Kidney Cancer

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What is Kidney Cancer?

Kidney cancer is a type of malignancy that originates in the kidneys, the two bean-shaped organs located on either side of the spine just below the ribcage. The kidneys are responsible for filtering blood, removing waste products, and regulating electrolytes and blood pressure. Kidney cancer typically begins in the lining of the tiny tubes (tubules) within the kidneys, with the most common type being renal cell carcinoma (RCC).

Importance of Early Detection

Detecting kidney cancer at an early stage is crucial for effective treatment and a favourable prognosis. In its early stages, kidney cancer may not produce noticeable symptoms, making regular check-ups and awareness of risk factors vital. When detected early, the cancer is more likely to be confined to the kidney and can often be treated successfully with surgical removal. Late-stage detection, where the cancer has spread to other parts of the body, may require more complex treatments and generally has a less favourable outcome.

Survival Rate

The survival rate for kidney cancer is highly dependent on the stage at which it is diagnosed, with a five-year survival rate of around 93% for localized kidney cancer (Stage I) and a significant decrease in survival rates for more advanced stages.

Types of Kidney Cancer

Kidney cancer is not a single disease but a category that encompasses several distinct types of malignancies that originate in different parts of the kidney. Here are the main types of kidney cancer:

Renal Cell Carcinoma (RCC)

Renal cell carcinoma is the most common type of kidney cancer, accounting for about 90% of all kidney cancer cases. It originates in the lining of the proximal convoluted tubule, a part of the small tubes in the kidney that filter and clean the blood. There are several subtypes of RCC, including:

  • Clear Cell RCC: The most common subtype, characterized by cells that appear clear or pale under a microscope.
  • Papillary RCC: The second most common subtype, forming finger-like projections within the tumour.
  • Chromophobe RCC: A rarer subtype, with cells that have distinct characteristics when viewed under a microscope.

Transitional Cell Carcinoma (TCC)

Transitional cell carcinoma, also known as urothelial carcinoma, accounts for about 5-10% of kidney cancers. Unlike RCC, which starts in the kidney itself, TCC begins in the renal pelvis, where the kidney connects to the ureter. This type of cancer can also occur in the bladder and other parts of the urinary system.

Wilms Tumor

Wilms tumour, or nephroblastoma, is a rare type of kidney cancer that primarily affects children, usually under the age of 5. It accounts for about 5% of childhood cancers and is highly treatable when detected early. The cause of Wilms tumour is not well understood, but it may be associated with certain genetic conditions.

Other Rare Types

In addition to the main types of kidney cancer, there are other rare forms that can occur, including:

  • Collecting Duct RCC: Originates in the kidney’s collecting ducts and is known for its aggressive nature.
  • Renal Sarcoma: A rare type of kidney cancer that starts in the blood vessels or connective tissue of the kidney.
  • Medullary Carcinoma: Often associated with a genetic condition called sickle cell trait, this rare type is aggressive and usually found in young adults.

Risk Factors

Understanding the risk factors for kidney cancer can aid in early detection and prevention. While having one or more risk factors does not mean that a person will develop kidney cancer, being aware of them can lead to more informed healthcare decisions. Here are the main risk factors for kidney cancer:

Genetic Factors

Certain inherited genetic mutations and familial syndromes can increase the risk of developing kidney cancer. These include:

  • Von Hippel-Lindau (VHL) Syndrome: A genetic disorder that increases the risk of various tumours, including clear cell RCC.
  • Hereditary Papillary Renal Carcinoma: A genetic condition that leads to an increased risk of papillary RCC.
  • Birt-Hogg-Dubé Syndrome: A genetic disorder that can lead to the development of chromophobe RCC and other tumour types.
  • Family History: Individuals with a close relative who has had kidney cancer may have an increased risk, although the reasons for this are not fully understood.

Lifestyle Factors

Certain lifestyle choices and environmental exposures can contribute to the risk of kidney cancer:

  • Smoking: Tobacco use is a significant risk factor, with smokers having a higher risk of kidney cancer compared to non-smokers. The risk decreases after quitting.
  • Obesity: Excess body weight may cause changes in hormones that increase the risk of kidney cancer.
  • Occupational Exposure: Exposure to certain substances, such as asbestos, cadmium, and organic solvents, in the workplace may increase the risk.

Medical Conditions

Some pre-existing medical conditions and treatments can also influence the risk of kidney cancer:

  • Hypertension: High blood pressure is associated with an increased risk of kidney cancer, although it is unclear whether the condition itself or the medications used to treat it are responsible for the increased risk.
  • Chronic Kidney Disease: Individuals with long-term kidney diseases or those on dialysis have a higher risk of developing kidney cancer.
  • Polycystic Kidney Disease: This inherited disorder, characterized by multiple cysts in the kidneys, may increase the risk of RCC.

The risk factors for kidney cancer are multifaceted and include genetic predispositions, lifestyle choices, and underlying medical conditions.

Symptoms and Signs

Common Symptoms

  • Blood in Urine (Hematuria): Urine may appear pink, red, or cola-colored.
  • Lower Back Pain: Pain on one side of the back, unrelated to injury.
  • Unexplained Weight Loss: Sudden loss of weight without a known cause.
  • Fatigue: Persistent tiredness.
  • Fever: Recurring fevers unexplained by infection.

Less Common Symptoms

  • Swelling in the Ankles and Legs: May occur if kidney cancer blocks blood flow in the renal vein.
  • High Blood Pressure: Sudden onset or difficult-to-control hypertension.
  • Anaemia: Decrease in red blood cells, leading to fatigue and pallor.
  • Changes in Liver Function Tests: May indicate kidney cancer.

When to See a Specialist

Consultation with a healthcare specialist is warranted if experiencing:

  • Persistent or recurrent symptoms.
  • Blood in the urine.
  • Significant weight loss.
  • Persistent pain in the side or lower back.


Physical Examination

A healthcare provider may perform a physical examination to check for any abnormalities, such as lumps or swelling in the kidney area.

Imaging Tests

  • Ultrasound: Utilizes sound waves to create images of the kidneys, helping to identify any unusual growths.
  • CT Scan: A type of X-ray that provides detailed cross-sectional images of the kidneys, aiding in the detection of tumours.


A biopsy involves taking a small sample of tissue from the kidney for examination under a microscope. This helps confirm the presence of cancer cells and may provide information about the type and aggressiveness of the cancer.

Staging of Kidney Cancer

Staging describes the size of the tumour and the extent to which it has spread within the kidney or to other parts of the body. The stages of kidney cancer are:

  • Stage I: Tumour is confined to the kidney and is less than 7 cm in size.
  • Stage II: Tumour is confined to the kidney but is larger than 7 cm.
  • Stage III: Tumour has spread to nearby lymph nodes or major blood vessels.
  • Stage IV: Tumour has spread beyond the kidney to other parts of the body.

The diagnosis of kidney cancer involves a combination of physical examination, imaging tests, biopsy, and staging. These procedures help determine the presence, type, and extent of the cancer, guiding the choice of treatment.

Treatment Options


Surgery is often the primary treatment for kidney cancer, especially if the tumour is confined to the kidney.

Types of surgery include:

  • Partial Nephrectomy: Removal of the tumour and a small margin of healthy tissue.
  • Radical Nephrectomy: Removal of the entire kidney, along with adjacent lymph nodes and adrenal gland if necessary.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It may be used to shrink the tumour before surgery or to treat cancer that has spread to other parts of the body.


Chemotherapy involves the use of drugs to kill cancer cells or stop them from growing. It is less common in kidney cancer treatment but may be used in certain cases, especially if other treatments are not effective.

Targeted Therapy

Targeted therapy uses drugs that specifically target the changes in cancer cells that help them grow and spread. These drugs can block the growth and spread of cancer cells while limiting damage to normal cells.


Immunotherapy boosts the body’s natural defences to fight cancer. It may be used alone or in combination with other treatments to enhance the immune system’s ability to target and destroy cancer cells.

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Prevention and Lifestyle Management

Diet and Nutrition

A balanced diet rich in fruits, vegetables, whole grains, and lean proteins may contribute to kidney health. Reducing the intake of high-fat and processed foods, as well as limiting alcohol consumption, can support overall well-being and may reduce the risk of kidney cancer.


Regular physical activity promotes general health and may help in maintaining a healthy weight, a factor that can influence the risk of kidney cancer. Engaging in activities such as walking, jogging, swimming, or other exercises for at least 150 minutes per week is generally recommended.

Regular Medical Check-ups

Regular medical examinations allow for early detection of any abnormalities, including those related to kidney health. Individuals with risk factors for kidney cancer, such as a family history or certain genetic conditions, may benefit from more frequent monitoring.


Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

Our Clinic Locations

Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

3 Mount Elizabeth, #11-16 Medical Centre, Singapore 228510

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

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    Frequently Asked Questions

    What are the early signs of kidney cancer?

    Early signs of kidney cancer may include blood in the urine, lower back pain on one side, unexplained weight loss, fatigue, and recurring fevers. Many of these symptoms are non-specific and can be related to other conditions.

    How is kidney cancer diagnosed?

    Diagnosis of kidney cancer typically involves a physical examination, imaging tests such as ultrasound and CT scans, a biopsy to examine tissue under a microscope, and staging to determine the extent of the cancer. These procedures collectively help in identifying the presence, type, and stage of the cancer.

    What are the treatment options for kidney cancer?

    Treatment options for kidney cancer may include surgery (either partial or radical nephrectomy), radiation therapy, chemotherapy, targeted therapy, immunotherapy, or a combination of these. The choice of treatment depends on the type, stage, and location of the cancer, as well as the patient’s overall health.

    Can kidney cancer be prevented?

    While there is no sure way to prevent kidney cancer, risk reduction may be possible through a healthy lifestyle. This includes maintaining a balanced diet, engaging in regular exercise, avoiding tobacco, limiting alcohol, and having regular medical check-ups, especially for those with known risk factors.