Renal cell carcinoma is the most common type of kidney cancer in adults. Its treatment is led by urologists and oncologists, while a nephrologist helps protect and preserve kidney function before, during and after treatment. This team approach is especially important for people who have existing kidney disease or only one working kidney.
What Is Renal Cell Cancer?
Renal cell cancer begins in the lining of the small tubes within the kidney. It is often found by chance when an ultrasound or CT scan is done for another reason. When detected early and confined to the kidney, it can often be treated effectively.
Because treatment frequently involves removing all or part of a kidney, the long-term health of the remaining kidney tissue becomes an important consideration.
Risk Factors
The exact cause is not always known, but certain factors may increase risk.
- Smoking
- Obesity
- High blood pressure
- Long-term dialysis and acquired cystic kidney disease
- Family history and certain inherited syndromes, such as von Hippel-Lindau disease
- Older age and male sex
Symptoms
Many early kidney cancers cause no symptoms. When symptoms occur, they may include the following, which should always be checked by a doctor.
- Blood in the urine
- Pain in the side or lower back that does not go away
- A lump in the abdomen or side
- Unexplained weight loss, fever or tiredness
- Anaemia or high calcium on blood tests
Diagnosis
Diagnosis usually relies on imaging such as ultrasound, CT or MRI, sometimes followed by a biopsy. Blood and urine tests assess overall kidney function, which helps the urology and oncology teams plan treatment. If kidney function is already reduced, the nephrologist may advise on precautions for contrast scans.
Treatment and the Role of the Nephrologist
Cancer treatment is decided by the urologist and oncologist and may include partial or complete removal of the kidney, ablation, active surveillance of small tumours, or targeted and immunotherapy medicines for advanced disease. The nephrologist works alongside them to look after kidney health.
After treatment, the urology and oncology team will arrange scans to watch for any return of the cancer, while the nephrologist monitors kidney function and blood pressure. Simple steps such as avoiding smoking, keeping a healthy weight, controlling blood sugar and blood pressure, and checking with your doctor before taking painkillers or herbal remedies can help protect the remaining kidney tissue over the years.
- Assessing kidney function before surgery to help plan kidney-sparing approaches where suitable
- Managing blood pressure, protein in the urine and chronic kidney disease after surgery
- Monitoring kidney side effects of targeted therapy and immunotherapy
- Adjusting medicine doses for kidney function
- Planning dialysis or transplant evaluation if kidney function becomes severely reduced
- Long-term follow-up for people living with one kidney
When to See a Nephrologist
A nephrologist review may be helpful if you have been diagnosed with kidney cancer and already have reduced kidney function, diabetes or high blood pressure, if you have had a kidney removed, or if your creatinine rises during cancer treatment.
Frequently Asked Questions
Can I live normally with one kidney after surgery?
Many people live healthy lives with one kidney. Regular checks of blood pressure, kidney function and urine protein are advisable to protect the remaining kidney.
Does a nephrologist treat kidney cancer?
The cancer is treated by urologists and oncologists. The nephrologist focuses on preserving kidney function and managing kidney-related complications as part of the team.
Why might my doctors prefer partial removal of the kidney?
When it is safe from a cancer perspective, removing only the tumour may help preserve more kidney function. The surgical team decides based on the size and location of the tumour.
Can cancer medicines affect my kidneys?
Some targeted therapies and immunotherapies may cause high blood pressure, protein in the urine or kidney inflammation. Regular monitoring helps detect these early.
Consult Dr. Satarupa Deb
If you have been diagnosed with renal cell cancer and want to protect your kidney health, book a consultation with Dr. Satarupa Deb at Bombay Hospital, South Mumbai, who works alongside your urology and oncology team.
This page is for general information only and is not a substitute for a medical consultation. Please consult a qualified doctor for diagnosis and treatment.