Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults.
Typically, twenty-five to thirty percent of patients are asymptomatic and the carcinoma is detected accidentally. Some of the symptoms that patients might complain about, although not common and usually indicative of advanced stages are:
Less common symptoms may include:
Renal cell carcinoma is a challenging and unique tumor because of the occurrence of paraneoplastic syndromes. The workup for RCC should also include laboratory tests for these paraneoplastic syndromes .
The use of imaging modalities is helpful in the evaluation of the renal mass. These include:
Differentiating a non-malignant and malignant renal mass can be difficult. Typically, when a patient presents for a physical examination for possible RCC it is most likely in the metastatic stage. The physical exam should pay close attention to the:
Some of the laboratory testing should include, but not limited to:
More than 50% of patients who are diagnosed with RCC in the early stages are cured. The approach of treatment is determined by the size and stage of the tumor. The primary care physician should review the patient’s current health status, renal function, oncologic issues and complication risks .
The main treatments available for renal cell carcinoma are:
Experimental therapies include:
There are studies available for those patients who may qualify. One such study ARGOS, ADAPT Phase 3, is a worldwide randomized study to examine their product to extend the survival rate of early diagnosed renal cell carcinoma patients .
RCC is the tenth leading cause of death in males. The rate of complications, transfusions, and in-hospital mortality is higher in patients treated with cytoreductive nephrectomy than in those who underwent nephrectomy. Risk is further increased in patients who are older, have higher comorbidity, or need secondary surgical procedures. A study by Heng et al found that progression-free survival at 3 and 6 months predicted overall survival among patients with metastatic renal cell carcinoma. The survival rate depends on if the cancer has already metastasized outside of the kidney and how well the patient tolerates the course of treatment. If RCC is diagnosed in the early stages the prognosis is good.
The following are factors associated with increased survival in patients with metastatic disease:
Renal cell carcinoma varies widely globally with the highest rates being in the North America and the Czech Republic . In the United States alone, there are 64,000 new cases and approximately 14,000 deaths per year . RCC is the seventh most common cancer in males. Statistics show that 50% of those with RCC die within 5 years after diagnosis  .
Gender and age
Renal cell carcinoma is 50% more prevalent in males than females. RCC most often occurs between 60 to 80 years of age with the median age being 64 .
The origin of renal cell carcinoma is in the proximal renal tubular epithelium. There are four hereditary syndromes that are associated with renal cell carcinoma :
Although there are no set prevention methods, avoiding causative factors can be helpful. Some of these factors include smoking, obesity, occupational and environmental exposures to toxic chemicals. Patients with acquired renal cystic disease undergoing long term dialysis or renal transplant, and patients with chronic hepatitis C should take precautions and report unusual symptoms such as blood in the urine, pain on urination or any of the other mentioned symptoms.
Renal cell carcinoma (RCC) is accountable for 80-85 percent of all primary renal neoplasms. There may be multiple tumors in one kidney or there could be tumors in both kidneys. This type of renal cancer is seen most frequently. There are several histologic subtypes of RCC. Knowing the type of cell will decide the type of treatment. It is also helpful to determine if it is an inherited genetic syndrome.
The subtypes are  :
Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults accounting for 95% of renal tumors.
Patients at risk should be precautious and report unusual symptoms such as blood in the urine, flank pain or a palpable mass in the abdomen or flank.
Diagnosis is generally by combination of physical examination, Laboratory tests and Imaging. Imaging forms an important part to know the spread, and to plan the treatment.
Most of the early cases are cured. The treatment varies depending on the stage of the disease.