How kidney cancer presents
The classic triad of blood in urine, flank pain and a mass is now rare, and usually means advanced disease. Far more tumours are picked up incidentally during an ultrasound for abdominal pain or a routine health check.
- Incidental mass on ultrasound or CT
- Visible blood in the urine
- A persistent dull ache in the flank
- Unexplained weight loss, fever or anaemia
- A varicocele appearing suddenly on the left in an adult
Treatment by tumour size
Nephrectomy is not automatic. Preserving working kidney tissue matters for long-term kidney function, particularly in patients with diabetes, hypertension or a single kidney.
- Under 4 cm: partial nephrectomy, or surveillance in frail elderly patients
- 4—7 cm: partial nephrectomy where technically feasible, otherwise radical nephrectomy
- Large or central tumours: radical nephrectomy, laparoscopic or open
- Advanced disease: targeted and immunotherapy with medical oncology, surgery in selected cases
Biopsy, second opinions and follow-up
A renal mass biopsy is useful in specific situations — a suspected lymphoma or metastasis, a small mass under surveillance, or before ablation — but most solid enhancing renal tumours proceed to surgery without one. After surgery, follow-up imaging is scheduled by stage and grade.
If you have been advised removal of the whole kidney for a small tumour, a second opinion on whether a partial nephrectomy is feasible is a reasonable thing to ask for.
Kidney Cancer Treatment — common questions
Can kidney cancer be cured?
Yes. Tumours confined to the kidney are cured by surgery alone in the large majority of cases, and small tumours have excellent long-term survival.
Will I need chemotherapy?
Conventional chemotherapy has little role in kidney cancer. Advanced disease is treated with targeted therapy or immunotherapy instead.
Can I live normally with one kidney?
Yes. A healthy remaining kidney compensates. Blood pressure, sugar control and avoiding NSAID painkillers become more important.
Is every kidney mass cancer?
No. Simple cysts, angiomyolipomas and infections can look alarming on ultrasound. A CT with contrast usually settles the question.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains kidney cancer treatment in general terms; your own treatment plan depends on your reports and examination.