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National Cancer Institute

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Renal cell cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is renal cell cancer?
STAGE EXPLANATION
Stages of renal cell cancer
Stage I
Stage II
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How renal cell cancer is treated
Treatment by stage
STAGE I RENAL CELL CANCER
STAGE II RENAL CELL CANCER
STAGE III RENAL CELL CANCER
STAGE IV RENAL CELL CANCER
RECURRENT RENAL CELL CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is renal cell cancer?

Renal cell cancer (also called cancer of the kidney or renal adenocarcinoma) is a disease in which cancer (malignant) cells are found in certain tissues of the kidney. Renal cell cancer is one of the less common kinds of cancer. It occurs more often in men than in women.

The kidneys are a "matched" pair of organs found on either side of the backbone. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a kidney bean. Inside each kidney are tiny tubules that filter and clean the blood, taking out waste products, and making urine. The urine made by the kidneys passes through a tube called a ureter into the bladder where it is held until it is passed from the body. Renal cell cancer is a cancer of the lining of the tubules in the kidney. If cancer is found in the part of the kidney that collects urine and drains it to the ureters (the renal pelvis), or is found in the ureters, refer to the PDQ patient information summary on transitional cell cancer of the renal pelvis and ureter.

A doctor should be seen if one or more of the following symptoms appear: blood in the urine, a lump (mass) in the abdomen, or a pain in the side that doesn't go away. Tiredness, loss of appetite, weight loss without dieting, and anemia (too few red blood cells) may also be symptoms.

If there are signs of cancer, a doctor will usually feel the abdomen for lumps. A doctor may order a special x-ray called an intravenous pyelogram (IVP). During this test, a dye containing iodine is injected into the bloodstream. This allows the doctor to see the kidney more clearly on the x-ray. The doctor may also do an ultrasound, which uses sound waves to find tumors, or a special x-ray called a CT scan to look for lumps in the kidney. A special scan called magnetic resonance imaging (MRI), which uses magnetic waves to find tumors, may also be done.

The chance of recovery (prognosis) and choice of treatment depend on the stage of the cancer (whether it is just in the kidney or has spread to other places in the body) and the patient's general state of health.


STAGE EXPLANATION


Stages of renal cell cancer

Once renal cell cancer has been found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for renal cell cancer:


Stage I

Cancer is found only in the kidney.


Stage II

Cancer has spread to the fat around the kidney, but the cancer has not spread beyond this to the capsule that contains the kidney.


Stage III

Cancer has spread to the main blood vessel that carries clean blood from the kidney (renal vein), to the blood vessel that carries blood from the lower part of the body to the heart (inferior vena cava), or to lymph nodes around the kidney. (Lymph nodes are small, bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells.)


Stage IV

Cancer has spread to nearby organs such as the bowel or pancreas or has spread to other places in the body such as the lungs.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the original area or in another part of the body.


TREATMENT OPTION OVERVIEW


How renal cell cancer is treated

There are treatments for most patients with renal cell cancer. Five kinds of treatment are used:

Surgery is a common treatment of renal cell cancer. A doctor may take out the cancer using one of the following:

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that contain radiation through thin plastic tubes (internal radiation therapy) in the area where the cancer cells are found. Radiation can be used alone or before or after surgery and/or chemotherapy.

Hormone therapy uses hormones (taken by pill or injected with a needle) to stop cancer cells from growing.

Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.

Sometimes a special treatment called arterial embolization is used to treat renal cell cancer. A narrow tube (catheter) is used to inject small pieces of a special gelatin sponge into the main blood vessel that flows into the kidney to block the blood cells that feed the tumor. This prevents the cancer cells from getting oxygen or other substances they need to grow.


Treatment by stage

Treatment of renal cell cancer depends on the type and stage of the disease, and the patient's age and general health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of renal cell cancer. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


STAGE I RENAL CELL CANCER

Treatment may be one of the following:

1. Surgery to remove the kidney and the tissues around it (radical nephrectomy). Lymph nodes in the area may also be removed.

2. Surgery to remove only the kidney (simple nephrectomy).

3. Surgery to remove the part of the kidney where the cancer is found (partial nephrectomy).

4. External beam radiation therapy to relieve symptoms in patients who cannot have surgery.

5. Injection of small pieces of a special gelatin sponge into the main artery that flows to the kidney to block blood flow to the cancer cells (arterial embolization). This is usually done only in patients who cannot have surgery.

6. Clinical trials.


STAGE II RENAL CELL CANCER

Treatment may be one of the following:

1. Surgery to remove the kidney and the tissues around it (radical nephrectomy). Lymph nodes in the area may also be removed.

2. External beam radiation therapy before or after radical nephrectomy.

3. Surgery to remove the part of the kidney where the cancer is found (partial nephrectomy).

4. External beam radiation therapy to relieve symptoms in patients who cannot have surgery.

5. Injection of small pieces of a special gelatin sponge into the main artery that flows to the kidney to block blood flow to the cancer cells (arterial embolization). This is usually done only in patients who cannot have surgery.

6. Clinical trials.


STAGE III RENAL CELL CANCER

Treatment may be one of the following:

1. Surgery to remove the kidney and the tissues around it (radical nephrectomy). Lymph nodes in the area may also be removed. If the cancer has spread to the main blood vessels that carry blood to and from the kidney (the renal vein or vena cava), part of the blood vessel may also be removed.

2. Injection of small pieces of a special gelatin sponge into the main artery that flows to the kidney to block blood flow to the cancer cells (arterial embolization) followed by radical nephrectomy.

3. External beam radiation therapy to relieve symptoms.

4. Arterial embolization to relieve symptoms.

5. Surgery to remove the kidney (simple or radical nephrectomy) to relieve symptoms.

6. External beam radiation therapy before or after radical nephrectomy.

7. Clinical trials of biological therapy in addition to other therapy.


STAGE IV RENAL CELL CANCER

Treatment may be one of the following:

1. Biological therapy.

2. External radiation therapy to relieve symptoms.

3. Surgery to remove the kidney (nephrectomy) to relieve symptoms.

4. If cancer has spread only to the area around the kidney, surgery to remove the kidney and the tissue around it (radical nephrectomy). If the cancer has spread to a limited area, surgery to remove the cancer where it has spread (metastasized) in addition to radical nephrectomy.

5. Clinical trials.


RECURRENT RENAL CELL CANCER

Treatment may be one of the following:

1. Biological therapy.

2. External radiation therapy to relieve symptoms.

3. Chemotherapy.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about renal cell cancer, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following booklet about renal cell cancer may be helpful:

What You Need To Know About Kidney Cancer

The following general booklets on questions related to cancer may also be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 06/1998


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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