat tissue surrounding the kidney, the main vein of the kidney (renal vein), or nearby lymph nodes. However, there is no spread to distant organs.

Stage 4: This is the most advanced stage of the disease. Cancer cells have crossed the fascia surrounding the kidney (Gerota's fascia) or metastasized (spread) to distant organs such as the lungs, bones, liver, or brain.

How is Kidney Cancer Treated?

A personalized kidney cancer treatment plan is created considering the patient's general health status, age, tumor size, stage, and kidney functions. Surgical interventions form the backbone of the treatment.

Robotic and Laparoscopic Surgery

In current medical approaches, kidney cancer surgery is generally performed with closed (minimally invasive) methods. There are two main surgical approaches based on the size and location of the tumor:

Partial Nephrectomy (Kidney-Sparing Surgery): This is a surgery where only the tumorous tissue along with a small amount of healthy tissue around it is removed, preserving the remaining healthy part of the kidney. It is especially preferred for small tumors and is very valuable for preserving the patient's long-term kidney functions.

Radical Nephrectomy: In cases where the tumor is very large or located in the center of the kidney, this is the process of removing the entire kidney, the surrounding fat tissue, and sometimes the adrenal gland.

These surgeries are performed in our clinic using high-tech Robotic Surgery or Laparoscopic Surgery methods. Robotic surgery provides the surgeon with a three-dimensional, high-resolution view and mobility at angles that the human hand cannot reach. For patients, it means less bleeding, less pain, smaller incision scars, and a much faster return to normal life.

Smart Drug Therapy and Immunotherapy

If the disease is in an advanced stage or has spread to other parts of the body, surgery alone is not enough. In this case, medical oncology steps in. Traditional chemotherapy is generally not effective in kidney cancer. Instead, targeted therapies (smart drugs) that prevent the growth of cancer cells and the formation of new blood vessels feeding the tumor are used. In addition, immunotherapy agents that stimulate the patient's own immune system to fight against cancer cells significantly increase survival rates in advanced-stage treatments.

Complications and Risk Groups

Untreated kidney tumors can grow over time and lead to a complete loss of kidney function. When cancer cells spread through the blood and lymph to the body, the lungs and bones are most commonly affected; this causes shortness of breath, a persistent cough, or severe bone pain.

Kidney cancers can also cause systemic effects called paraneoplastic syndromes. Due to certain substances secreted by the tumor, calcium levels in the blood can reach dangerous levels, red blood cells can be overproduced, disrupting blood fluidity, or abnormalities can be seen in liver function tests. Heavy smokers for many years, patients with severe obesity, and individuals undergoing dialysis due to chronic kidney failure are in the highest risk group for the development of these complications.

When to See a Doctor?

Taking the signals your body gives you seriously can be life-saving. If you notice any of the following symptoms, you should consult a urology specialist without delay:

• Noticing visible blood, a pinkish tint, or clots in your urine.
• A dull pain on the side of your lower back or in your back that does not go away with changing position or resting, lasting for weeks.
• A hard mass or feeling of swelling in your abdominal area that you can feel with your hand.
• Experiencing unexplained, involuntary, and rapid weight loss.

Emergencies: In cases of heavy bleeding with clots in the urine and these clots blocking the urinary tract causing an inability to urinate (globus), sudden unbearable flank pain, feeling faint due to excessive blood loss, or confusion, you should immediately call 112 or go to the emergency room of the nearest hospital.

The Process and Follow-up at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, the diagnostic and treatment processes for kidney cancer are carried out with a multidisciplinary approach where Urology, Medical Oncology, Radiology, and Pathology specialists work together. Thanks to our fully equipped emergency room serving 24/7 and our advanced technology imaging center in our hospital, the diagnostic process is completed rapidly.

When coming to your outpatient clinic appointment, bringing your previous blood test results, ultrasound or tomography reports, and CDs/images with you will ensure the process progresses much more smoothly. We are also by your side in the postoperative period with our regular follow-up protocols. To avoid delaying your treatment plan and to consult with our specialist physicians, you can easily complete your transaction through our appointment page.

Frequently Asked Questions

Is every mass in the kidney cancer?

No, not every mass detected in the kidney means cancer. Simple kidney cysts, in particular, are fluid-filled benign sacs and are very common in society. By examining the structure of the mass in detail with imaging methods, it can largely be distinguished whether it is benign or malignant.

Is kidney cancer surgery risky?

All surgical interventions have certain risks related to general anesthesia or bleeding. However, thanks to current robotic and laparoscopic surgical techniques, the amount of bleeding is reduced, and the risk of damaging surrounding tissues is minimized. When performed by an experienced surgical team, it is a very safe procedure.

Can a healthy life be maintained with a single kidney?

Yes, if the remaining kidney is completely healthy, a single kidney can easily meet all the body's filtering and cleaning needs. Patients who have had one kidney removed via radical nephrectomy can maintain their normal lifespan and quality of life by having regular check-ups and eating a healthy diet.

Does kidney cancer recur after treatment?

The risk of kidney cancers recurring (relapsing) after treatment depends on the stage at which the tumor was first detected and its degree of aggressiveness. While this risk is low in those caught at an early stage, it is higher in advanced stages. Therefore, regular doctor follow-ups and imaging tests, especially more frequently in the first years after surgery, are of vital importance.

Is seeing blood in the urine definitely cancer?

Seeing blood in the urine (hematuria) is not only a symptom of cancer. Urinary tract infections, kidney stones, prostate enlargement, or heavy exercise can also cause bleeding in the urine. However, to definitively determine the underlying cause, a urological examination and tests are absolutely necessary.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.