Page last updated: December 2024
The information on this webpage was adapted from Understanding Kidney Cancer - A guide for people with cancer, their families and friends (2024 edition). This webpage was last updated in December 2024.
Expert content reviewers:
This information was developed based on international clinical practice guidelines, and with the help of a range of health professionals and people affected by kidney cancer:
- Dr Alarick Picardo, Urologist, Fiona Stanley Hospital, WA
- Heidi Castleden, Consumer
- Donna Clifford, Urology Nurse Practitioner, Royal Adelaide Hospital, SA
- Mike Kingsley, Consumer
- Prof Paul De Souza, Medical Oncologist and Professor of Medicine, Nepean Cancer Care Centre, The University of Sydney, NSW
- Prof Declan Murphy, Urologist and Director of Genitourinary Oncology, Peter MacCallum Cancer Centre, VIC
- Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA
- Luke O’Connor, Urology Nurse, Royal Brisbane and Women’s Hospital, QLD
- A/Prof Shankar Siva, Radiation Oncologist and Cancer Council Victoria Colebatch Fellow, Peter MacCallum Cancer Centre, VIC
- A/Prof Homi Zargar, Uro-Oncologist and Robotic Surgeon, Western Health and Royal Melbourne Hospital, VIC
The kidneys
The kidneys are two bean-shaped organs, each about the size of a fist. They are found deep inside your abdomen (belly), positioned near the middle of your back, on either side of the spine.
The kidneys are part of the body’s urinary system, which also includes the:
- ureters – tubes that take urine from the kidneys to the bladder
- bladder – a hollow sac that stores urine (wee) until you need to urinate
- urethra – a tube that takes urine from the bladder to outside the body.
An adrenal gland sits above each kidney. The adrenal glands produce a number of hormones. Although these glands are not part of the urinary system, kidney cancer can sometimes spread to them.
What the kidneys do
- Filter blood – The main role of the kidneys is to filter and clean the blood. Blood flows through the renal artery into each kidney, where it is filtered through tiny networks of tubes called nephrons. The clean blood then flows out through the renal vein to the rest of the body.
- Make urine – When the kidneys filter the blood, they remove excess water and waste products to make urine (wee or pee). The urine collects in an area of each kidney called the renal pelvis, and then flows through the ureters into the bladder.
- Produce hormones – The kidneys also help your body control how much blood it needs. They do this by making hormones that regulate blood pressure and trigger the production of red blood cells.
“Kidney cancer can be a silent cancer until it is quite advanced, so I do feel thankful that it was discovered incidentally, when it was small and easier to treat.” Chris
Types of kidney cancer
Kidney cancer is cancer that starts in the cells of the kidney. Most kidney cancers are renal cell carcinoma (RCC), sometimes called renal cell adenocarcinoma. RCCs start in the cells lining the tiny tubes found in the nephrons.
In the early stages of RCC, the tumour is in the kidney only. Usually one kidney is affected, but in rare cases there is a tumour in both kidneys.
As the cancer grows, it can spread to areas near the kidney, such as the surrounding fatty tissue, veins, adrenal glands, lymph nodes, ureters or the liver. It may also spread to other parts of the body, such as the lungs, bones or brain.
Subtypes of RCC
There are several subtypes of RCC:
- Clear cell (about 80% of RCC cases) – cancer cells look empty or clear
- Papillary (about 10-15% of RCC cases) – cancer cells are arranged in finger-like fronds
- Chromophobe (about 5% of RCC cases) – cancer cells are large and pale
- Other types of RCC (about 5-10% of RCC cases) – including renal medullary carcinoma, collecting duct carcinoma, MiT family translocation RCC, sarcomatoid RCC and other very rare types.
Other types of kidney cancer
RCC is the most common type of kidney cancer, but there are other less common types:
- Urothelial carcinoma (or transitional cell carcinoma) – this can begin in the ureter or in the renal pelvis, where the kidney and ureter meet. It is also known as upper tract urothelial cancer.
- Wilms tumour (or nephroblastoma) – this type of kidney cancer is most common in younger children, but it is still rare.
- Secondary cancer – very rarely, cancer can spread from a primary cancer somewhere else in the body to the kidney. This is known as secondary cancer (metastasis). This secondary cancer is not kidney cancer and it behaves more like the primary cancer.
How common is kidney cancer?
Each year about 4700 Australians are diagnosed with kidney cancer. Men are twice as likely as women to be diagnosed with kidney cancer.
It is the sixth most common cancer in men and the tenth most common cancer in women (excluding non-melanoma skin cancers). It is more common in people over 50, but it can occur at any age.
Learn more
Symptoms
Most people with kidney cancer have no symptoms and many are diagnosed with the disease when they see a doctor for an unrelated reason. Kidney cancer signs usually include:
- blood in the urine (haematuria) or a change in urine colour – it may look red, dark, rusty or brown
- pain in the lower back or side not caused by injury
- a lump in the side or abdomen (belly)
- constant tiredness
- unexplained weight loss
- fever (not caused by a cold or flu).
Cancer can affect the amount of hormones produced by the kidneys. If this affects blood production, it can lead to a low red blood cell count (anaemia), a high red blood cell count (polycythaemia) or high levels of calcium in the blood (hypercalcaemia).
Sometimes, these problems can cause symptoms such as fatigue, dizziness, headaches, constipation, abdominal (belly) pain and depression.
These symptoms can also occur with other illnesses, so they don’t necessarily mean you have kidney cancer – only testing can confirm a diagnosis. If you are concerned, make an appointment with your general practitioner (GP).
Risk factors
The exact cause of kidney cancer is not known. Research shows that people with certain risk factors are more likely to develop kidney cancer.
Having a risk factor does not mean you will develop kidney cancer, and some people develop kidney cancer without having any known risk factors. If you are concerned, talk to your doctor.
Risk factors for kidney cancer include:
- smoking – people who smoke have almost twice the risk of developing kidney cancer as those who don’t smoke. About 1 in 3 kidney cancers are thought to be related to smoking; the longer a person smokes and the more they smoke, the greater the risk
- obesity – too much body fat may cause changes to some hormones that can lead to kidney cancer
- high blood pressure – whatever the cause, high blood pressure increases the risk of kidney cancer
- kidney failure – people with end-stage kidney disease have a higher risk of developing kidney cancer
- family history – people with a parent, brother or sister (first-degree relative) with kidney cancer are at increased risk
- inherited conditions – about 2–3% of kidney cancers develop in people who have particular inherited syndromes, including von Hippel–Lindau disease, Birt-Hogg–Dubé syndrome, hereditary papillary RCC, hereditary leiomyomatosis RCC, tuberous sclerosis, and Lynch syndrome.
If you are worried about your family history or whether you have inherited a particular syndrome, talk to your doctor about having regular check-ups or ask for a referral to a family cancer clinic.
Contact cancer support
Health professionals
Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist such as a urologist, who will arrange further tests.
If kidney cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting.
During and after treatment, you will see a range of health professionals who specialise in different aspects of your care, which may include a nephrologist, radiologist, dietician and physiotherapist, among others.
