News

Canada’s ninth most common cancer often goes undetected until it is advanced, making treatment more challenging

“I don’t get no respect!” was the famous catchphrase of the late American comedian Rodney Dangerfield.[1]

In the world of cancer, the same lament could be made for kidney cancer. Unless people have been touched by it themselves or through family and friends, it’s not among the types of cancer that come to mind for most people. It’s been called a “forgotten disease”[2] and one that gets “too little attention.”[3]

But kidney cancer deserves more attention. Among Canadian men, it is the sixth leading type of cancer, and it ranks ninth among the full population.[4] In 2020, an estimated 7,500 Canadians were diagnosed with kidney and renal pelvis cancer and 1,950 Canadians died from this cancer.[5]

As with most cancers, there is no specific cause for kidney cancer. However, there are indications that inherited genetic factors and a family history of the disease can play a role. Smoking and obesity are also factors that increase the risk of kidney cancer.[6]

One of the challenges for kidney cancer patients and physicians is that it tends to be a “silent” disease, meaning it often does not cause noticeable symptoms until it is quite advanced. Symptoms of the disease, including palpable mass, flank pain or blood in the urine, may only arise when the cancer has grown to a large size. This can lead to more advanced disease stage at diagnosis and can make treatment more challenging.[7]

It’s important to note, however, that most patients do not get diagnosed at a later stage when symptoms are manifest. Patients often get diagnosed with incidental kidney cancer, which means it is discovered when they are being tested for something else (i.e., by ultrasound, CT scan, or another type of test).[8]

As well, the discovery of a growth or mass in the kidney does not automatically mean there is kidney cancer. Many such tumours in the kidney are not cancerous, but this can only be determined with a biopsy or when the growth is removed surgically and examined in a lab.[9]

As with most cancers, the type of treatment differs on the exact nature of the kidney cancer and its stage, meaning whether the tumour is still relatively small and localized in the kidney (an early stage) or whether it has spread elsewhere in the body (a more advanced stage).

Immunotherapy has now joined surgery, chemotherapy, radiation and targeted therapy as options for treating kidney cancer.[10] Active surveillance, where the tumor is closely monitored with regular diagnostic tests and clinic appointments, may also be an option when the tumor is small.[11]

Surgery is the most common first treatment in early-stage kidney cancer when the tumour can be removed, often in conjunction with radiation or chemotherapy if the cancer has spread. Immunotherapy is proving to be a useful new way to treat cancer and is now recommended in the Canadian treatment guidelines for advanced kidney cancer.[12]

Those guidelines also include a section outlining the role patient and caregiver information should play in the treatment of advanced kidney cancer. The guidelines say that patients and caregivers should be given access to multidisciplinary care and information on community resources, specifically those available through Kidney Cancer Canada, and be strongly encouraged to enrol in the Canadian Kidney Cancer information system (CKCis) database. Since there can be a hereditary influence in who gets kidney cancer, the guidelines also recommend patients be screened for this risk, with appropriate genetic testing as the standard of care.[13]

“It’s vital for Canadians diagnosed with or caring for someone with kidney cancer to educate themselves about the disease, its potential impact and the available treatment options so they can make the best possible decisions with their doctor for their individual situation,” said Christine Collins, Executive Director of Kidney Cancer Canada. “We can also offer patients the opportunity to connect with others who have already been on this cancer journey to provide peer support and information.”

Now it’s time for all of us to spread the word to help kidney cancer get the respect and awareness it deserves, so that more Canadians who get the disease have an earlier shot at diagnosis and effective treatment.

For more information on kidney cancer, visit the following website:

[1] Biography, Rodney Dangerfield, https://www.biography.com/performer/rodney-dangerfield

[2] Ipsen Inc., It’s time to talk about kidney cancer! June 17, 2019, https://www.ipsen.com/its-time-to-talk-about-kidney-cancer/

[3] Charles K, Kidney cancer gets too little attention, but it’s one of the 10 most common cancer diagnoses, New York Daily News, Oct. 11, 2015, https://www.nydailynews.com/life-style/daily-checkup-kidney-cancer-attention-article-1.2385577

[4] Canadian Cancer Society, Canadian Cancer Statistics, Table 1.2 p. 25

[5] Canadian Cancer Society, kidney cancer statistics: https://cancer.ca/en/cancer-information/cancer-types/kidney/statistics

[6] Kidney Cancer Canada, Kidney Cancer Risk Factors, https://www.kidneycancercanada.ca/guide/risk-factors/

[7] Kidney Cancer Canada, Understanding Kidney Cancer, https://www.kidneycancercanada.ca/guide/understanding-kidney-cancer/

[8] Idem.

[9] American Urological Association, What is kidney cancer? https://www.urologyhealth.org/urology-a-z/k/kidney-cancer

[10] Canadian Cancer Society website: https://cancer.ca/en/cancer-information/cancer-types/kidney/treatment

[11] Canadian Cancer Society website: https://cancer.ca/en/cancer-information/cancer-types/kidney/treatment/active-surveillance

[12] Canil C, Kapoor A, Basappa NS, et al. Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021. Can Urol Assoc J 2021;15(4):84-97. https://www.kidneycancercanada.ca/wp-content/uploads/2021/04/CUA-guidelines-Management-of-Advanced-Kidney-Cancer.pdf

[13] Canil C, Kapoor A, Basappa NS, et al. Management of advanced kidney cancer: Kidney Cancer Research Network of Canada (KCRNC) consensus update 2021. Can Urol Assoc J 2021;15(4):84-97. https://www.kidneycancercanada.ca/wp-content/uploads/2021/04/CUA-guidelines-Management-of-Advanced-Kidney-Cancer.pdf

No content of this article is intended as medical advice. If you have questions about your health, consult a healthcare professional.