Papillary renal cell carcinoma (PRCC) is a type of kidney cancer. It starts in the small tubes in the kidneys that filter waste from the blood. PRCC may be Type 1 or Type 2, which can affect the outlook.
PRCC starts in the tubules of the kidney. Tubules are very small tubes that filter waste products from the blood.
Renal cell carcinomas (RCC) account for about
PRCC is a non-clear cell renal carcinoma. The name refers to the small, finger-like shapes that grow in the tumors, called papillae.
PRCC may be Type 1 or Type 2. Type 1 is
PRCC is less common than clear cell renal cell carcinoma (ccRCC), which accounts for most renal cell carcinomas.
Some people may not experience symptoms in the early stages of PRCC. When symptoms do occur, they can be similar to those of other conditions.
A person should contact a doctor if they experience the following symptoms, which could indicate PRCC or other kidney conditions.
Symptoms of PRCC may include:
- a lump in the side
- blood in the urine
- pain in the side
- fatigue
- fever
- weight loss
- anemia
Risk factors that
- smoking tobacco
- excess body weight
- using certain pain medications, such as acetaminophen, for a long time
- high blood pressure
- a family history of kidney cancer
- advanced kidney disease
- certain inherited genetic conditions, such as hereditary papillary renal carcinoma, von Hippel-Lindau syndrome, and Cowden syndrome
- being exposed to certain chemicals in the workplace regularly, such as cadmium and trichloroethylene
A person cannot prevent PRCC, but they can take steps to reduce their controllable risk factors.
A doctor may first ask questions about a person’s symptoms and personal and family medical history, and perform a physical examination.
If a person has symptoms of PRCC, a doctor
- blood tests
- urine tests
- imaging scans, such as ultrasound, MRI, and CT scans
Treatment for PRCC can depend on various factors, including the type and stage of the cancer.
Treatment for PRCC
- Surgery: Surgeons may perform
- a partial nephrectomy to remove the cancer and some surrounding tissue
- a simple nephrectomy to remove the kidney
- a radical nephrectomy, to remove the kidney, adrenal gland, surrounding tissue, and lymph nodes
- Radiation therapy: Radiation therapy uses high-energy radiation to kill cancer cells and stop their growth.
- Targeted therapy: Targeted therapy uses targeted therapy drugs to identify and attack cancer cells.
- Immunotherapy: Immunotherapy drugs help a person’s immune system fight cancer cells.
- Chemotherapy: Chemotherapy drugs kill cancer cells and stop them from dividing. However, doctors
do not usually treat PRCC with chemotherapy.
Are there clinical trials exploring new treatments for PRCC?
Researchers are testing new types of treatment for PRCC in clinical trials.
A 2024 review of clinical trials suggests promising future treatments. These include a combination of the following therapies:
- MET TKIs: Mesenchymal epithelial transition factor receptor (MET) tyrosine kinase inhibitors (TKIs), such as cabozantinib (Cabometyx), are drugs that disrupt certain signaling pathways and stop activity on the MET gene. The MET gene is involved in cell growth. However, mutations in the gene can lead to the growth and spread of abnormal genes, which may result in cancer.
- Immune checkpoint inhibitor (ICI): ICIs are a newer type of therapy that helps the body’s immune system target and fight cancer cells.
- Vascular endothelial growth factor (VEGF) inhibitors: VEGF is a protein that can enable tumor growth. High levels of VEGF may be a biomarker for cancer. Drugs that inhibit VGEF work by blocking the protein or the protein receptors.
While the current research provides promising results, more evidence is necessary to confirm the safety and efficacy of using and combining these therapies to treat PRCC.
Is surgery always necessary for papillary renal cell carcinoma?
Doctors may not recommend surgery for everyone with PRCC. Although surgery is a common treatment for all types of RCC, it may not always be possible or the best course of action.
If the cancer has spread or surgery is not possible for another reason, doctors may consider other treatments instead. These can
- cryosurgery, in which a doctor uses an instrument to freeze and destroy cancerous tissue
- arterial embolization, a procedure in which a doctor inserts a substance into the blood vessel that flows to the kidney, preventing the cancer cells from receiving oxygen
- thermal ablation, or radiofrequency ablation, in which a doctor uses heat to destroy abnormal tissue
The outlook for PRCC depends on several factors, including the type and stage of cancer and a person’s overall health.
The more common Type 1 PRCC typically has a better outlook than Type 2, which is more aggressive.
In general, Type 1 PRCC may also have a better outlook than other types of RCC, especially with an early diagnosis.
According to the
- 93% for localized cancer, which has not spread beyond the kidney
- 75% for regional cancer, which has spread to nearby lymph nodes or structures
- 18% for distant cancer, which has spread to distant areas of the body
A person can live with one working kidney after surgery. However, if doctors need to remove both kidneys, or the remaining kidney does not function properly, they will require dialysis or a kidney transplant.
Papillary renal cell carcinoma (PRCC) starts in the kidneys’ tubules, which filter waste from the blood.
The treatment and outlook for PRCC can depend on the type and stage of the cancer and other factors.
Treatment typically involves surgery to remove part or all of the kidney, and therapies including radiation, targeted therapy, and immunotherapy. Clinical trials are currently exploring new treatments, with promising results.
The outlook is often positive for people with PRCC who receive an early diagnosis and treatment.