GoodRx Guide
Renal Cell Carcinoma: Your GoodRx Guide
Comprehensive information for you or a loved one — including treatment options and discounts on popular medications.
Definition
Renal cell carcinoma is the most common type of kidney cancer. There are several types of renal cell carcinoma, including:
Clear cell (most common)
Non-clear cell (less common)
Papillary
Chromophobe
Medullary
Oncocytoma
Translocation
Collecting duct carcinoma
Other rare subtypes defined by certain mutations
Sarcomatoid (a more aggressive form of clear and non-clear cell renal cell carcinoma)
Renal cell carcinoma develops when cancer cells start to grow uncontrollably inside the kidney. The kidneys are part of the urinary tract. The kidneys have several important jobs, they:
Make urine and remove waste from the body
Make hormones that control blood pressure
Make hormones that control the production of red blood cells
Symptoms
Most people with early renal cell cancer don’t have any symptoms. But when the cancer grows and spreads, people start noticing changes like:
Flank (side) pain
Blood in the urine
A lump or mass in the abdomen or side
Scrotal swelling (varicocele)
Lower leg swelling
Fatigue or tiredness
Fevers
Diagnosis
An imaging study is the first step to diagnosing renal cell carcinoma. You may need a CT scan or an MRI of your abdomen and pelvis. You may also need imaging tests of other parts of your body, like your chest and brain. This is to look for cancer spread if you have an aggressive form of kidney cancer.
Many times, people find out by accident that they have kidney cancer. They may have an imaging study for another reason that shows a lump in their kidney. Others find out they have kidney cancer because they have concerning symptoms and an imaging study shows a lump in the kidney.
After finding a tumor, people meet with a specialist team for cancer staging.
You may need a biopsy of your tumor. This lets your team remove some tissue from the tumor and look at it under a microscope. They can also test your tumor for tumor markers. This information can help predict how your cancer will act over time.
Your team may also recommend more imaging studies like a bone scan or PET scan. These imaging tests look for evidence of cancer spread (metastasis).
After these steps, your team will be able to determine your cancer stage. A cancer stage is based on:
Tumor size
Spread to lymph nodes
Spread to other parts of the body
There are four stages for renal cell cancer. Stage 1 is the earliest and stage 4 is the most advanced.
Treatments
Treatment for renal cell carcinoma depends on the stage.
People with early-stage cancer can have surgery to remove the tumor and part or all of the kidney (radical or partial nephrectomy). Sometimes ablation therapies are used to remove small renal tumors. In these cases, surgery can cure kidney cancer. But people still need to follow up regularly over several years to make sure the cancer does not come back.
People with high-risk forms of kidney cancer or metastatic kidney cancer may need additional medications after surgery. This is adjuvant therapy, and it’s to lower the risk of cancer returning (relapse). Options include:
Pembrolizumab (Keytruda): This is an IV (intravenous) immunotherapy given every 3 to 6 weeks for a year. It can lower the risk of cancer returning.
Sunitinib: This is a pill that may also lower the risk of cancer returning.
It’s not yet clear if adjuvant therapy improves overall survival. Adjuvant therapy comes with risks, so the decision to use adjacent therapy is very personalized.
People with more advanced cancer receive additional treatment, including systemic therapy. If your cancer returns, you will also need systemic therapy.
Systemic therapy is a general term for medications that you receive by mouth or IV. There are two types of systemic therapy to treat kidney cancer:
Targeted therapy: These medications stop cancer cells from growing.
Immunotherapy: These medications help the immune system kill cancer cells.
Many new medications have been developed in the last 15 years. These medications may be given together or alone. These treatments are helping people with kidney cancer live longer.
Living
Receiving a cancer diagnosis is overwhelming. It can be hard to know what to do next.
But the first step in this journey is to find the right care team. Renal cell carcinoma is not a common type of cancer. So it’s especially important to find a team that has experience treating this condition. Start by calling your nearest National Cancer Institute (NCI) Designated Cancer Center.
It’s also helpful to create a support system. You can join a support group to help you navigate the experience and answer your questions. The Kidney Cancer Association also offers support groups for caregivers.
Finally, you’ll want a trusted source of information. The Kidney Cancer Association offers a patient liaison who can help answer questions. They also offer videos and articles on everything related to kidney cancer. And they have information on how to use complementary and alternative therapies.
Common concerns
Renal cell cancer tends to affect people as they get older. The average age for renal cell carcinoma diagnosis is 64 years old. Males are more likely than females to get a diagnosis of renal cell carcinoma.
People with a family history of certain cancers can be at risk of developing kidney cancer at younger ages. If you have a family history of cancer, talk with your healthcare provider about genetic testing. This testing can spot mutations (changes) that increase the risk of developing cancer.
Renal cell carcinoma is rare, so screening is not recommended for most people. But you may need screening for renal cell carcinoma if you have:
A genetic condition that increases your risk of renal cell carcinoma (like tuberous sclerosis or von Hippel-Lindau disease)
Advanced chronic kidney disease (also called end-stage renal disease)
A history of receiving kidney radiation
First-degree relatives who had renal cell carcinoma
This is a difficult question because the answer may be different from person to person. In fact, people with early kidney cancer usually live as long as they normally would because surgery can cure the cancer.
The average 5 year survival rate for renal cell carcinoma is 77%. But people with early renal cell carcinoma have a 5 year survival rate of 93%. People with more advanced renal cell carcinoma have lower 5 year survival rates. But recent advances in immunotherapies and targeted therapies have significantly improved survival rates.
Current survival rates are based on data that are several years old. They don’t yet account for the benefits of these newer therapies.
References
American Cancer Society. (2020). What is kidney cancer?
American Cancer Society. (2023). Survival rates for kidney cancer.
Garfield, K., et al. (2022). Renal cell cancer. StatPearls.
Kidney Cancer Association. (n.d.). Drug information.
Kidney Cancer Association. (n.d.). Find a specialist for an accurate diagnosis.
Kidney Cancer Association. (n.d.). Kidney Cancer Association virtual support groups.
Kidney Cancer Association. (n.d.). Step 5: Get support.
Kidney Cancer Association. (2023). Kidney cancer: Fast facts.
MedlinePlus. (n.d.). Renal cell carcinoma.
National Cancer Institute. (n.d.). Find a cancer center.
National Cancer Institute. (2023). Renal cell cancer treatment (physician data query®)–patient version.
National Comprehensive Cancer Network Guideline for Patients. (2022). Kidney cancer.
Smart Patients. (n.d.). Smart patients kidney cancer community.
