Kidney cancer prognosis: What you need to know
The kidneys filter the blood, remove unwanted substances from the body, help manage blood pressure, and make sure the body has enough red blood cells.
A person can live with one kidney, but if both kidneys stop working, this will have a severe impact on the body.
Often, a person will not have any early signs of kidney cancer. The sooner they notice any changes, the better their prognosis is likely to be. If cancer spreads beyond the kidneys, it becomes harder to treat.
In 2019, the American Cancer Society predict that around 73,820 people will receive a diagnosis of kidney cancer, and about 14,770 people will die as a result of this cancer. The average age at diagnosis is 64 years. It is rare for a person to develop kidney cancer before the age of 45, although some types can affect younger people.
This article covers diagnosis, the stages of the disease, 5-year survival rates, and some tips for living with kidney cancer.
A doctor will do a series of tests to diagnose kidney cancer.
A person may find out they have kidney cancer if they go to a doctor with:
- blood in the urine
- lower back pain
- a lump on the side or lower back
- reduced appetite and weight loss
- a fever
The doctor will ask about other symptoms and the individual's personal and family history. They will also carry out a physical examination.
The doctor will do a range of tests to find out what is causing the problem. Some people find they have kidney cancer during a routine exam.
The doctor may recommend the following tests:
Urinalysis: A lab test will look for blood or cancer cells in the urine.
Blood tests: A complete blood count (CBC) will check the levels of red and white blood cells and platelets. Low levels of red blood cells may indicate anemia, which is a sign of kidney cancer. Other blood tests may give clues about kidney and liver function. They can also check for the levels of certain chemicals, such as calcium and sodium.
Imaging tests: A CT, MRI, or ultrasound scan can reveal whether a tumor or other changes are present. An X-ray can show if cancer is present in the lungs or other areas. Angiography is a type of scan that involves injecting dye to assess kidney function.
Biopsy: If a doctor suspects cancer, they may recommend a kidney biopsy, which involves taking a small tissue sample for testing in a laboratory. Learn more here about what to expect during a biopsy.
These tests can help work out the type, grade, and stage of cancer. These factors will help the doctor make a prognosis.
When doctors diagnose cancer, they work out the stage that the cancer has reached; in other words, how far advanced it is and to what extent it is affecting the body.
This determines treatment options and prognosis.
The ACS describe the stages of kidney cancer as follows:
Localized (includes stage 1 and 2): When the tumor is in the original location
Regional (includes stage 3 and some stage 4): When it has spread to nearby areas, such as lymph nodes
Distant (includes most stage 4): When it has reached other parts of the body, such as the lungs or liver.
Localized, or early stage, cancer is easier for doctors to treat and usually has a better outcome. Around 66% of people with kidney cancer receive a diagnosis at this stage.
What is chronic kidney disease? Learn more here.
The type of kidney cancer a person has can affect the outlook, as some are more aggressive than others.
Renal cell carcinoma
The type of kidney cancer can affect the prognosis.
Around 90% of people with kidney cancer will have renal cell carcinoma. This usually grows as a single tumor in one kidney.
There are several types of renal cell carcinoma.
The main types are:
Clear cell carcinoma: This is the most common type, accounting for 70–75% of renal cell carcinomas.
Papillary renal cell carcinoma: Around 10% of renal cell carcinomas are of this type.
Chromophobe renal cell carcinoma: This accounts for around 5% of cases.
Of these three types, clear cell carcinoma has the worst prognosis, and chromophobe renal cell carcinoma the best, with only 7% of cases going on to affect more distant parts of the body.
There are also several other types of kidney cancer.
Transitional cell carcinoma: These start in the area where the kidneys meet the ureters. Around 5–10% are this type.
Wilms tumor: Also known as nephroblastoma, these usually affect children.
Renal sarcoma: These start in the blood vessels or connective tissue of the kidney an account for around 1% of cases.
Collecting duct carcinoma and renal medullary carcinoma are aggressive types of kidney cancer, which doctors find challenging to treat. People with these types of cancer may have a poorer prognosis than people with other types.
Doctors also talk about high- and low-grade cancers. High-grade cancers are more likely to spread. A person with low-grade cancer may have a better outlook.
5-year survival rate
Statistics show that from 2008–2014, people with a kidney cancer diagnosis had the following chances of surviving at least another 5 years.
- Localized: 93%
- Regional: 69%
- Distant: 12%
- Overall, for all stages: 75%
It is worth noting that:
- Many people survived longer than 5 years.
- Medical advances mean that since experts gathered these statistics, the chance of survival is likely to have risen.
- The risk will vary between individuals, and a range of factors can affect it.
However, the sooner a person has a diagnosis and starts treatment, the better the outlook is likely to be.
Factors affecting outlook
A person's overall health may impact on their outlook.
Several factors can impact the outlook for an individual, including:
- overall health and other conditions they may have
- family history
- if this is the first diagnosis or a recurrence
- the type of cancer and how it responds to treatment
Tips for managing
Some people with kidney cancer will have complete remission. However, this is not always possible.
The Kidney Cancer Association suggest the following tips for living with kidney cancer during and after treatment:
Follow a healthful diet and maintain a suitable weight, as these can improve overall health.
Avoid using any supplements or alternative therapies without first discussing it with a doctor, as some of these may cause serious harm to the body.
Quit smoking, if applicable. Smoking is a risk factor for kidney cancer.
Exercise to reduce stress levels, boost overall health, and enhance recovery after treatment.
Talk to friends and loved ones about kidney cancer and its effects. The better they understand, the more appropriate support they can offer.
Check early with your insurance provider about the kind of care they will cover.
Will a kidney transplant help a person with kidney cancer?
If kidney cancer treatment involves the removal of all or part of the kidney, and the other kidney is not working well enough to clean your blood, then dialysis or a kidney transplant becomes part of your treatment. It may help, but typically, at this stage, the person may have complications of end-stage renal disease (ESRD) or kidney failure from complications of their cancer.
Speak to an oncologist about the stage of your cancer, treatment course, and the quality of life you want to have if you are considering a kidney transplant.Christina Chun, MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.