Renal cell cancer is a disease in which malignant  cells form in tubules of the kidney.
Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney. There are 2 kidneys, one on each side of the backbone, above the waist. The tiny tubules in the kidneys filter and clean the blood, taking out waste products and making urine. The urine passes from each kidney into the bladder through a long tube called a ureter. The bladder stores the urine until it is passed from the body.

Cancer that starts in the ureters or the renal pelvis (the part of the kidney that collects urine and drains it to the ureters) is different from renal cell cancer.

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer.

Risk factors include the following:

Being a smoker.
Misusing certain pain medicines, including over-the-counter pain medicines, for a long  time.
Having certain genetic conditions, such as von Hippel-Lindau disease or hereditary papillary renal cell carcinoma.
Possible signs of renal cell cancer include blood in the urine and a lump in the abdomen.
These and other symptoms may be caused by renal cell cancer or by other conditions.

There may be no symptoms in the early stages. Symptoms may appear as the tumour grows. A doctor should be consulted if any of the following problems occur:

Blood in the urine.
A lump in the abdomen.
A pain in the side that doesn't go away.
Loss of appetite.
Weight loss for no known reason.
Anaemia.
Tests that examine the abdomen and kidneys are used to detect (find) and diagnose renal cell cancer

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.

Urinalysis: A test to check the colour of urine and its contents, such as sugar, protein, blood, and bacteria.

Liver function test: A procedure in which a sample of blood is checked to measure the amounts of enzymes released into it by the liver. An abnormal amount of an enzyme can be a sign that cancer has spread to the liver. Certain conditions that are not cancer may also increase liver enzyme levels.

Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to check for cancer. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.

Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. A thin needle is inserted into the tumour and a sample of tissue is withdrawn. A pathologist then views the tissueunder a microscope to check for cancer cells.

The prognosis  and treatment options depend on the following:

The stage of the disease.

The patient's age and general health.

After renal cell cancer has been diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other parts of the body.
The process used to find out if cancer has spread within the kidney or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

The following stages are used for renal cell cancer:
Stage I
In stage I, the tumour is no larger than 7 centimetres and is found in the kidney only.

Stage II
In stage II, the tumour is larger than 7 centimetres and is found in the kidney only.

Stage III
In stage III, cancer is found:

in the kidney and in 1 nearby lymph node; or
in an adrenal gland or in the layer of fatty tissue around the kidney, and may be found in 1 nearby lymph node; or
in the main blood vessels of the kidney and may be found in 1 nearby lymph node.
Stage IV
In stage IV, cancer has spread:

beyond the layer of fatty tissue around the kidney and may be found in 1 nearby lymph node; or to 2 or more nearby lymph nodes; or to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes.

Four types of standard treatment are used:

Surgery
Surgery to remove part or all of the kidney is often used to treat renal cell cancer. The following types of surgery may be used:

Partial nephrectomy: A surgical procedure to remove the cancer within the kidney and some of the tissue around it. A partial nephrectomy may be done to prevent loss of kidney function when the other kidney is damaged or has already been removed.
Simple nephrectomy: A surgical procedure to remove the kidney only.
Radical nephrectomy: A surgical procedure to remove the kidney, the adrenal gland, surrounding tissue, and, usually, nearby lymph nodes.
A person can live with part of 1 working kidney, but if both kidneys are removed or not working, the person will need dialysis (a procedure to clean the blood using a machine outside of the body) or a kidney transplant (replacement with a healthy donated kidney). A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given as needed.

When surgery to remove the cancer is not possible, a treatment called arterial embolization may be used to shrink the tumour. A small incision is made and a catheter (thin tube) is inserted into the main blood vessel that flows to the kidney. Small pieces of a special gelatine sponge are injected through the catheter into the blood vessel. The sponges block the blood flow to the kidney and prevent the cancer cells from getting oxygen and other substances they need to grow.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are 2 types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, a body cavity such as the abdomen, or an organ, the drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defences against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

Other types of treatment are being tested in clinical trials. These include the following:
Stem cell transplantation
Stem cells (immature blood cells) are removed from the blood or bone marrow of a donor and given to the patient through an infusion. These re-infused stem cells grow into (and restore) the body's blood cells.

Treatment Options by Stage
Stage I Renal Cell Cancer
Standard treatment of stage I renal cell cancer may include the following:

Surgery (radical nephrectomy, simple nephrectomy, or partial nephrectomy).
Radiation therapy as palliative therapy to relieve symptoms in patients who cannot have surgery.
Arterial embolization, as palliative therapy.

Stage II Renal Cell Cancer
Standard treatment of stage II renal cell cancer may include the following:

Surgery (radical nephrectomy or partial nephrectomy).
Surgery (nephrectomy), before or after radiation therapy.
Radiation therapy as palliative therapy to relieve symptoms in patients who cannot have surgery.
Arterial embolization, as palliative therapy.
New treatments for stage II renal cell cancer are being studied in clinical trials. Information about these and other ongoing clinical trials is available from the NCI Cancer.gov Web site.

Stage III Renal Cell Cancer
Standard treatment of stage III renal cell cancer may include the following:

Surgery (radical nephrectomy). Blood vessels of the kidney and some lymph nodes may also be removed.
Arterial embolization followed by surgery (radical nephrectomy).
Radiation therapy, as palliative treatment to relieve symptoms and improve the quality of life.
Arterial embolization, as palliative therapy.
Surgery (nephrectomy), as palliative treatment.
Radiation therapy before or after surgery (radical nephrectomy).
One of the treatments being studied in clinical trials for stage III renal cell cancer is biologic therapy following surgery.

Stage IV Renal Cell Cancer
Standard treatment of stage IV renal cell cancer may include the following:

Biologic therapy.
Radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.
Surgery (nephrectomy), as palliative treatment.
Surgery (radical nephrectomy, with or without removal of cancer from other areas where it has spread).
New treatments for stage IV renal cell cancer are being studied in clinical trials.

Treatment Options for Recurrent Renal Cell Cancer
Standard treatment of recurrent renal cell cancer may include the following:

Biologic therapy.
Radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.
Chemotherapy.
 

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