In the 1980s, the American Cancer Society reported that 80% of kidney cancers were diagnosed in the late stages. Today, thanks to better screening methods, only about 40% of cases are discovered at the advanced stage even though patients may not have any kidney cancer symptoms.
At MD Anderson, we're continuing to make progress in improving kidney cancer diagnoses and kidney cancer treatment. We spoke with Eric Jonasch, M.D., associate professor in Genitourinary Medical Oncology, to find out more about kidney cancer treatment and research, as well as prevention and diagnosis. Here's what he had to say.
Who's at risk for kidney cancer? What signs and symptoms should people look for?
Those who have a first-degree relative, like a parent or sibling, who have had kidney cancer are more likely to develop kidney cancer. So are men, as this type of cancer is seen in men twice as often as in women.
In addition, the older we get, the greater our risk becomes. Most kidney cancer patients are over age 60. People who are obese, have high blood pressure or smoke also are more likely to be diagnosed with kidney cancer.
How is kidney cancer diagnosed?
Increasingly, kidney cancer is diagnosed incidentally, when a patient comes in for an unrelated complaint that requires a CT scan and the care team discovers a mass in the kidney.
Kidney cancer symptoms don't often show themselves, but patients whose cancer has progressed to a later stage may experience pain in the stomach or lower back, or blood in their urine.
Patients with kidney cancer also may experience unexplained high hemoglobin levels, unexplained uncontrollable blood pressure or unexplained and persistent weight loss.
Once the cancer is spotted through the CT scan, and there is no sign of spread to other organs, the surgical team may proceed directly to a surgical removal of the tumor. But if the tumor looks abnormal or like it has grown outside of the kidney, they may perform a biopsy to determine if it is a different cancer type.
How is kidney cancer treated typically?
The type of treatment used depends on the stage of the patient's kidney cancer. If the tumor has not spread and is only inside the kidney, then the patient will only need an operation to remove the tumor.
If the tumor has spread, or metastasized, beyond the kidneys, then the care team will perform a surgery followed by a type of therapy: immunotherapy, blood vessel starving therapy (also called antiangiogenic therapy), or a type of targeted therapy called an mTOR inhibitor.
If the tumor has metastasized and the patient is not otherwise healthy, then doctors will start the therapy before performing the surgery.
What are the latest advances in treatment available for kidney cancer patients at MD Anderson?
We're currently conducting a clinical trial on immunotherapy using checkpoint antibodies. These antibodies will help stimulate the immune system to help fight the cancer. So far, it appears that these agents show promise in the treatment of kidney cancer.
We're also researching to find more targeted therapies for the four different sub-types of kidney cancer. Currently, we're working on one that targets the MET protein to fight papillary kidney cancer.
What are some ways to lower kidney cancer risk?
While we can't stop getting older, there are some things we can do to help lower our kidney cancer risk. These include stopping smoking or never starting, exercising, maintaining a healthy weight and watching your blood pressure. Having a healthy lifestyle is very, very important.
Really, anything that can help lower your overall cancer risk will help lower your kidney cancer risk.