Renal Cell Carcinoma
Renal cell carcinoma (RCC) is the most prevalent form of kidney cancer, accounting for roughly 90% of all kidney malignancies in adults. It develops in the cells lining the small tubules inside the kidney and is notable for often growing silently, symptoms may not appear until the tumour is fairly large or has spread.
Key points
- RCC arises in the tubules lining the kidney and often grows silently until it is advanced or has spread.
- Risk rises after age 50 and is roughly doubled in men, with smoking, obesity and hypertension as established drivers.
- Loss of VHL tumour-suppressor function drives abnormal growth of blood vessels, a mechanism that targeted medicines such as sorafenib and everolimus exploit.
How renal cell carcinoma develops and who it affects
RCC most commonly arises in people over 50, and incidence is roughly twice as high in men as in women. Established risk factors include smoking, obesity, long-term high blood pressure, and chronic kidney disease. In many countries, rising rates of obesity and hypertension have contributed to a steady increase in diagnoses over recent decades.
Genetically, the most common subtype, clear cell RCC, frequently involves loss of function in the VHL tumour-suppressor gene, which triggers abnormal blood vessel growth within the tumour. This mechanism is directly relevant to how targeted medicines work.
Targeted treatments for advanced disease
When RCC is caught at an early, localised stage, surgery to remove part or all of the affected kidney offers good outcomes. Advanced or metastatic disease requires systemic therapy.
Targeted agents form the backbone of medical treatment. Sorafenib is a multikinase inhibitor that blocks signals driving tumour cell growth and angiogenesis; it has been widely used for advanced clear cell RCC. Everolimus works through a different mechanism, inhibiting the mTOR pathway that RCC cells often rely on for growth and survival, it is commonly used after initial targeted therapy stops working. Both are part of a broader class of medicines reviewed on the oncology support category page.
Blood in the urine, a persistent lump in the flank, or unexplained weight loss and fatigue warrant prompt medical review, as these are classic warning signs of RCC.