A patient-friendly overview on kidney cancer, or renal cancer, or renal cell carcinoma (RCC); including symptoms, causes and treatment alternatives - from cancer drugs, surgery, radiotherapy and chemotherapy to immunotherapy, virotherapy, ablation, cryoablation, off-label drugs and complementary therapies.
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Kidney Cancer
About 90% of kidney cancer or renal cancer first appears in the lining of the tubes inside the kidney, and this is called renal cell carcinoma, or RCC. Although most tumours can grow to quite a large size, and there may be more than one, spread outside the kidney to other organs is usually slow and symptoms tend to be seen well before this stage.
Kidney cancer accounts for 3 per cent of all UK cancers and has increased at around 2 per cent per year over the last 30 years. In the UK there are about 13,000 cases per year; in the USA this figure is 74,000. The average age at diagnosis is 64 according to the ACS.
Kidney cancer is twice as likely in males than females, possibly because they are more likely to smoke and work in toxic environments.
If the cancer is detected in its early stages, surgery or ablation may be enough to cure the cancer. They are used only when a tumour is confined to the kidney. Increasingly, ablation and immunotherapy is used in modern conventional treatment.
Your Kidneys
Two broad bean-shaped kidneys, each the size of a tennis ball, lie behind the intestines with one either side of the spine. A large renal artery takes blood to each, so that they can filter the blood, removing waste materials as urine, which passes down the ureter to the bladder, and from there down the urethra to the outside world.
The newly cleaned blood then passes through the renal vein and back to the heart.
The kidneys do not just clean your blood. They also produce certain hormones like calctriol (which helps regulate blood calcium levels), erythropoietin (which helps stimulate red cell production in the bone marrow) and rennin (which helps regulate blood pressure).
Obviously the filtration of toxins in the blood, lays the kidneys open to toxic damage.
The Causes of Kidney Cancer
There are several factors that appear to increase risks according to American Websites:
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Hereditary factors: For example conditions such as von Hippel-Lindau disease, Hereditary leiomyoma and hereditary papilliary renal carcinoma, Birt-Hogg-Dube (BHD) syndrome, .
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Cigarette smoking: Several studies have shown that long-term smoking doubles risk; and it is thought that one third of kidney cancers are associated with smoking.
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Being overweight: There seems a correlation that risk increases with excess weight, and especially obesity. This is probably due to hormone imbalances and the propensity of fat, which is an excellent solvent, to store toxins.
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High Blood Pressure: There is some indication of increased risk with hypertension and high blood pressure (1). Taking drugs such as Ramapril for over 5 years can also cause be a risk factor.
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Kidney diseases: People with kidney disease, especially those needing dialysis, have a higher risk of kidney cancer.
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Age: Most cases occur in the over 60s. The disease is rare before that age.
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Chemical Carcinogens: Chemicals such as asbestos, cadmium and lead are indicated, often from the workplace. Organic solvents and pesticides are appearing on the radar too. And working in the steel and coal industries has also been linked to an increased risk.
See - Cancer risk in the workplace
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Some Drugs: For example, some over-the-counter painkillers have been linked to increased risk, especially where they have been used long-term. In one large meta-analysis researchers found that acetaminophen and non-aspirin NSAIDs are associated with a significant risk of developing kidney cancer (2).
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Caffeine: Excess intake of caffeine has been linked to the disease.
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Yeasts, pathogens: There is a human genitourinary microbiome thsat links to the gut microbiome; and pathogens are now known to inhabit the urinary tract and the kidneys.
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One pathogen known to damage the kidneys is E coli (3).
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In one meta-analysis on diseased kidneys with or without kidney stones, pathogens were shown to be present, including Enterobacteriaceae, Streptococcaceae, Streptococcus and decreased abundances of helpful Prevotellaceae, Prevotella, Prevotella 9 and Roseburia (4).
Sugar has been shown to be a risk factor. Soft drinks and juice consumption heighten risk of renal cancer (5). Diabetes and poor sugar control are definitely risk factors (6).
There has been some discussion over a causal role for fat, red meat and processed foods, but research appearing n the December 3, 2008 issue of the Journal of the National Cancer Institute disproved this. Certainly, people with higher levels of blood fats are more likely to have metastases.
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Different types of Kidney Cancer
Kidney cell cancer is not a single disease but is in fact made up of a variety of cell types with differing clinical outcomes. A family history of kidney cancer increases risk of developing the disease, particularly among individuals who have a sibling diagnosed with kidney cancer.
Genetic, hereditary factors are important. In several cancers genetic predisposition can be influenced by chemical toxins (including hormones) and this is true for kidney cancer. For example, a faulty gene lies behind von Hippel-Lindau disease(VHL), Birt-Hogg-Dube (BHD) syndrome, hereditary papillary renal carcinoma (HPRC) and hereditary leiomyomatosis and renal cell cancer (HLRCC). Kidney cancers that develop because of inherited faulty genes are also more likely to happen at a younger age and are more likely to cause several tumours, which can affect both kidneys.
It is hoped that understanding the different forms of the disease will allow, eventually, for more targeted treatments.
By far the most common type of kidney cancer is renal cell carcinoma (RCC), which accounts for 90% of all kidney cancers. This is a cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products. Other forms you may have are renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects) or Wilms tumour, which is a type of kidney cancer that usually develops in children under the age of 5.
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Symptoms of Kidney cancer
- Blood in the urine this may be only occasional. However, blood in the urine does not mean you have cancer - it could be caused by inflammation, kidney stones or simple infections.
- Pain in the side or mid/lower back; a lump in the abdomen.
- Anaemia and tiredness.
- Fever/sweating.
- Sudden weight loss.
- Secondary hormone effects such as increased blood pressure, excess production of red blood cells, and increased blood calcium levels (resulting in thirst, sickness, tiredness, and constipation).
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Diagnosis of kidney cancer
Initially, blood tests, urine tests and liver function tests can be used. A painless ultrasound can usually detect a kidney cancer. Also an intravenous dye and then an X-Ray may be used.
If a kidney cancer is diagnosed, you will be sent for further tests to evaluate the aggressivity of the cancer (the Grade) and to see if it has spread (the Stage). Doctors need to know how much of the kidney is damaged, how many tumours there are, and if there is spread to adjacent lymph nodes or further afield. These tests can include:
CT (CAT) scans - where detailed pictures of areas inside the body, are taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.
MRI tests - (magnetic resonance imaging) where a magnetic imaging system linked to a computer makes a series of detailed pictures of areas inside the body.
Biopsy where a sample of tissue cells is taken so they can be viewed under a microscope by a pathologist to check for signs of cancer. With renal cell cancer, a thin needle is inserted into the tumour and a sample of tissue taken.
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Treatment alternatives for kidney cancer
The orthodox options are:
* Surgery removal of the whole of a kidney, or just the tumour within. This may be through normal surgery or via keyhole surgery. Adjacent lymph nodes may be removed if affected.
Watch on YouTube, 'How Chris Woollams helped Jose Brooks beat her Kidney cancer' (6 years later).
* Ablation - An alternative treatment when the cancer is confined to the kidney is ablation. This may heat the tumour via a probe inserted through the skin, or freeze the tumour via a hollow probe providing a freezing gas. Another way of heating the tumour - some people call it cauterising - is to use High Intensity Focus Ultrasound or HIFU. There is no need for a probe to penetrate the skin. You can find out more by
clicking this link. Sometimes
arterial embolisation may be used, especially if the patient is too weak to have surgery. Here a substance is injected into the artery supplying blood to the kidney, so that the blood supply to the infected organ ceases. A tumour deprived of blood should then die.
"Confused by it all? Do you want to build a programme for your personal kidney cancer that increases your odds of survival? Read what others say about a chat with Chris Woollams."
* Radiotherapy Radiotherapy is commonly used to treat kidney cancer where there is spread to other areas. Care has to be taken to prevent the radiotherapy beam damaging other organs. You can read how to improve the success of your radiotherapy treatment by
clicking this link. Sometimes Proton Beam Therapy is a better option.
* Chemotherapy - Two immunotherapy drugs have been used over the past few years - interferon and interleukin, although the former, interferon, is much more commonly employed. The aim is to stimulate the immune system to kick out the cancer. You can read a personal story of a patient taking interferon by
clicking this link.
However, as we covered in icon, when 4 new drugs were turned down by NICE, a leading UK Professor openly said interferon didn't work very well! (About 75% of the 3,600 people with advanced kidney cancer do not respond well to interferon).
A new era arrived with a new breed of drugs, called monoclonal antibodies:
- Sutent (sunitinib),
- Avastin (bevacizumab),
- Nexavar (sorafenib)
- Torisel (temsirolimus)
Monoclonal antibodies each only work for a particular targeted group of people. Sometimes there are tests to show if you are someone who would benefit from a particular drug. Professor Peter Littlejohns, the clinical and public health director of NICE, originally said the institute took account of how much extra a new drug would cost to produce an extra year of healthy life. The four kidney drugs cost up to six times the normal NHS limit of about 30,000 a patient per quality-adjusted life year.
For information on your Cancer Drugs and chemotherapy click here.
According to the American National Institute of Cancer Sunitinib has already been linked with heart failure and hypertension. And according to Memorial Sloan-Kettering there are better drugs on the way! A Phase III Clinical Trial on Everolimus has been stopped, so clear was its success (NB: according to the Hospital). Everolimus, a once-daily oral therapy, targets the mTOR protein, which acts as a central regulator of tumour cell division, cell metabolism, and blood vessel growth.
However, the response to these drugs may be none, or just a couple of months increased survival. And again we quote Sloan-Kettering: "More than 400 patients participated in this study, all of whom had disease that had progressed with currently available targeted therapies sunitinib and/or sorafenib. Patients were randomised to receive everolimus or a placebo. After six months, 26 percent of patients in the everolimus group had disease that had not progressed, compared to only 2 percent of the placebo group. The average difference in progression free survival was four months for everolimus, compared to 1.9 months for the placebo group."
Put another way, after 6 months 74 per cent had a disease that had progressed.
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Kidney cancer - emerging alternative treatments
* Immunotherapy - PD-1 Inhibitors target a protein on the T-cells that blocks the cells from attacking. Both Pembrolizumab (Keytruda) and Nivolumab (Opdivo) are approved for use with kidney cancer.
PD-L1 and CTLA-4 inhibitors attack a different protein which occurs more usually on the tumour cells and blocks the immune response. The two main drugs are Ipilimumab and Avelumab (Bavencio).
The side-effects can be minor or major. Immunotherapy drugs, especially when two (for example, Nivolumab and Ipilimumab) are used together can prompt the immune system to attack other organs! The most common issue is liver toxicity.
If you are going to have immunotherapy, please read 'How to make your immunotherapy work properly'
Never take antibiotics or Proton Pump inhibitors in the 6 weeks before immunotherapy, or during (read article)
And read 'How to cure liver toxicity'.
Off-Label Drugs for Kidney cancer
This is a hot topic in the UK with oncologists using metformin (the diabetes drug) or a statin such as atorvastatin. The aim? To cut the blood sugar and restrict the cancer feeding; and to cut the blood fats (like cholesterol and triglycerides) and restrict the cancer spreading.
You can read more by following this link.
Go to: Building an off-label drugs protocol for cancer
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Building an integrative programme
Of course, there are other things a person can do. You can try to remove heavy metals from your body: Selenium (200 micrograms), chlorella, and beneficial bacteria can all help, (There are even clinical trials on beneficial bacteria and their ability to chelate/bind to heavy metals in the body). Indole-3-carbinol has been shown in several research studies to be able to reduce toxicity in cells, including very dangerous dioxins. You can read about all of these in detail on this Website.
You might think about killing excess yeasts (e.g. by taking 2 x 150mg Oregano oil per day) or pathogens like E. coli (by using 200 mg of artemisinin); or even parasites (Para Free Plus).
You might want to employ a diet that has good research behind it - the colourful Mediterranean Diet would be the place to start. Indeed, why not read the CANCERactive guidelines on Diet and Exercise for cancer?
You may want to explore Dietary therapies and nutritional supplements. We have a whole section on our Website on Diet, nutrition and supplements. Or you may want to find out more about complementary therapies, energy therapies and the like. You can read our simple guide on these by clicking this link.
You might also like to read the personal story 'Never Give Up' (click here). It is one woman's account of her fight to save her husband's kidneys when he developed cancer.
"If you are looking for supplements please go to the Natural Selection shop where they have selected the best of the best and you can buy with confidence".
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References
1. Association of Hypertension and Blood Pressure With Kidney Cancer Risk; Chang Seong Kim et al; 27 April 2020 Hypertension
2. Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies; Toni K. Choueiri et al; Int J Cancer. 2014 Jan 15; 134(2): 384–396.
3. How E. coli bacteria can harm your kidneys; Kidney fund
4. The gut microbiota profile of adults with kidney disease and kidney stones: a systematic review of the literature; Jordan Stanford et al; BMC Nephrol. 2020; 21: 215.
5. Soft drink and juice consumption and renal cell carcinoma incidence and mortality in the European Prospective Investigation into Cancer and Nutrition; Alicia K. Heath et al; Cancer Epidemiol Biomarkers Prev. 2021 Jun 1; 30(6): 1270–1274.
6. Kidney cancer and diabetes - what's the connection? Dr S. Adam Ramin; US News,Aug. 2, 2018, at 6:00 a.m.
The CANCERactive Difference: Intelligent Information. Independent Voice.
IMPORTANT INFORMATION
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* Cancer (and its related illnesses) are very serious and very individual diseases. Readers must always consult directly with experts and specialists in the appropriate medical field before taking, or refraining from taking, any specific action.
This web site is intended to provide research-based information on cancer and its possible causes and therapies, so that you can make more informed decisions in consultation with those experts. Although our information comes from expert sources, and is most usually provided by Professors, scientists and Doctors, our easy-to-understand, jargon-free approach necessitates that journalists, not doctors, write the copy. For this reason, whilst the authors, management and staff of CANCERactive, icon , and Health Issues have made every effort to ensure its accuracy, we assume no responsibility for any error, any omission or any consequences of an error or omission. Readers must consult directly with their personal specialists and advisors, and we cannot be held responsible for any action, or inaction, taken by readers as a result of information contained on this web site, or in any of our publications. Any action taken or refrained from by a reader is taken entirely at the readers own instigation and, thus, own risk.
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