Kidney Cancer

If you are reading this page, then perhaps you or your loved one has been diagnosed with a kidney tumor or kidney mass. We are sorry to hear this news. However, we want to give you hope and strength by providing the best knowledge on this disease.

The doctors at Broward Urology Center are very experienced with managing all types of kidney tumors that are both cancerous and benign. We have all been extensively trained in helping you make the best decision in your care.

Dr. Yogel has had over 25 years of surgical experience managing complicated kidney tumors. Drs. Chenven and Gorbatiy both have completed extra 2 years of fellowship training in addition to 20 years of total surgical experience managing complicated kidney tumors with the most cutting edge minimally invasive techniques including laparoscopy, robotic and ablative surgery. We commonly work as a team and help all our patients decide the best approach for their specific tumor.

Please use this website to educate yourself about kidney tumors, so that you would be ready and comfortable when discussing the details during your visit in our offices.

When making an appointment to see the doctors, please make our staff aware that you were diagnosed with a kidney tumor so that they may expedite the scheduling of your visit.

What Is a Kidney?

Kidneys are fist-sized organs that help the body get rid of toxins and extra water by filtering the blood and making urine. Most people have two kidneys located on either side the flank (upper back) region. The kidney has two parts: the meat of the kidney that does all the work of the kidney and the inner part of the kidney where urine collects and drains down a tube towards the bladder.

What Is a Kidney Tumor?

A Kidney tumor, also referred to as a “mass” or “lesion” is simply a solid growth in the kidney. There are growths in the kidney that may be full of liquid (resembling a pimple) that are referred to as kidney cysts. Majority of kidney cysts are benign and in most cases do not require any intervention. However, solid tumors typically need to be addressed. Please click here to learn more about Kidney Cysts.

What Is the Concern with Kidney Tumors?

The concern is raised because the majority of kidney tumors are cancerous (malignant). On average, a tumor that is about 4 cm (roughly under 2 inches) has an 80% chance of being a cancer. The larger a tumor, the greater chance of it being a cancer.

Why Would a Person Develop a Kidney Tumor?

Majority of kidney tumors (both benign and malignant) are typically a random occurrence and may happen to even healthy individuals. However, there are known causes of kidney tumors including a history of tobacco and obesity. Patients on dialysis are also more prone to developing kidney tumors. There many types of hereditary syndromes that may predispose patients to kidney tumors. Typically, patients with hereditary problems may have multiple close relatives with history of kidney tumors and may be diagnosed a young age. Rarely, patients with a history of certain cancers, like breast or lung cancer, have their original cancer spread (metastasize) to the kidney.

How Are Most Kidney Tumors Discovered?

Most kidney tumors do not cause any symptoms or pain and thus are generally discovered up by accident with some kind of ultrasound or belly scan or MRI done for other complaints. However, in more advanced cases where the tumors are very large or deep inside the kidney, people may complain of abdominal pain, blood in the urine, or actually feeling a mass in the belly.

What “Tests” Can Be Done to Detect a Kidney Tumor?

There are no blood tests that may detect a kidney tumor. Only pictures of the kidney such as a Kidney Ultrasound, CT scan of the abdomen or MRI of the abdomen may show the tumor. Another important factor is that the CT and MRI tests must be done with IV dye to see a kidney tumor.

Generally CT and MRI are considered to be “better” than an ultrasound in seeing a tumor as they typically show a sharper picture of the kidney and may allow for more precise measurement and kidney anatomy evaluation. MRI is not necessarily better than CT scan but may sometimes given a different perspective on the tumor and sometimes is helpful in confirming a diagnosis or sometimes helps differentiate a tumor from a kidney cyst. Thus, it is not uncommon for doctors to order several types of scans to help us learn more about the growth in the kidney and the overall kidney anatomy.

How Quickly Do Kidney Tumors Grow?

On average, tumors that are under 2 inches typically grow very slowly at a rate of 3-4 mm (3/16th of an inch) per year. However, the larger the tumors, the faster they may grow. Both benign and cancerous tumors may grow at similar speed.

If a tumor is cancerous, what are the chances of this cancer spreading? The majority of kidney tumors are confined to the kidney on diagnosis. The risk of metastasis (spread) of the cancer outside of the kidney and into other parts of the body mostly depends on the size of the tumor. In tumors under 4 cm or about 1.5 inches, the chance of metastasis is about 2%. For tumors greater than 7 cm, the chance goes up to 15-20%. The areas to which kidney cancer tends to spread include the lungs, bones.

What Are the Most Common Types of Kidney Tumors?

The most common type of kidney tumor is a kidney cancer called Renal Cell Carcinoma. Among the benign types of tumors, the Oncocytoma is the most common followed by the Angiomyolipoma.

What Types of Doctors Treat Kidney Tumors?

Urologists are the primary doctors who treat kidney tumors. However, we sometimes use other types of specialists to help us with certain types of treatments. For example, in cases where the kidney tumor is cancerous, we work closely with the Medical Oncologists (cancer doctors) to provide the necessary drugs to control the disease. Also, we often use the expertise of special x-ray doctors called Interventional Radiologists for certain ablative treatments as well as kidney tumor biopsies. In certain advanced tumors that extend from the kidney into the major arteries or veins, we then work closely with our Vascular or General Surgeon colleagues. Though Urologists are the kidney surgeons, Nephrologists are the kidney function specialists whom we frequently consult to help us in management of poorly functioning and diseased kidneys both before and after surgery for kidney tumors.

Once the Diagnosis of a Kidney Tumor Is Made, What the Next Step?

If after the review of necessary imaging, the suspicion of the kidney tumor being a cancer is high, then we need to get certain blood work and x-rays or CT scan of the lungs to see if the cancer has not spread. Additional testing may also be required. If the tumor appears to be confined to the kidney, then we would discuss the necessary treatment options.

Does Every Kidney Tumor Need to Be Treated?

No. In cases where the tumor is very small and growing very slowly, it may certainly be closely monitored and intervention be done when the timing is right. In cases where the tumor is a metastasis from another type of cancer, then the majority of time, the way to treat the kidney tumor is simply restart the treatment for the original cancer and would not require a separate procedure for the tumor.

Do I Need to Have a Biopsy of the Kidney Tumor?

Biopsy is recommended ONLY in cases where it may change the plan of treatment. If there is suspicion that the tumor may be lymphoma or a tumor that has metastasized to the kidney, a biopsy is then typically done. A biopsy may certainly be done for patients who request it.

How Is a Biopsy of the Tumor Done? What Are the Risks with a Kidney Biopsy?

A biopsy is done by Interventional Radiology doctors. They typically numb up the skin in the back area and use a small needle under ultrasound or CT scan guidance to take a sample of the tumor. This is a quick outpatient procedure.

Risks of a biopsy include bleeding and infection. Serious side effects occur in <2% of patients Tumor spillage with a biopsy is extremely rare. Biopsies may result in unclear results in about 10-15% of cases. Rarely, the biopsy may miss the tumor and also in 10% of cases, benign tumors may co-exist with malignant tumors in the same tumor.

We do not recommend biopsies of cystic tumors (tumors that have a component of solid and fluid areas.

What Are the Treatment Options of for a Solid Kidney Tumor?

Please refer to the individual pages regarding each specific treatment, but in summary the treatment options for solid kidney tumors (starting with the least aggressive to the most aggressive option) include:

1. Active Surveillance – close monitoring with repeat imaging of the kidneys over time; Surveillance may be done with or without a diagnostic biopsy.
2. Kidney Tumor Embolization – certain benign tumors (like Angiomyolipomas) are treated with this procedure where the Interventional Radiologist is able to cut off the blood supply to the tumor.
3. Kidney Tumor Ablation – either through the back (percutaneous) or laparoscopically (small belly opening), a special needle is used to penetrate the tumor and either burn it to destruction or freeze it to death.
4. Partial Nephrectomy – considered to be the standard treatment for most smaller kidney tumors and in some larger masses that are in a good location, a partial nephrectomy means that a surgeon cuts the tumor out of the kidney and saves the rest of the normal kidney. This surgery may be done these days through small holes in the belly (laparoscopically) as well as with they assistance of a “robot” machine that allows for the surgeon to control small laparoscopic instruments with joysticks. The robot machine has become an essential tool for this operation as it dramatically improved the safety and duration of the surgery compared to the traditional laparoscopic methods. In rare cases, the surgery may also be done with the traditional open large cut.
5. Radical Nephrectomy – surgery to remove the entire kidney is reserved for larger kidney tumors and the smaller tumors that appear to be involving the main blood supply to the whole kidney. This surgery is commonly done laparoscopically and at times with the assistance of the robot device. For patients with very large tumors, the surgery may need to be done with larger incisions in the belly and with the assistance of other surgical specialists.

What About Chemotherapy and Radiation Options for Kidney Tumors?

Radiation is not effective in kidney tumors. However, it may be used to control pain in bones if a kidney cancer has spread to a bone in the body.

Traditional chemotherapy (the kind you see patients lose hair with) is not effective in kidney cancer. However, we have a lot of other types of treatments called “targeted immunotherapy” that have improved the survival of many patients with metastatic kidney cancer.