Diagnosis & Staging
The kidneys are two bean-shaped organs 4.5 inches (11.4 cm) long. They are against the back abdominal wall, one on each side of your spine.
The kidneys filter your body's blood to remove salt, toxins and water. Filtering makes urine (pee). The kidneys also return water to the body to make sure the body tissues have enough water.
You can live with only one kidney. If one kidney is removed, the remaining kidney grows larger over the next few months to handle the extra load.
90% (90 out of 100) of tumours start in the kidney parenchyma and are often called renal cell cancers. Parenchyma is the part of the kidney that filters the blood and collects waste to make pee.
Kidney cancer is not very common. Only 4% (4 out of 100) of all cancers are kidney cancers.
The survival rate for people with early stage kidney cancer is up to 75% (75 out of 100).
Kidney cancer often has no symptoms. It is hard to find kidney cancer in the early stage.
Symptoms of kidney cancer may include:
- Blood in your urine. You may see this when you urinate (go pee) or it may only be seen under a microscope. This is called hematuria.
- A dull pain in the flank region (around the back and side of the abdomen) that does not go away.
- Fullness in the upper abdomen or a lump in this area.
- 15 - 20% (15 - 20 out of 100) of people with kidney cancer have all three symptoms listed above. These go away when the tumour is removed.
- High blood pressure. 25% (25 out of 100) of people with kidney cancer have this. It goes away when the tumour is removed.
- Fever or a fever that keeps coming back.
- Loss of appetite.
- Nausea (feeling queasy).
- Fatigue (extreme tiredness).
- Anemia (low red blood cell count).
- Polycythemia (high red blood cell count).
- Unexplained weight loss.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose kidney cancer include:
- Urine tests
- Blood tests
- X-rays: to see the tumour and if cancer has spread.
- IVP (intravenous pyelogram): a special dye is injected into your bloodstream. The dye goes into your urine and allows your doctor to see your urinary system with an x-ray machine.
- Computed tomography (CT scan): to see the tumour and if cancer has spread.
- Ultrasound: to see tumour the tumour.
- Most common kidney cancer. 85% (85 out of 100) of kidney cancers.
- Most common in people between age 50 and 70.
- Men are affected twice as much as women [see note below].
- These tumours grow in the renal pelvis (area of the kidney where two or three of the major chambers of the kidney join together).
- They affect the kidney's collecting systems and behave like cancers of the bladder or ureter. BC Cancer treats these cancers the same way we treat transitional cell carcinomas of the bladder. Bladder cancer information
- Not very common. About 8% (8 out of 100) of kidney tumours.
- In 50% (50 out of 100) of people with this cancer, the tumour has grown into the muscle.
- Most common in between people age 60 and 80.
- Found mostly in children.
- About 5% (5 out of 100) of all kidney cancers.
Note: Available statistics do not have information about the inclusion of transgender and gender diverse participants. It is unknown how these statistics apply to transgender and gender diverse people. Patients are advised to speak with their primary care provider or specialists about their individual considerations and recommendations.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
- Stage 1: Tumour is only in the kidney. Tumour is smaller than 7 cm across.
- Stage 2: Tumour is only in the kidney. Tumour is bigger than 7 cm across.
- Stage 3: Tumour has grown into the blood vessels near the kidney, or into lymph nodes near the kidney or into the fat around the kidney.
- Stage 4: Tumour has grown through the outer layer of the kidney or the cancer has spread to other parts of the body (called distant metastasis or metastatic kidney cancer).
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing. A pathologist will give the cancer a grade after looking at the cells under a microscope.
Kidney cancer can be grade 1, 2, 3 or 4 (may be called the Fuhrman grade). The lower the number, the lower the grade.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.