Metastatic Renal Cell Carcinoma

What are known risk factors for renal cell carcinoma?

Possible risk factors include age, smoking habits, exposure to carcinogens, radiation etc. Only about 4% of all kidney cancers is inherited.

Risk factors that clearly put one at risk of kidney cancer are not very well-known as in the case of most other cancers. Some of the known risk factors include:

I. Demographic factors

Age has been found to be a major determinant of incidence. Peak incidence is found above about 60 years of age, with 80% of cases within 40- 69 year population. In children, RCC represents only about 2-6% of all renal tumours. No correlation between socio-economic status or education with incidence of RCC has been found so far.

II. Smoking

A high incidence of RCC has been shown in smokers when compared to non-smokers.

III. Chemical carcinogens

Chemicals such as Asbestos, Cadmium, benzidine, benzene herbicides and vinyl chloride have been found to increase the risk of RCC. Coal oven workers, firefighters, workers exposed to asphalt and tar have been reported to be at high risk of RCC.

IV. Chronic intake of diuretics

Persons with a chronic intake of diuretics (drugs that increase the amount of water and salt expelled from the body) have been shown to be at a higher risk of developing RCC.

V. Familial factors

Most of the cases of RCC not inherited, while only 4% are familial. Some of the inherited sub-types of RCC include Von Hippel-Lindau (VHL) disease, hereditary papillary renal carcinoma and familial clear cell renal cell carcinoma.

VI. Diet and Obesity

Obesity has been shown to account for about 30% of all renal cancers. In addition, a hypercaloric (high in calories) diet is found to increase risk.

VII. Viruses

An immunosuppressant state related to the HIV infection determines that prevalence of RCC in the infected population rises 8.5 times compared to the prevalence of the noninfected ones. The influence of the polyomavirus SV 40 and of the adenovirus 7 has also been detected in experimental studies.

What are the symptoms?

As in many other types of cancer, symptoms are usually felt at advanced stages of the disease. Some of these include:

• Blood in the urine (Painless)
• Low back pain on one side
• Lump felt on the side or lower back
• Tiredness
• Loss of appetite
• Unexplained weight loss
• Fever that doesn’t go away
• Low red blood cell counts