Kidney cancer is a type of genitourinary cancer. It starts when cells in your kidneys grow out of control. Your kidneys sit in the middle of your torso, behind other organs.

Most people have 2 kidneys—one right and one left—and each works on its own. So, your body can still work well if you need one removed.

The kidneys are the beginning of the body's urinary system. They filter wastes from your blood and extra fluid from your body.

The kidneys also make hormones, help control blood pressure, regulate red blood cell production, and keep steady pH levels in your body. They also create an active form of vitamin D needed to build strong bones.

Kidney cancers can develop in different parts of the kidney and in different age groups. Understanding the type of kidney cancer you have helps guide treatment and follow-up care.

Wilms tumors

Our pediatric cancer team treats kidney cancers that are more likely to occur in children, such as Wilms tumors. Also called nephroblastoma, Wilms is the most common type of kidney cancer in children. Typically affects one or both kidneys in kids under age 5.

Renal cell carcinoma

Renal cell carcinoma (RCC) accounts for 9 out of 10 kidney cancers in adults. RCC starts in cells that line the tubules, the structures in the kidney that filter blood and create urine. 

Doctors classify the RCC subtypes based on the cells' appearance under a microscope.

• The most common subtype is clear cell RCC, where the cells look clear or very pale.
• Non-clear cell RCC are darker under the microscope. Some subtypes have finger-like projections (papillary renal cell carcinoma) or other unique features.

Urothelial carcinoma

Urothelial carcinoma (UCC) starts in the cells that line the kidney drainage system and drainage tube that drains urine from the kidney to the bladder. This drainage tube is called the ureter. Urothelial cells form the lining for the drainage system from the kidney to the bladder.

Because the cancer is located in the drainage system of the kidney and not the kidney tissue itself, the diagnosis process and treatment options are very different for UCC compared to RCC.

Survival rates and treatment options for kidney cancer vary depending on the type and whether it has spread. Cure rates for RCC are very high since most of the time we find kidney cancer early.

Since your cancer type and stage may differ from someone else's, we help you decide what treatment options may work best for you and your kidney health.

Cancer surgery

For many people, surgery is the only treatment needed. Surgeons who treat this condition are urologists—experts in the urinary tract—and you’ll likely have one on your care team.

At Carilion, we use minimally invasive techniques whenever possible. These include small, pen-shaped tools that allow surgeons to reach and remove tumors through smaller incisions. We may also use robotic-assisted surgery, such as the da Vinci system, along with advanced imaging to precisely target tumors.

Your urologist will recommend removing either the entire kidney (radical nephrectomy) or part of the kidney (partial nephrectomy), depending on your situation. They may also remove nearby lymph nodes to check whether the cancer has spread. Your care team will walk you through your options and help you choose the approach that’s right for you.

If the cancer has spread, we may also recommend surgery to remove tumors in other parts of the body, such as the lungs, liver, or bones.

Ablation therapy

Removing the cancerous tumors is the best way to cure kidney cancer. However, for people who have other serious health problems, surgery may not be the best option.

Instead, we can treat small tumors using ablation therapy to destroy cancer cells. Ablation means a procedure that destroy one tumor at a time, usually using radiofrequency or ice.

Radiation therapy

We use high-energy rays to target and kill cancer cells. We aim the radiation at the cancer cells to stop their growth and potentially destroy the tumor. Sophisticated machinery, scanners, and molding devices ensure the cancer is the target, not the surrounding healthy cells.

For kidney cancer, we use stereotactic body radiation therapy. This is an advanced type of external beam radiation therapy. A machine outside the body delivers the radiation to the kidney area.

Cancer medicines

Working with a medical oncologist, we create a plan tailored to each person with kidney cancer.

Cancer drugs travel through the body to kill or control the growth or spread of cancer cells. These medicines can also stop cancer from coming back. 

Types of cancer medicines include:

• Targeted therapy: Some cancer cells have a target that we can use to kill the cancer cells and leave healthy cells relatively untouched. If your cancer has these targets, we may be able to use targeted therapies.
• Immunotherapy: Medicines that boost your immune system to attack cancer cells.
• Non-targeted therapy: Medicines like chemotherapy kill rapidly growing cells. Chemo doesn't work well for most kidney cancers. It may be an option for less common types, such as renal medullary carcinoma.

Active surveillance

Sometimes, kidney tumors are benign, meaning they’re not cancer. Other times, doctors find small kidney cancers in an elderly, frail, or seriously ill person. 

A cautious “active surveillance” approach may be better than aggressive treatment in these cases. You’ll have regular checks to see if the cancer is growing. Your team can help with this challenging decision. 

Clinical trials 

At Carilion, we partner with Blue Ridge Cancer Care and the Massey Cancer Center at Virginia Commonwealth University. Together, we can help you access clinical trials for kidney cancer when that's the best option.