Kidney Cancer

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When I met my doctor [at City of Hope], he immediately made me feel at ease. I didn’t feel like a victim; I felt like I was going to be victorious." Joelle Hood, kidney cancer survivor

Kidney cancer can develop in adults and children, representing 3.8 percent of all new cancer cases in the United States. Kidney cancer is more common in men than women and among African Americans and American Indian and Alaska Native populations.

If you have been recently diagnosed with kidney cancer, talk to our integrated group of experts who will ease your concerns and focus on providing you the best possible care from the moment of diagnosis to active treatment to recovery and survivorship.

Request a Consultation

If you have been diagnosed with kidney cancer or are looking for a second opinion consultation about your treatment, you may request an appointment online or contact us at 800-826-4673. Please visit Making Your First Appointment for more information. 

Located in Southern California, City of Hope has been named a National Cancer Institute comprehensive cancer center, the highest designation that recognizes our commitment to cancer treatment, research and education. As a founding member of the National Comprehensive Cancer Network, our doctors also help develop and improve evidence-based kidney cancer treatment guidelines for patients throughout the country.

Highlights of our kidney cancer program include:

  • Our team’s ability to treat complex kidney cancers, including patients with advanced cancers and patients with other medical conditions
  • Our leadership in urologic surgeries, including minimally invasive and robotic operations that reduce discomfort and recovery time
  • Our surgeons’ experience in kidney-sparing cancer surgeries, preserving urinary function
  • Genomic and molecular profiling to identify the best possible treatments
  • A wide portfolio of drugs that can fight cancer better with fewer side effects
  • Ongoing research and clinical trials of promising new therapies, including immunity-based and stem cell therapies
  • Follow-up and recovery program focused on restoring urinary function and improving quality of life




What is kidney cancer?

Kidney cancer is a disease involving the abnormal and uncontrolled growth of cells in the kidneys, a pair of organs that removes waste products from the bloodstream and excretes them as urine.

About 90 percent of kidney cancers are renal cell carcinomas, which originate in the tubules that transport waste materials from the blood to the urine.

Rarer kidney cancers include transitional cell carcinoma (originating from the lining of the renal pelvis – where urine goes before it is transported to the ureter and urinary bladder), Wilms tumor (a subtype that primarily occurs in children) and renal sarcoma (from blood vessels and connective tissues within the kidney).

What increases your risk of kidney cancer?

Factors that can elevate risk of kidney cancer include:

  • A personal or family history of kidney cancer
  • Having an advanced kidney disease, particularly those requiring dialysis
  • Smoking
  • Obesity
  • High blood pressure
  • Gender: Kidney cancer is more common in men
  • Race/ethnicity: African-Americans and American Indians/Alaska Natives have a slightly higher risk of developing kidney cancer
  • Workplace chemicals: Exposure to cadmium, organic solvents and some herbicides increases kidney cancer risk.
  • Inherited genetic mutations, such as von Hippel-Lindau disease, hereditary renal cell carcinoma and Birt-Hogg-Dube syndrome

What are the symptoms of kidney cancer?

Most common kidney cancer symptoms are linked with urination changes, including:

  • Blood in the urine
  • A lump in the lower back
  • Persistent pain in your lower back on one side
  • Fatigue
  • Loss of appetite and unexplained weight loss
  • Anemia

Although these symptoms can be caused by other conditions, you should check with a doctor – preferably a urologist – so he or she can make a definitive diagnosis.

Sources: National Cancer Institute and American Cancer Society

Diagnosing kidney cancer

Once you notice symptoms, or as part of a routine examination, your doctor may use the following tests to look for kidney cancer:

  • Physical exam
  • Blood test: Abnormal readings in blood analysis – particularly red blood cell count, liver enzyme or blood calcium readings – can be indicative of kidney cancer.
  • Urine lab test (urinalysis): A sample of your urine is taken and examined for cancerous or precancerous cells or biomarkers indicating kidney cancer.
  • Biopsy: Surgical removal of suspicious tissues for further examination

If cancer is found, additional tests are performed to determine the type and stage of disease. These diagnostic tests include:

  • Computed tomography (CT or CAT) scan: This test involves taking a series of X-ray images at different angles to form a computer-generated image, which determines tumor size, location and number. CT scans may also be used to guide a biopsy.
  • Magnetic resonance imaging (MRI): This procedure images the kidneys using a powerful magnet, radio waves and a computer. Contrast agents may be injected to create clearer images. MRI may also be used to guide a biopsy.
  • Positron emission tomography (PET) scan: For this test, a radioactive material is injected into your bloodstream. Because cancer cells grow and divide faster than normal cells, they will absorb more of this radioactive material, which is then detectable as bright spots in a PET scanner.
  • Ultrasound: High energy sound waves are used to create images of the kidney, and they may be also be used to guide a biopsy.
  • Bone scan: This procedure uses a small amount of radioactive material to determine if kidney cancer cells have spread to the bones.
  • Chest X-ray: Because the lungs are a common site for kidney cancer’s spread, a chest X-ray may be used to see if the disease has metastasized.
  • Genomic testing: The cancerous tissue is tested to see if it exhibits certain genetic mutations, which can be used to determine better treatments.

Based on the results of these tests, the kidney cancer is then staged according to its size, number of lymph nodes affected and whether it has spread to nearby or distant organs. Kidney cancer is also evaluated by “grades” based on how much it resembles normal kidney cells and how aggressively it grows.

What are the current screening guidelines for kidney cancer?

There are currently no screening guidelines for kidney cancer, since no screenings have been shown to lower risk of dying from kidney cancer for people of average risk. However, your physician may recommend screening if you are at a high risk of developing kidney cancer, due to:

  • Personal/family history
  • Specific genetic mutations
  • Kidney conditions
  • Workplace chemical exposure

What are the treatment options for kidney cancer?

City of Hope has more active clinical trials for kidney cancer patients than any other center in the region." Sumanta Pal, M.D., Kidney Cancer Program co-director

Your kidney cancer is every bit as unique as you are, and that is why treatment at City of Hope is focused around you and your loved ones.

This means our physicians will personally consult with you about your disease, treatment options and desired outcomes. Afterward, our multidisciplinary team of specialists will work together to discuss, design and deliver an individual treatment plan to best meet those goals.

The innovative treatments we use to treat kidney cancer include surgery, drug therapy and radiation therapy.


Surgery is a common treatment option for most kidney cancer patients, and can be curative for patients with early-stage, localized cancers.

Depending on size, stage, grade and location of the tumor, surgeries performed include:

  • Radical nephrectomy: This involves surgical removal of the whole kidney, along with the adrenal gland and fatty tissue surrounding the kidney.
  • Partial nephrectomy: Also known as a nephron sparing surgery, this procedure only removes the part of the kidney that contains cancer.
  • Removal of metastases: For kidney cancer that has spread to other sites – such as the lung, bone, brain or liver – surgery to remove the primary kidney tumor and secondary metastatic tumors can extend survival and relieve symptoms.

When surgical removal of tumors is not an option, our doctors may aim to destroy or starve the tumors using other localized techniques, such as:

  • Applying extreme cold to the tumor (cryoablation)
  • Applying a high-energy current to the tumor (radiofrequency ablation)
  • Blocking the blood supply that feeds the tumor (arterial embolizaion)

Leader in kidney cancer surgery

  • City of Hope is a nationwide leader in kidney cancer surgery, specializing in minimally invasive robotic procedures that use smaller incisions compared to traditional open surgery - this equals less pain and blood loss as well as a shorter recovery time, allowing patients to be treated with follow-up therapies sooner.
  • Our surgeons have performed over 8,300 urologic procedures robotically, more than any other hospital in the western United States.  With our expertise, most of the renal surgical procedures can be done robotically.
  • For metastatic disease, our urologic surgeons will coordinate with other surgical oncologists so that primary and secondary tumors can be removed in a single operation.
  • After surgery, City of Hope also has a recovery and follow-up program for postsurgical patients, aimed at helping them minimize risk of complications and recover as quickly and fully as possible. Specialists in this program include nurses, rehabilitation therapists, occupational therapists, clinical social workers, psychologists, psychiatrists, dieticians and other supportive care medicine experts.

Drug Therapy

Drug therapy may be given to patients to fight kidney cancer cells throughout the body by killing them or stopping their growth and spread. These drugs include:

  • Chemotherapy, which targets rapidly-dividing cells, including kidney cancer cells
  • Targeted therapy, which selectively identifies and attacks kidney cancer cells
  • Immunotherapy, which stimulates the patient’s own immune system to attack cancer cells

Drugs may also be prescribed to treat conditions related to kidney cancer or its treatments, such as low blood cell counts, nausea or pain.

The drug or drug combination used depends on the type and stage of kidney cancer, previous treatments used, the patient’s health and overall treatment goals. This personalized medicine approach may be further enhanced by molecular or genetic testing of your cancer, which can help identify treatments that are more effective and with fewer side effects.

City of Hope has a wide portfolio of cancer-fighting drugs available in its on-site pharmacy, allowing our medical oncologists to plan and prescribe a drug regimen that can best fight kidney cancer while minimizing side effects.

In addition to standard drug treatments, patients may also be eligible for new, promising drugs through our clinical trials program.

Radiation Therapy

Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. It may be delivered externally using focused beams of energy, or internally by placing a radiation-emitting substance placed in or near the tumor site.

Kidney cancer is typically not treated with radiation therapy, due to the organ’s sensitivity to radiation and the cancer’s resistance to it. However, radiation may be used to treat secondary tumors at other sites or to alleviate symptoms associated with advanced cancer.

Because City of Hope offers the expertise of specialists in all fields related to kidney cancer, our patients receive greater continuity of care and more coordinated treatment planning. Our multidisciplinary team includes urologists, urologic surgeons, medical oncologists, nephrologists, palliative care specialists, case managers and more, working cooperatively to provide the most effective, innovative and advanced kidney cancer treatments available.

Urologic Oncologists

Kevin G. Chan, M.D.

Clinical Specialties

  • Urologic Oncology
  • Urology
Clayton S. Lau, M.D.

Clinical Specialties

  • Urologic Oncology
  • Urology
Bertram Yuh, M.D., M.S.H.C.P.M., M.I.S.M.

Clinical Specialties

  • Urologic Oncology
  • Urology
Jonathan Lim Yamzon, M.D.

Clinical Specialties

  • Urologic Oncology
  • Urology
Ali Zhumkhawala, M.D.

Clinical Specialties

  • Urologic Oncology
  • Urology

Medical Oncologists

Tanya Dorff, M.D.

Clinical Specialties

  • Medical Oncology
Sumanta Kumar Pal, M.D.

Clinical Specialties

  • Medical Oncology

Radiation Oncologist

Sagus Sampath, M.D.

Clinical Specialties

  • Radiation Oncology

Kidney cancer research and clinical trials

At City of Hope, kidney cancer clinicians and researchers collaborate extensively to develop and evaluate new therapies for better survival and quality-of-life outcomes. Our patients have access to a wide variety of clinical trials including new chemotherapy and targeted therapies, hormone therapies with fewer side effects, novel surgical techniques, innovative radiation approaches and new prevention strategies.

These trials give current patients access to promising, leading-edge therapies and improve overall care for future patients worldwide. Visit our clinical trials page to learn more about current studies and their eligibility criteria.

Some of our current research projects include:

  • PD-1 inhibitors (nivolumab): These drugs stimulate the body's immune system to fight kidney cancer. City of Hope has ongoing studies in conjunction with multiple cancer centers to determine optimal dose for maximum effectiveness.
  • MET inhibitors (cabozantinib): Led by City of Hope investigators, this study is exploring MET inhibitors such as cabozantinib; this class of drugs may be helpful in blocking proteins that fuel kidney cancer growth.
  • Genomics of rare kidney cancer: City of Hope is conducting research into the less common subtypes of kidney cancer, and whether genetic markers on these rare cancers can drive better detection and treatment.
  • Imaging of kidney cancer: In addition to using leading-edge robotic techniques, City of Hope surgeons have been exploring the use of fluorescent dyes that may highlight areas of kidney cancer during surgical procedures; this may prove to be an invaluable technique that enables surgeons to more completely excise the cancer.

Living with kidney cancer

No two cancer patients are the same, even if they have the same kind of cancer." Diane Geske, kidney cancer caregiver

When you come to City of Hope, you automatically gain access to an unparalleled array of support services to help you and your loved ones take each step during and after your kidney cancer treatment.

We can help with all of the following concerns, and more:

Learn more about these resources at our Living with Cancer or Supportive Care Medicine sites.

For more information about the supportive care programs we offer, please contact the Sheri & Les Biller Patient and Family Resource Center at 626-218-2273 (CARE).

Joelle, kidney cancer survivor

Joelle was shocked when she learned she had kidney cancer. Her doctor referred her to City of Hope, and Joelle knew she would be in good hands. After minimally invasive robotic surgery, Joelle is now cancer free.

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