Patient Education

The kidneys are two bean-shaped organs located just below the rib cage, one on each side of your spine. Healthy kidneys filter blood to remove waste and extra water to make urine.

Kidney cancer, also known as renal cell carcinoma or RCC, is a disease in which malignant (cancer) cells form in the tubules of the kidney. It means the healthy kidney cells in one or both kidneys grow out of control.

In Singapore, it accounts for 1-2 per cent of all cancers or approximately 2.4 and 1.3 of every 100,000 men and women respectively. The condition mostly affects the elderly above 65 years old. Kidney cancer is not common in people younger than age 45

The prevalence of this disease has been rising in recent years at an annual rate of approximately 2-3 per cent.

Here are the 5 things you should know about kidney cancers.

1. Renal cell carcinoma (RCC) is the most common type of kidney cancer, with about 9 in 10 kidney cancers classified as such. There are several subtypes of RCC. Hereditary kidney cancer is rare and it only occurs in a small subset of patients (less than 5 per cent of the total) due to the presence of faulty genes.

2. Early kidney cancer often does not show symptoms.
Although symptoms may not show at first, there are some signs that should prompt you to see a doctor such as blood in the urine, pain in the side that does not go away, a mass on the side or lower back, tiredness, unexplained weight loss, a fever, and swelling of the ankles and legs. People with these symptoms should tell their doctor so that any problem can be diagnosed and treated as early as possible. Early kidney cancer has very high cure rate of 93% 5 year-survival rate.

3. Risk factors for developing kidney cancer
Risk factors for developing kidney cancer include smoking tobacco, obesity, high blood pressure and people who receive long-term dialysis to treat chronic kidney failure. Additionally, if someone in your family is known to have had kidney cancer, the chances for developing kidney cancer are greater.

4. Treatment options and recommendations
There are many treatment options available for patients with RCC.
The treatment options for early kidney cancer may include: surgery, radiofrequency ablation which uses thermal energy to destroy tumour cells.
Treatment options for advanced kidney cancer meaning the cancer has spread to other parts of the body, may include surgery to remove the kidney in combination with systemic therapy. Systemic therapy includes targeted therapy and immunotherapy.
The oncologist will help advise the treatment that is best for you based on the size of the tumour and whether or not it has spread outside the kidney.

5. Active surveillance to protect the remaining healthy kidney is very important

Rarely, people get cancer in both kidneys.

One good kidney is enough to lead a normal life, most people with one kidney removed do not end up with kidney failure requiring dialysis.

Once you've had cancer in one kidney, there is a slightly increased chance of getting cancer in the other kidney.

Post kidney cancer treatment, typically the oncologist suggests imaging every three to six months for two years then every six to 12 months annually. The initial evaluation should include a complete staging evaluation (bloodwork, chest/abdomen/pelvis imaging) to exclude the possibility that the disease has already spread and give a thorough surveillance on the remaining healthy kidney. CT or MRI for the initial evaluation and then alternate between CT, MRI, and ultrasound to minimize radiation exposure to the patient and to comprehensively evaluate the tumour. The exact protocol is customized to each patient.

Your oncologist will also advise you on the risks of impaired kidney function depending on the presence of factors such as diabetes, high blood pressure and advanced age.

"Expert knowledge means better care for cancer"

Written by:
Dr Akhil Chopra
MBBS (Delhi)
American Board Certified (Intl Med)
American Board Certified (Hematology)
American Board Certified (Med Oncology)