Renal Cell Carcinoma Treatment: Strategies to Combat Kidney Cancer

20 Jul, 2023

What is Renal Cell Carcinoma?

Renal cell carcinoma is a condition characterized by the development of cancerous cells in the tubular lining inside the kidney. It is a common type of kidney cancer. Diagnosing and treating the disease in its early stages improves the quality of overall outcomes. In most cases, the tumor forms in one kidney only. However, there may be a simultaneous presentation of tumors in both kidneys. The types of renal cell carcinoma include clear cell, papillary, and chromophobe renal cell carcinoma. 

Risk Factors for Renal Cell Cancer

Important renal cell carcinoma risk factors include:


Smoking increases the risk of renal cell malignancies. The risk starts reducing as one quits smoking. 

Misusing Pain Medicines

Misusing certain analgesics, especially over-the-counter analgesics, for a long period of time increases the risk of this condition.

Being Overweight

Compared to healthy people, overweight and obese individuals are at increased risk for renal cell malignancies.

Having High Blood Pressure

People with high blood pressure (hypertension) are at increased risk of developing renal cell cancer.

Family History of Renal Cell Cancer

People with close family members who have renal cell malignancies are at increased risk of developing this cancer.

Certain Genetic Conditions

Certain genetic conditions, such as von Hippel-Lindau disease, tuberous sclerosis complex, or Birt-Hogg-Dube syndrome, increase the risk of renal cell cancer. 

Renal Cell Carcinoma Symptoms

Common renal cell carcinoma symptoms include:

Blood in The Urine

Patients often pass red, pink, or brown-colored urine due to hematuria (the presence of blood in the urine).

Lump in the Abdomen

The presence of a lump or an abnormal mass in the kidney area is one of the common renal cell carcinoma symptoms.

Pain in the Side That Doesn’t Go Away

Patients often experience persistent pain on one side or the back. 

Loss of Appetite

Loss of appetite is also one of the renal cell carcinoma symptoms that shouldn’t be ignored.

Weight Loss for No Known Reason

Patients with renal cell carcinoma also start losing weight while not trying to lose any. In some cases, this weight loss happens rapidly.


Anemia is also one of the renal cell carcinoma symptoms, and patients tend to experience extreme fatigue.

Tests to Diagnose Renal Cell Cancer

Physical Exam and Health History

The doctor comprehensively examines the patients overall health, especially in the context of the presented symptoms. Further, a detailed medical history is also evaluated to determine the cause of symptoms.

Ultrasound Exam

Ultrasound examination involves using high-energy sound waves to create images of the kidneys to detect any lesions or abnormal tissues. 

Blood Chemistry Studies

The patients may also undergo certain blood tests to determine the levels of various substances in the blood. These tests include complete blood cell count (to detect anemia) and levels of uric acid and creatinine in the blood (to determine the health of the kidneys). 


The doctors also advise the patients to undergo a complete urine analysis to detect the presence and levels of certain substances in the urine. These include sugar, protein, bacteria, and white blood cells. 

CT Scan

Computed tomography (CT) scan provides detailed images of the kidneys from different angles with an X-ray machine linked to a computer. The radiologists may also inject the dye for clearer images. A CT scan helps doctors determine the presence and extent of kidney tumors.


Magnetic resonance imaging (MRI) involves using powerful magnetic fields and radio waves to develop high-quality images of the kidneys. The radiologists deliver a special dye called gadolinium, which is taken up by the abnormal tissues to provide clearer images. 


A biopsy is a procedure in which samples of the tumor or abnormal tissues are obtained and sent to the laboratory for microscopic examination. It is generally recommended for a confirmatory diagnosis of cancer. A biopsy will also help with accurate renal cell carcinoma staging. A thin, hollow needle is guided to the abnormal tissues under imaging techniques, such as CT. The procedure is known as a CT-guided biopsy. However, the doctor may not recommend a biopsy in all cases.

Renal Cell Cancer Treatment Options

There are different types of renal cell carcinoma, and while devising a treatment plan, the doctor will consider the type of RCC, its stage, its grade, and the patient’s overall health status. Several treatment options for renal cell carcinoma are available. 


Surgery is one of the main treatments recommended for renal cell malignancies. Renal cell cancer surgery includes partial nephrectomy, simple nephrectomy, and radical nephrectomy. In partial nephrectomy, the surgeon removes only a portion of the affected kidney, while the complete kidney is removed in simple nephrectomy. In advanced stages, the surgeon may recommend radical nephrectomy that includes removing the kidney, adrenal gland, nearby lymph nodes, and healthy tissues. Laparoscopic kidney surgery and robotic kidney surgery are the minimally invasive surgeries available for renal cell malignancies, and they help in preventing a large scar on the abdomen.

Radiation Therapy

Radiation therapy uses high-energy particles to kill cancerous cells. The therapy is used to treat cancer and is also part of palliative therapy to relieve cancer symptoms. Radiation therapy may be external or internal. External radiation therapy delivers radiation from a machine present outside the body. Internal radiation therapy involves delivering radioactive pellets into or near the cancerous tissues. Internal radiation therapy is also called brachytherapy


Chemotherapy is recommended as a kidney tumor treatment if surgery alone is not able to treat it completely. Chemotherapy uses several drugs to kill or stop the growth of cancer cells. These drugs can be administered either orally or injected into the blood or muscles. Chemotherapy may accompany surgery or radiation therapy


Immunotherapy for renal cell carcinoma boosts the immune system and makes the cancerous cells more vulnerable to the immune system. The therapy is also known as biological therapy.

  • Immune checkpoint inhibitor therapy: This therapy inhibits the checkpoint proteins that prevent the attack of T-cells on cancerous cells.
  • CTLA-4 inhibitor therapy: The drugs delivered in CTLA-4 inhibitor therapy inhibit the CTLA-4 protein present in the T-cells. 
  • PD-1 and PD-L1 inhibitor therapy: PD-1 is present on the T-cell surface, while PD-L1 is present on the cancer cell surface. The attachment of PD-1 to PD-L1 prevents the T-cell from killing cancer cells. PD-1 and PD-L1 inhibitors prevent the attachment of both proteins. 
  • Interferon: Interferon delays the growth of cancer cells.
  • Interleukin-2 (IL-2): It boosts the activity and growth of several immune cells, such as lymphocytes. These cells kill the cancer cells. 

Targeted Therapy

Targeted therapy targets proteins and enzymes that are essential for the existence of cancerous cells. Targeted therapy may be used along with antiangiogenic agents to manage advanced cancer. Not all types of renal cancer can be treated with targeted therapy. Therefore, patients are made to undergo a battery of tests before this treatment in order to check if they are the right candidate for this form of kidney tumor treatment.

Renal Cell Carcinoma Treatment According to Stages

Treatment of Stage 1 Renal Cell Cancer


Renal cell cancer surgery is the first line of treatment, as stage 1 cancers are often localized and can be treated effectively with surgery. It could be done through open surgery or minimally invasive surgeries, such as laparoscopic kidney surgery or robotic kidney surgery.

  • Partial Nephrectomy: It involves the removal of a part of the affected kidney.
  • Radical Nephrectomy: Radical nephrectomy is a surgical intervention that removes the affected kidney, adrenal glands, surrounding lymph nodes, and healthy tissues.

Ablation Therapies

Ablation therapy is a procedure in which the blood supply to the cancerous tissues is blocked. The blood supply is blocked through tiny gelatin beads or sponges. 

Active Surveillance

In some patients, frequent monitoring is the only intervention required. It includes imaging and blood tests at regular intervals. 

Clinical Trials

Certain patients with advanced cancer, generally not responsive to standard therapy, may enroll in clinical trials related to new treatments for renal cell malignancies.

Treatment of Stage 2 Renal Cell Cancer


Renal cell carcinoma surgery is recommended for stage 2 cancers. Early-stage cancers often respond well to surgery. 

  • Partial Nephrectomy:  This surgical intervention involves the removal of a part of the kidney affected by renal cell malignancies. 
  • Radical Nephrectomy: This surgery removes the complete kidney, adrenal gland, surrounding lymph nodes, and healthy tissues. 

Ablation Therapies

When administered as a kidney tumor treatment, ablation therapy involves the blocking of arteries supplying the blood to cancerous tissues and results in the shrinking of the tumor.

Active Surveillance

Certain patients with stage 2 renal cancer undergo routine monitoring, including frequent imaging and blood tests. 

Clinical Trials

Patients with stage 2 renal cell cancer also enroll themselves in clinical trials to benefit from new treatments for renal cell malignancies. 

Treatment of Stage 3 Renal Cell Cancer


Renal cell cancer surgery is recommended for stage 3 cancers by uro-oncologists. Depending on the severity of the disease, the organ affected may be removed completely, along with nearby lymph nodes.

  • Radical Nephrectomy: Radical nephrectomy is a procedure that involves the removal of a complete kidney, adrenal gland, surrounding lymph nodes, and some healthy tissues. 

Systemic Therapies

  • Targeted Therapy: This kidney tumor treatment targets proteins and enzymes essential for the survival of cancerous cells, causing their death.
  • Immunotherapy: Doctors recommend immunotherapy for renal cell carcinomas that are in stage 3, as it boosts the immune system and makes the cancer cells vulnerable to getting killed by the immune system.

Radiation Therapy

Radiation therapy uses high-energy radiation to destroy renal cancer cells. The radiation may be delivered from outside, or radioactive beads may be placed in or around the tumor. 

Clinical Trials

Some patients with stage 3 renal cancer may enroll in clinical trials for new therapies that can manage this condition.

Treatment of Stage 4 Renal Cell Cancer

Systemic Therapies

  • Targeted Therapy: When administered as a kidney tumor treatment, targeted therapy kills or stops the growth of cancer cells by targeting essential enzymes and proteins.
  • Immunotherapy: Immunotherapy is an advanced renal cell carcinoma treatment that boosts the immune system and inhibits the processes that assist in escaping cancer cells from the damaging effects of immune cells. 


  • Cytoreductive Nephrectomy: Cytoreductive surgery, or debulking surgery, is the only type of renal cell cancer surgery recommended for stage 4 renal cell malignancies. It involves removing the primary lesions in patients with metastatic renal cancer before initiating systemic therapy. 

Radiation Therapy

Radiation therapy is often administered in combination with systemic therapies and surgery, to reduce the tumor load and improve the quality of life among patients.

Supportive Care

Supportive care is recommended for patients with advanced renal cell malignancies to enhance their quality of life. It involves the management of various symptoms, such as fatigue, anemia, pain, anorexia, and venous thromboembolism. 

Clinical Trials

Patients with stage 4 renal cell cancer may enroll themselves in clinical trials related to new treatments for this condition. 

Why Choose HCG for Renal Cancer Treatment?

The department of uro-oncology at HCG provides comprehensive diagnosis and treatment facilities for several types of renal cancer. HCG offers a patient-centric approach to renal cancer treatment. The center has advanced diagnostic techniques, with all the diagnostic procedures available under a single roof. HCG also offers advanced treatment options for treating early-stage to advanced (metastatic) renal cell cancer. The uro-oncologists providing healthcare services at HCG are extensively experienced in handling simple to complex cases of renal cell malignancies through updated renal cell carcinoma treatment guidelines.


Renal cell malignancies form in the lining of the tubules inside the kidney. Several factors, such as smoking, obesity, family history, and high blood pressure, enhance the risk of renal cell cancer. Diagnostic techniques for renal cell malignancies include blood and urine tests, physical examinations, imaging tests, and biopsy. Renal cancer treatment is customized, based on stage, and includes surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy. 

Frequently Asked Questions

1. What is the success rate of treating renal cell carcinoma?

The success rate of renal cancer treatment depends upon several factors, such as the age of the patients, renal cell carcinoma staging, underlying medical conditions, response to treatment, and overall health of the patients. Patients with advanced renal cell malignancies have relatively poorer outcomes than patients with early stages. 

2. Is Stage 4 renal cell carcinoma curable?

Stage-4 renal cell malignancies have poor outcomes. Today, we have advanced renal cell carcinoma treatments that are showing promising results. However, survivability depends upon the overall health of the patient, response to treatment, and underlying medical conditions.

3. How long is recovery from renal cell carcinoma surgery?

Like other surgeries, recovery after renal cell carcinoma surgery depends upon the type of surgery, overall health, and age of the patients. Usually, it takes about 6 to 12 weeks for complete recovery from the surgery.

4. What are the complications of renal cell carcinoma treatment?

Complications associated with renal cell carcinoma treatment include weakness, fatigue, skin rashes, nausea, fever, loss of appetite, muscle pain, hair loss, infection, bleeding, weight loss, and altered taste.

5. What are the chances of renal cell carcinoma recurrence?

Patients with advanced-stage renal cell cancer are at increased risk of cancer recurrence. Renal cell cancer commonly recurs within two years after surgery. Almost 20% of patients with localized renal cell cancer have a recurrence.

6. What are the symptoms of renal cell carcinoma recurrence?

Symptoms of renal cell cancer recurrence depend on the site at which the tumor is formed. It may develop in the kidney or other areas of the body (due to metastasis). 

7. Can lifestyle changes help to prevent renal cell carcinoma?

There is no method to completely prevent the occurrence of renal cell malignancies. However, certain measures reduce the risk of cancer. These include quitting smoking, managing weight, and controlling high blood pressure.

8. How is the choice between radical nephrectomy and partial nephrectomy made?

The choice between radical nephrectomy and partial nephrectomy depends on the extent of the cancer. In cancer limited to a particular region in the kidneys, partial nephrectomy is recommended. However, radical nephrectomy is advised if the cancer spreads to a significant part of the kidney and nearby lymph nodes. 

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