Kidney cancer: spotting the signs

Kidney cancer is the seventh most common cancer in the UK. On average, just under 14,000 people are diagnosed each year.

Among the key challenges of diagnosing is that often there may be no obvious symptoms and therefore it could be detected when testing for other conditions, such as a urinary tract infection (UTI). It’s helpful to always have this cancer in the back of your mind as a consideration when you’re speaking to patients. 

In practice, this means many cases are not diagnosed until they're well advanced. Kidney Cancer UK is urging better awareness of risk factors and early symptoms, enabling health care professionals to refer patients for further investigations in a more timely way.   

What are the main symptoms?   

When there are symptoms, the NHS says these may include:  

• blood in urine 
• a lump or swelling in someone’s back, under their ribs or in their neck 
• pain between ribs and waist that doesn’t go away 
• a loss of appetite or losing weight, without trying  
• feeling tired or lacking in energy 
• a high temperature that doesn’t go away
• perspiring a lot, including at night. 

However, these symptoms may be caused by other concerns so it’s essential nursing staff have this in the back of their mind when caring for patients. 

“Potentially, the symptoms can be misinterpreted,” says Callum Metcalfe-O’Shea, RCN Professional Lead for Long-Term Conditions.

“Blood in the urine one of the most common signs, but often we think first about UTIs or kidney stones. It’s about being mindful that kidney cancer could also be a cause. Health care professionals, particularly nursing staff, need to be aware of the risks and what to look out for.”  

What role can nursing staff play in diagnosis and treatment? 

"Even if you’re not a specialist in this area, you can advise patients with red flag symptoms, such as fever or unexplained weight loss, to seek expert review and further screening,” Callum says.

Nursing staff are also pivotal in treatment. “But it’s also important that we look at cancer holistically,” she adds.

“For many patients, this is a real and significant psychological trauma, and they may need signposting to relevant support services. Nursing staff should also be considerate of family, carers and relatives who may also need support.”   

What are the more common treatments? 

Depending on the stage and size of the tumour, these may include surgery to remove either the whole kidney or part of it. Patients may also need to have some lymph nodes removed.   

Those not well enough for surgery may be offered arterial embolism, which blocks its blood supply, helping to shrink the cancer and control symptoms. Other treatment options include cryotherapy, which uses small needles to freeze the cancer cells, or radiotherapy ablation, which uses radio waves to kill cancer cells.

Patients may also have radiotherapy, chemotherapy, or targeted medicines.

How can I help patients following diagnosis? 

Looking at what happens after someone’s treatment has ended is another area where nursing staff can make a difference, says Callum. “We need to look at living beyond cancer,” he says. “For those who’ve had treatment, there may be some long-term side-effects, such as tiredness, loss of libido or changes to their appearance.

"For patients, it’s also about living beyond cancer treatments and nursing staff are vital in ensuring they have access to the right help.”