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According to the American Cancer Society, approximately 79,000 Americans will be diagnosed with kidney cancer in 2022. Kidney cancer ranks in the top-10 most common cancers in both men and women. Overall, the lifetime risk for developing kidney cancer is about 2% for men and 1% for women. Renal cell carcinoma is the most common type of kidney cancer, accounting for about 9 out of 10 diagnoses.

For Kidney Cancer Awareness Month, Dr. Brandon Manley, a genitourinary surgeon at Moffitt Cancer Center, answered frequently asked questions about the disease.

What are the common symptoms of kidney cancer?

Blood in urine, abdominal discomfort, changes in bowel habits, appetite loss, nausea and vomiting are some of the most common symptoms. Many symptoms don’t appear until a tumor is 10cm or larger and begin to put pressure on the stomach. Larger tumors can also affect hormone regulation which leads to fluctuation in blood pressure, light headedness and abnormal results in bloodwork.

How is kidney cancer diagnosed?

Most kidney tumors are diagnosed incidentally. Many patients don't have symptoms until later stages, or with aggressive disease. Most people tend to go get evaluated for other common things like gallbladder and kidney stones or diverticulitis. If you walked into any ER in the U.S. for one of those issues, you're likely going to get a CT scan. It’s not uncommon that we see patients who presented with different kind of symptoms and in the CT scan we find a suspicious mass in their kidney. If there’s suspicion of kidney cancer, sometimes we’ll order a biopsy to determine the diagnosis and management plan.

How is kidney cancer treated?

For most patients with localized disease, a surgery called total/radical nephrectomy or partial nephrectomy is usually the preferred treatment. That involves removing part of, or an entire kidney. We can also consider interventional radiology procedures, which we call ablation. Typically, ablation is performed though cryotherapy, which involves freezing the tumors. For patients with small renal masses, there are some situations where we'll watch those tumors under active surveillance, because some of them can behave very indolently. For patients with metastatic disease, we use systemic therapy which is typically a combination of immunotherapy and targeted therapy.

What advancements have been made in kidney cancer surgery?

What’s unique about Moffitt is that we offer what’s called a retroperitoneal approach, where we perform robotic surgery through the back, instead of going through the abdomen. A lot of times you’re worried about scar tissue in the abdominal area. We can stay out of there altogether and can offer patients a minimally invasive approach.

Is there a genetic risk associated with kidney cancer?

There's a class of very well-defined syndromes, which make up less than 5% of the tumors that we see. We don't know all the reasons why some patients appear to have these tumors are arising their family. The most classic one is Von Hippel-Lindau syndrome (VHL), which is a dominant disease, meaning that, if one of your parents has it, you have about a 50% chance of getting it.