Renal Cell Carcinoma
Renal cell carcinoma (RCC) represents 2-3% of all cancers. Learn more about this disease, its diagnosis and treatments.
Many renal masses remain asymptomatic until the late stages of the disease.
Currently, more than 50% of RCCs are detected incidentally when non-invasive imaging is used to investigate a variety of nonspecific symptoms and other abdominal diseases . The classic triad of flank pain, gross haematuria, and palpable abdominal mass is now rare (6-10%) and correlates with advanced disease.
Paraneoplastic syndromes are found in approximately 30% of patients with symptomatic RCCs. Most common paraneoplastic syndromes are: Hypertension, cachexia, weight loss, pyrexia, neuromyopathy, amyloidosis, elevated erythrocyte sedimentation rate, anemia, abnormal liver function, hypercalcemia and polycythemia.
Physical examination has only a limited role in the diagnosis of RCC. However, the following findings should prompt radiological examinations: Palpable abdominal mass; palpable cervical lymphadenopathy; non-reducing varicocele and bilateral lower extremity oedema, which suggests venous involvement7.
If symptoms or the results of the physical exam suggest kidney cancer, more tests will probably be performed including lab tests and imaging tests.
- Lab tests
- Complete blood count (CBC)
- Blood chemistry tests
- Imaging tests
- Computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and ultrasound can be very helpful in diagnosing most kinds of kidney tumours, although patients rarely need all of these tests.
- Other tests, such as chest x-rays and bone scans, are more often used to help determine if the cancer has spread (metastasized) to other parts of the body.
2-3% of all cancers
Many renal masses remain asymptomatic
is the first treatment option
1 Chow WH, Dong LM, Devesa SS. . Epidemiology and risk factors for kidney cancer. Nat Rev Urol 2010; 7: 245–257
3 Lindblad P. Epidemiology of renal cell carcinoma. Scand J Surg 2004;93(2):88-96 http://www.ncbi.nlm.nih.gov/pubmed/15285559
4 Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 2013 Apr;49(6):1374-403. http://www.ncbi.nlm.nih.gov/pubmed/23485231
5 Levi F, Ferlay J, Galeone C, et al. The changing pattern of kidney cancer incidence and mortality in Europe. BJU Int 2008 Apr;101(8):949-58 http://www.ncbi.nlm.nih.gov/pubmed/18241251
6 Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
7 Guidelines on Renal Cell Carcinoma, European Association of Urology, 2017– http://uroweb.org/guideline/renal-cell-carcinoma/
8 American Cancer Society. https://www.cancer.org/cancer/kidney-cancer/treating.html
9 European Association of Urology. Guidelines for Clear Cell Renal Cancers That Are Resistant to Vascular Endothelial Growth Factor Receptor–Targeted Therapy https://uroweb.org/wp-content/uploads/Powles-T-et-al.-Eur-Urol-2016-69-4.-Updated-EAU-Guidelines-for-clear-cell-renal-cancer-patients-who-fail-VEGF-targeted-therapy.pdf