The kidneys are part of the urinary system. The kidneys filter the blood to remove excess water and waste products. These are then made into urine (pee).
Each year over 12500 people in the UK are diagnosed with kidney cancer. Kidney cancer usually only affect one kidney . It is very uncommon for cancer to be in both kidneys.
There are different types of kidney cancer. About 8 out of 10 (80%) kidney cancers are renal cell cancers (RCC). They start in the cortex of the kidney. Kidney cancer can also start in the ureter and renal pelvis but this is rare.
This information is about renal cell cancers. We have separate information about ureter and renal pelvis cancer.
Sometimes kidney cancer can spread to lymph nodes close to the kidney. Lymph nodes are part of the lymphatic system. The lymphatic system helps protect us from infection and disease.
Types of kidney cancer
There are different types of kidney cancer. About 8 out of 10 kidney cancers (80%) are renal cell cancers (RCC). They start in the cortex of the kidney.
There are different types of RCC. The most common type is clear cell renal cancer.
Less common types are:
- papillary renal cell cancer
- chromophobe renal cell cancer.
Kidney cancer can also start in the renal pelvis. This is usually a type of cancer called urothelial cancer or transitional cell carcinoma. We have separate information about the treatment of cancer in the renal pelvis.
Another rare type of kidney cancer is called collecting duct cancer (CDC). This cancer has features of both RCC and of urothelial cancer.
There are different types of RCC. The most common type is clear cell renal cancer.
The causes of kidney cancer are unknown. But there are certain things that can affect the chances of developing kidney cancer. These are called risk factors.
Having a risk factor does not mean you will definitely get kidney cancer. And if you do not have any risk factors, you may still develop kidney cancer.
We have more information about the causes and risk factors of kidney cancer.
Sometimes doctors see a possible kidney cancer when you are having a scan for another reason. You may not have any symptoms.
If you have symptoms, you usually start by seeing your GP. They will examine you and arrange for you to have some tests. They may test your pee (urine). They may also do blood tests to check:
- your general health
- the number of cells in your blood (full blood count)
- how well your liver and kidneys are working.
If your GP is not sure what the problem is, or they think your symptoms may be caused by kidney cancer, they usually refer you to the hospital to see a specialist doctor. This doctor is called a urologist.
If you have blood in your urine, you may be referred to a specialist clinic. This is called a haematuria clinic. These clinics can often do tests on the same day.
If your test results or symptoms suggest you may have kidney cancer, you should be seen by a specialist within 2 weeks.
Sometimes tests for kidney cancer find a kidney cyst. These are fluid-filled lumps. They are common and usually harmless. Your doctor may need to do further tests to check this is the case. Most cysts do not any need treatment or follow-up. But sometimes your doctor may recommend you have follow-up scans or treatment.
At the hospital
The urologist or specialist nurse will ask you about your symptoms and your general health. They will also examine you and arrange some of the following tests:
You will have blood samples taken. These help your doctors to check how well your kidneys and liver are working. They also show the number of blood cells in your blood. This is called a full blood count.
A CT scan takes a series of x-rays which create a three-dimensional (3D) picture of the inside of the body.
If doctors see a possible kidney cancer while doing a scan for another reason, they may request a CT scan to look at the kidneys. Your doctor or nurse may call this a triple-phase CT scan.
A flexible cystoscopy looks for changes inside the bladder. You may have this test if you have blood in the urine. You usually have this test under a local anaesthetic, so you are awake during it. Before the cystoscopy you are asked to give a sample of urine, which is checked for infection.
Waiting for test results can be a difficult time. We have more information that may help.
If tests show you are likely to have kidney cancer, your doctor may want to do some further tests.
These tests will give them more information about the size and position of the cancer and whether it has spread to other parts of the body. This is called staging and will help you and your doctor decide on the best treatment for you. These may include some of the following tests:
A biopsy is when a sample of tissue is taken from the body and tested for cancer cells. Usually, the sample is collected from an abnormal area of the kidney. But if doctors think that kidney cancer has spread to a different part of the body, the sample may be taken from there.
Not everyone will have a biopsy. The doctor may decide you need a biopsy to plan the treatment most suitable for you. The doctor uses an ultrasound scan or a CT scan to guide them to the area of kidney they want to take the biopsy from.
During a biopsy, the doctor injects some local anaesthetic into the skin to numb the area around the kidney. They then guide a needle through the skin into the kidney. They use the needle to take a small sample of tissue. They send the sample to the laboratory to be checked for cancer cells. If cancer is found, tests are used to find out more about the type and grade of kidney cancer.
You may need to stay in hospital for a few hours, or overnight, after a biopsy.
A CT scan takes a series of x-rays which create a three-dimensional (3D) picture of the inside of the body. You may have a CT scan of your chest, tummy (abdomen) and pelvis. This is usually done to see whether the cancer has spread outside of the kidney to other parts of your body.
Your cancer doctor uses information from your test results to advise on the best treatment for you. This information includes the type of kidney cancer you have and the stage and the grade.
The stage of the cancer describes its size and whether it has spread. The grade of the cancer gives an idea of how quickly the cancer might grow and spread.
We have more information about the staging and grading of kidney cancer.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
The treatment you will have depends on a number of factors, including the position, type, stage and grade of the cancer.
Your team will also consider:
- how well your kidneys work
- your general health
- your personal preferences.
Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.
You may have some treatments as part of a clinical trial.
This information is about treatment for a type of kidney cancer called renal cell cancer (RCC).
Monitoring a kidney cancer is way of delaying treatment until it is needed. It is sometimes called active surveillance. The main advantage of monitoring is that you can avoid the risks or side effects of treatment. You may be offered monitoring if you have very small, slow-growing kidney cancer. It is most likely to be offered to people who have health problems that would increase the risks of surgery.
Radiotherapy uses high-energy rays to destroy cancer cells. You may have radiotherapy to control kidney cancer that cannot be removed with surgery. Radiotherapy is also given to treat the symptoms of kidney cancer such as bleeding. It can also be used to treat kidney cancer cells that have spread to other parts of the body such as the lung, brain or bones.
After your treatment has finished, you will have regular check-ups with your cancer doctor, urologist or nurse. They will tell you how often and for how long you will need to have check-ups. This will depend on the type of treatment you had and the risk of the cancer coming back.
If you have advanced cancer, it will depend on any treatment you need to help control the cancer.
Some people will have regular blood tests and CT scans or chest x-rays to check for any signs of the cancer coming back. If cancer comes back in the kidney but nowhere else, it may be possible to have further surgery to remove it.
You can talk to your cancer doctor or specialist nurse about any problems or worries you have at these check-ups. But if you notice any new symptoms or have any problems between appointments, contact your cancer doctor or nurse for advice.
Many people feel anxious before their appointments. You may worry about the cancer coming back. This is natural. It can help to get support from family, friends or your specialist nurse.
You may get anxious between appointments. You may worry about the cancer coming back. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
- Call the Macmillan Support Line on 0808 808 00 00.
- Chat to our specialists online.
- Visit our kidney cancer forum to talk to people who have been affected by kidney cancer, share your experience, and ask an expert your questions.
Some other organisations, such as Kidney Cancer UK, also offer support to people affected by kidney cancer.
Well-being and recovery
After treatment, you may just want to get back to everyday life. But you may still be coping with the side effects of treatment or adjusting to physical changes. You may also be dealing with some difficult emotions. Recovery takes time, so do not rush. Try to be kind to yourself.
Some people choose to make lifestyle changes to improve their health and well-being. Even if you had a healthy lifestyle before cancer, you may be more focused on making the most of your health.
If you have health problems, such as kidney disease, it is important to check with your doctor before making any changes to your lifestyle or diet.
If you have had part or all of a kidney removed, it is a good idea to look after your remaining kidney or kidneys. Reducing your risk of high blood pressure, heart problems and diabetes will help protect the kidneys.
Below is a sample of the sources used in our kidney cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
Escudier B, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 30: 706-720, 2019. doi:10.1093/annonc/mdz056 Published online 21 February 2019. Available from www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2819%2931157-3 (accessed April 2021).
European Association of Urology. Renal cell carcinoma guidelines. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4. Available from www.uroweb.org/guideline/renal-cell-carcinoma (accessed April 2021).
National Institute for Health and Care Excellence (NICE): Nivolumab with ipilimumab for untreated advanced renal cell carcinoma. Technology appraisal guidance (TA581). Published 15 May 2019. Available from www.nice.org.uk/guidance/ta581 (accessed April 2021).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Lisa Pickering, Consultant Medical Oncologist.
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