Most cancers are named after the part of the body where the cancer first begins, and kidney cancer is no exception. Kidney cancer begins in the kidneys -- two large, bean-shaped organs -- one located to the left, and the other to the right of the backbone. Renal is the Latin word for kidney, and kidney cancer may also be referred to as renal cancer.

Causes of Kidney Cancer

he causes of kidney cancer are unknown, but men seem to have twice the risk of contracting the disease. There is a strong association between cigarette smoking and kidney cancer. Cigarette smokers are twice as likely as non-smokers are to develop kidney cancer. Working around coke ovens has been shown to increase people's risk of developing this cancer. Certain types of painkillers that contain the chemical phenacetin are associated with kidney cancer. The United States government discontinued use of analgesics containing phenacetin about 20 years ago. Obesity may be yet another risk factor for kidney cancer. Some studies show a loose association between kidney cancer and occupational exposure to cadmium, petroleum products, lead, and asbestos.

Signs & Symptoms of Kidney Cancer

The primary symptoms of RCC include the following:

Abdominal mass or lump
Blood in the urine (hematuria)
Enlargement of one testicle
Fatigue
Intermittent fever
High blood pressure (less frequently)
Pain in the side (flank) or lower back not associated with injury
Persistent fatigue
Rapid, unexplained weight loss
Swelling (edema) in the legs and ankles
Weight loss

Diagnostic Tests

Renal ultrasonography and a computed tomography scan can distinguish between simple cysts and renal cancer. In many cases, these tests eliminate the need for renal angiography. Other tests that aid diagnosis and help in staging include excretory urography, nephrotomography, and kidney-ureter-bladder radiography.

Additional relevant tests include liver function studies, which show increased alkaline phosphatase, bilirubin, and transaminase levels and prolonged prothrombin time. Such results may point to liver metastasis. If the tumor hasn't metastasized, these abnormal values reverse after tumor resection.

Treatment

Radical nephrectomy, with or without regional lymph node dissection, offers the only chance of cure. It's the treatment of choice in localized cancer or with tumor extension into the renal vein and vena cava. Nephrectomy doesn't help in disseminated disease.

Because this disease resists radiation, this treatment is used only when the cancer has spread into the perinephric region or the lymph nodes or when the primary tumor or metastatic sites can't be completely excised. In this case the patient usually needs high doses of radiation.

Chemotherapy is erratically effective against kidney cancer, and hormonal therapy has no proven results. Biotherapy with Iymphokine-activated killer cells plus recombinant interleukin-2 shows promise but is expensive and causes many adverse reactions. Interferon is somewhat effective in treating advanced disease.

Prevention Tips

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

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