The incidence of kidney cancer continues to rise annually. Kidney cancer, specifically renal cell carcinoma (the most prevalent type of cancer that affects the kidneys), begins with the mutation of normal kidney cells. These cancerous cells then begin to multiply at a much faster rate than normal cells would, forming a tumor. Once a renal tumor is large enough, its cells begin to release a substance that promotes the surrounding blood vessels to grow adjacent to the tumor. This process is referred to as angiogenesis. The increased blood supply to the area enables the tumor to continue to grow and increases the risk of metastasis (the spread of cancer to other parts of the body) by carrying free tumor cells from the kidney throughout the rest of the circulatory system.

The production of the substance that promotes the vascularisation of the tumor, called vascular endothelial growth factor (VEGF), can be triggered by a combination of a lack of oxygen in the tumor, certain tumor cell genes, and the body’s own immune system. Consequently, therapeutic treatment options are often aimed at minimizing the production of VEGF and preventing or blocking these triggering mechanisms.

Symptoms
There are often no obvious signs or symptoms of kidney cancer until a tumor has become very large, so this type of cancer is often discovered incidentally by a routine ultrasound, CT scan, or other type of test. Most of the solid masses in the kidney that are discovered this way are in fact malignant tumors. When symptoms of kidney cancer are apparent, they may include:
Pain in the abdomen or back pain, just below the ribs
A mass in the abdomen
Blood in the urine (hematuria)
A persistent reoccurring fever
Fatigue
Unexplained weight loss
High blood pressure (hypertension)
Swelling in the ankles

Overall Management
Approaches to the treatment of kidney cancer depend of the level of progression and generally fall under one of two main categories, surgical management and medical management. If a tumor remains localized to the kidney, only surgical management is required and laparoscopic techniques are employed where possible. However, if the cancer has spread (metastasized) from the kidney to other parts of the body; medical management becomes necessary, sometimes in conjunction with surgery.

The surgical management of kidney cancer involves either the removal of an entire kidney (radical nephrectomy or simple nephrectomy) or only the part(s) of a kidney affected by cancer (partial nephrectomy, also called nephron-sparing surgery). Medical management options for more advanced kidney cancers may include radiotherapy, chemotherapy, immunotherapy, targeted therapy, or some combination of these. Targeted therapies act on the molecular pathways involved in the development of kidney cancer and seem to be the most promising medical management approach to date.