Most cancers are named after the part of the body where the cancer first begins, 肾癌也不例外. Kidney cancer begins in the kidneys—two large, bean-shaped organs—one located to the left, and the other to the right of the backbone. Renal is the Latin word for kidney, and kidney cancer may also be referred to as renal cancer.

According to the American Cancer Society (ACS), about 81,800 people in the U.S. are expected to be diagnosed with kidney and renal pelvic cancers in 2023. The most common type is called renal cell cancer. The information contained on this page refers to renal cell cancer.

What are the risk factors for renal cell cancer?

The exact cause of renal cell cancer is unknown. However, there are certain risk factors that are linked to it. These risk factors, according to the ACS, are as follows:

• 吸烟. 吸烟 increases the risk of kidney cancer. The risk seems related to the amount you smoke.
• 石棉. Studies show a link between exposure to asbestos and kidney cancer.
• 镉. 在那里 may be a link between cadmium exposure and kidney cancer. 镉 may increase the cancer-causing effect of smoking.
• 家族病史. 家族病史 of kidney cancer increases a person's risk.
• 性别. Men are twice as likely to develop renal cell cancer than women.
• 希佩尔-林道综合征. This is a disease caused by a gene mutation that increases the chances of renal cell cancer.
• Birt-Hogg-Dube综合症. Patients who have this disease are more likely to develop renal cell cancer.
• 其他遗传性综合症. Patients with hereditary papillary renal cell carcinoma, hereditary leiomyoma-renal cell carcinoma, and hereditary renal oncocytoma are more likely to develop kidney cancer.
• 肥胖. 肥胖 increases a person's risk of kidney cancer.
• 晚期肾病. Patients with advanced kidney disease who have been on dialysis for a long time may develop renal cell cancer.
• 高血压. Patients who have high blood pressure have a higher risk for kidney cancer.
• 利尿剂(水丸). Drugs that eliminate excess body fluid may raise the risk of kidney cancer, 虽然这还不清楚.
• 比赛. African-Americans have a slightly higher risk of kidney cancer.

What are the symptoms of renal cell cancer?

The following are the most common symptoms of renal cell cancer. However, each individual may experience symptoms differently. 症状可能包括:

• 尿中带血
• 迅速的，无法解释的体重下降
• Low back pain (not caused by an injury)
• 食欲不振
• 脚踝和腿部肿胀
• Mass or lump on the side or lower back
• 乏力
• Recurrent fever (not caused by a cold or the flu)
• 高血压 (less frequently)
• 贫血(不常见)
• 疼痛无法缓解在侧面

The symptoms of renal cell cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is kidney cancer (renal cell cancer) diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for kidney cancer may include the following:

• 血液和尿液化验
• 静脉肾盂造影(IVP). 肾脏的一系列x光片, 输尿管, and bladder with the injection of a contrast dye into the vein to detect tumors, 异常, 肾结石, 或者任何障碍, 并评估肾血流量.
• Renal angiography (also called arteriography). A series of X-rays with the injection of a contrast dye into a catheter, which is placed into the blood vessels of the kidney, to detect any signs of blockage or 异常 affecting the blood supply to the kidneys.
• Other imaging tests (to show the difference between diseased and healthy 组织), 包括以下内容:
• Computed tomography scan (also called a CT or CAT scan). A noninvasive type of X-ray procedure that takes horizontal, 或轴向, images of the brain or other internal organs to detect any 异常 that may not show up on an ordinary X-ray.
• 磁共振成像(MRI). A noninvasive procedure that uses radio waves and strong magnets to produce very detailed two-dimensional views of an internal organ or structure, 尤其是大脑和脊髓.
• 超声波(也叫超声). A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, 组织, 和器官. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
• 胸部x光片. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal 组织, 骨头, 还有器官的影像.
• 骨扫描. A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints to detect bone diseases and tumors to determine the cause of bone pain or inflammation.

Based on results of other tests and procedures, a biopsy may be needed. A biopsy is a procedure in which a sample of the tumor is removed and sent to the laboratory for examination by a pathologist.

What are the different types of kidney cancer?

The main type of kidney cancer is called renal cell carcinoma (RCC). 关于 9 out of 10 kidney cancer tumors are this type. If you have this type of kidney cancer, you may have more than one tumor in one or both kidneys. These may be large by the time they are diagnosed. But most cases of kidney cancer are found before the cancer has spread to other organs.

碾压混凝土有不同的类型. A healthcare provider called a pathologist identifies these types by looking at the cancer cells under a microscope. 碾压混凝土的类型包括:

• 透明细胞. 这是最常见的碾压混凝土类型. 癌细胞看起来苍白或透明.
• 乳头状. This is the second most common type of RCC. This type of tumor has tiny fingerlike growths.
• Chromophobe. 这是一种罕见的RCC. The cells are larger than other types of RCC.
• 透明细胞乳头状. Recently recognized and usually less aggressive variant of kidney cancer
• 收集管. 这也是一种罕见的RCC形式. The cancer cells look like irregular tubes.
• 不保密的. This includes tumors that have cells from more than 1 type of cancer. It also includes tumors with cells that don’t fit into the other categories.

其他类型的肾癌

Other less-common types of kidney cancers include:

• 移行细胞癌. This is also known as urothelial carcinoma and unlike other kidney cancers, forms in the tubes that drain the kidney. These tubes have the same lining as the bladder and thus this type of kidney cancer can act and look like bladder cancer.
• 霍奇金病的肿瘤. This cancer most always occurs in children. 这在成人中非常罕见.
• 肾肉瘤. This is a very rare type of kidney cancer. It begins in the blood vessels and connective 肾脏周围组织s.

不是癌症的肾肿瘤

在那里 are several types of kidney tumors that are not cancer (benign). These include renal cell adenoma, renal oncocytoma, and angiomyolipoma. Oncocytomas are the most common benign tumors but are often difficult to distinguish from kidney cancers. All these benign tumors may still affect kidney function and can cause pain and other symptoms. But the cells usually do not spread to other organs.

如何治疗肾癌?

Specific treatment for kidney cancer will be determined by your doctor based on:

• Your age, overall health, and medical history
• 疾病的范围
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• 你的意见或偏好

治疗包括:

• Surgical removal of the tumor or nephrectomy is the most common treatment for kidney cancer. These procedures can be performed minimally invasive (laparoscopic or robotic) or with open surgery. The following are different types of nephrectomy procedures:
• 根除性肾脏切除手术. The whole kidney is removed (with the tumor inside) as a package together with the adrenal gland, 肾脏周围组织, 有时, 这个区域的淋巴结. This is usually performed for larger tumors. If performed, the remaining kidney is generally able to perform the work of both kidneys.
• 简单的肾切除术. 只有肾脏被切除了.
• 部分切除. Only the part of the kidney that contains the tumor is removed. This is the preferred for smaller localized tumors.

其他疗法

• 消融治疗. A less invasive option to treat small tumors using thermal energy in well selected patients. This is usually done with image guidance such as CT.
• 放射治疗. 放射治疗 uses high-energy X-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.
• 靶向治疗. 靶向治疗 uses drugs that attack specific parts of cancer cells. These drugs work differently from standard chemotherapy drugs, and often have less severe side effects. They are commonly the first line of treatment for advanced kidney cancer. 例子包括舒尼替尼(索坦), 索拉非尼(多吉美), temsirolimus(一), everolimus (Afinitor), bevacizumab (Avastin) and pazopanib (Votrient).
• Biological therapy (also called immunotherapy). Biological therapy is a treatment that uses the body's own immune system to fight cancer.
• 化疗. 化疗 is the use of drugs to kill cancer cells. Unfortunately, kidney cancer is often resistant to chemotherapy drugs.
• 动脉栓塞. 动脉栓塞 is a procedure in which small pieces of a special gelatin sponge, 或者其他材料, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow. It may also be used before an operation to make surgery easier, or to provide relief from pain when removal of the tumor is not possible.

If you or a family member has been diagnosed with kidney cancer, you may want to consider getting a second opinion. In fact, some insurance companies require a second opinion for such diagnoses. 根据美国癌症学会, it's rare that the time it will take to get a second opinion will have a negative impact on your treatment. The peace of mind a second opinion provides may be well worth the effort.