Kidney Cancer Facts and more Types of Cancer | NFCR

Kidney Cancer

Kidney Cancer

Kidney cancer is among the 10 most common cancers in both men and women. While the rate of people being diagnosed with kidney cancer has been slowly increasing since the 1990s, in part due to increased use of medical imaging, the death rate has been slowly declining since the middle of the 1990s.

Key Facts

  • An estimated 76,080 new cases of kidney cancer will be diagnosed in the U.S. in 2021, with 13,780 deaths expected to result from the diagnosis.
  • The lifetime risk for developing kidney cancer is about 1 in 46 in men and 1 in 80 in women.
  • Men are twice as likely to develop kidney cancer as women.
  • Kidney cancer is uncommon in people younger than 45 and the average age of people when they are diagnosed is 64.
  • The overall five-year survival rate for people with kidney cancer is 75%.
  • Risk factors include smoking, obesity, high blood pressure, family history of kidney cancer, advanced or chronic kidney disease, and exposure to radiation therapy or carcinogenic chemicals such as trichloroethylene. African Americans and American Indians/Alaska Natives have slightly higher rates of renal cell carcinoma (most common type of kidney cancer) than do Caucasians.
Source: American Cancer Society’s Cancer Facts & Figures 2021 and the Society’s website

Signs and Symptoms

A symptom is a change in the body that a person can see and/or feel. A sign is a change that the doctor sees during an examination or on a laboratory test result. If you have any of the symptoms below, it does not mean you have cancer but you should see your doctor or health care professional so that the cause can be found and treated, if needed.

  • Blood in the urine
  • Low back pain on one side (not caused by injury)
  • A mass (lump) on the side or lower back
  • Fatigue (tiredness)
  • Loss of appetite
  • Weight loss not caused by dieting
  • Fever that is not caused by an infection and that doesn’t go away
  • Anemia (low red blood cell counts)
  • swelling of the ankles and legs
  • high blood pressure
  • For men, rapid development of enlarged veins around a testicle (particularly the right testicle)
Source: American Cancer 2021 and American Society of Clinical Oncology 2021
Orange Kidney Cancer Ribbon
76080
new cases expected in 2021
13780
deaths expected in 2021
64
average age of diagnosis

Kidney Cancer Research

In addition to specific projects listed below, genomics research is helping us attack kidney cancer – and all types of cancer. NFCR has distinguished itself from other organizations by emphasizing long-term, transformative research and working to move people toward cancer genomics.

Danny R. Welch, Ph.D.
Danny R. Welch, Ph.D.

Cancer that spreads from the primary tumor (metastasis) is the main reason that cancer patients lose their battle. Dr. Danny Welch and his team have discovered eight genes that get turned off when cancer cells become metastatic cells and are known as metastasis suppressor genes. A large effort in his lab is to determine how these suppressors normally prevent the spread of cancer so that unique anti-metastasis therapies can be developed. His current metastasis research has high impact for patients with kidney, breast, lung, ovarian, pancreatic, prostate, and skin cancer.

In addition, Dr. Welch’s team has identified genetic changes that predict whether or not patients will develop metastasis. At least some of these genetic changes occur in mitochondria – where cells convert nutrients into energy. Mitochondrial DNA is present in every cell and is small enough to be rapidly analyzed. This means that a simple blood draw and analysis of mitochondrial DNA could be used to guide doctors in treating those patients who are susceptible to metastasis and may need more aggressive treatment. Or, such a blood test could spare patients at low risk from having to undergo some of the side effects of treatment.

Paul Fisher, M.Ph., Ph.D.
Paul Fisher, M.Ph., Ph.D.
Dr. Web Cavenee
Web Cavenee, Ph.D.

Dr. Paul Fisher is developing gene therapies with IL/24, an immune modulator gene he discovered. IL/24 causes primary and spreading tumor cells throughout the body to commit ‘cell suicide’ but is non-toxic to healthy cells. IL/24 also activates the immune system, inhibits new blood vessel formation to starve tumors of vital blood and nutrients, and sensitizes tumor cells to radiation, chemotherapy and immunotherapy.

One IL/24 gene therapy includes a gene that fluoresces (lights up) when IL/24 finds and destroys tumor cells for a theranostic or detection- and treatment-monitoring approach. IL/24 when combined with a patient’s own immune T cells (adoptive cell therapy) supercharges the T cells to fight cancer. Research progress is advancing these gene therapies for primary and metastatic kidney, prostate, breast, lung, colon, brain and other cancers.

Together, Dr. Fisher and Dr. Web Cavenee have focused lL/24 gene therapy research for a new treatment for the aggressive brain cancer, GBM. With support from NFCR, IL/24 gene therapy will advance soon to a Phase I clinical trial to provide GBM patients hope for a new effective treatment. This treatment could one day benefit kidney cancer patients, too.

Xiang-Lei Yang, Ph.D. and Paul Schimmel, Ph.D.
Xiang-Lei Yang, Ph.D. and Paul Schimmel, Ph.D.

Aminoacyl-tRNA synthetases (aaRS) are vital ancient enzymes that make proteins in all living things. Dr. Paul Schimmel and Dr. Xiang-Lei Yang, experts in aaRS research, also study the enzyme’s other unexpected roles. One aaRS, SerRS, inhibits a pro-cancer gene and thwarts cancer’s growth and may play a role in activating the immune system to inhibit tumor progression. Expression of SerRS positively correlates with greater survival in patients with triple negative breast cancer as well as those with clear cell renal carcinoma and other cancers. SerRS may also be a suppressor of metastasis as enzyme levels are significantly decreased in breast tissue during metastasis. This critical research may lead to a novel way to treat cancer. SerRS level could potentially be used as a negative biomarker for metastasis, guiding selection of patients in clinical trials.

Wayne Marasco, M.D., Ph.D.
Wayne Marasco, M.D., Ph.D.

Dr. Wayne Marasco, who received NFCR funding for 25 years, has had great success in developing Mabs – proteins that are produced to bind to only one substance. One Mab attaches to carbonic anhydrase IX (CAIX), a protein highly expressed in renal cell carcinoma, the most common type of kidney cancer. Once attached, the CAIX Mab stops abnormal cancer growth. His team developed a promising immunotherapy for metastatic kidney cancer. The therapy not only includes CAIX Mabs to bind to CAIX growth-promoting proteins on kidney cancer cells, but also unblocks the immune system ‘T cells’ to enable more rigorous attacks against cancer.

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Kidney Cancer Detection Advances

About 73,820 new cases of kidney cancer are forecast to be diagnosed among Americans in 2019, and nearly 14,770 can be expected to die from the disease. Cancer of the kidneys, like any cancer, is most curable at an early stage. However, the majority of early-stage tumors do not present symptoms. In fact, many cases are discovered “by accident” during imaging for a range of other health conditions, by which point tumors have proceeded to advanced stages. But researchers in the United Kingdom recently identified a protein marker in the blood that could act as warning beacon five years in advance of the current standard of detection. When the molecule, called KIM-1, occurs in greater concentrations, the scientists found, the higher the risk is of developing kidney cancer. KIM-1 levels were also found to be linked with poor survival of the disease, as those with the highest levels in their blood were less likely to live. In the future, the scientists think that testing for blood KIM-1 levels could be used alongside imaging to confirm suspicions of kidney cancer, or help to rule out the disease. KIM-1, short for “kidney injury molecule-1,” is a type-1 transmembrane protein and is not normally present, but is expressed with injury. KIM-1 has proved to be an outstanding indicator of kidney injury in rat trials, outperforming blood urea nitrogen and serum creatinine levels as predictors of histopathological changes in the proximal tubule (part of the kidney’s filtration structure) in response to many pathophysiological states or toxicants. Previous to the British research, studies in humans strongly suggested that tissue expression and urinary excretion of KIM-1 are specific markers of injury, as well as predictors of outcome. “This work is a big step forward,” said Dr. David Muller of Imperial College London. “KIM-1 is the only blood biomarker shown prospectively to distinguish between people at high and low risk of kidney cancer. The next steps are to look more closely at whether KIM-1 levels can help detect tumors that have a good prognosis.” Professor Charles Swanton, Cancer Research UK’s Chief Clinician, adds: “The potential of blood tests for the detection and monitoring of cancers is becoming increasingly apparent, and this work offers further evidence that they could become powerful tools in the clinic. There is a pressing need to shift kidney cancer diagnoses towards earlier stages, when treatment is more likely to be successful, and this promising research is progress towards that goal. This work is still in early stages, so prospective studies of larger populations are needed before this approach could be widely adopted.” “It’s now crucial to understand more about how KIM-1 could be incorporated into patients’ treatment,” comments Dr. Rural Bhatt, a senior author based at Harvard Medical School. “We’re excited about progressing this important work further and testing whether KIM-1 levels could help identify patients who may benefit from additional treatment after surgery, and therefore potentially improve their outlook.” Cancer markers in the blood comprise an expanding and exciting field. Such NFCR fellows as Daniel Haber, Ph.D., and Wei Zhang, Ph.D., are leading figures. More advances seem to be around the corner, […]

Simulations Could Extend Life for Kidney Cancer Patients

Surgery is one of the oldest treatments for cancer. Even as research and technology have progressed, surgery has remained an excellent choice of treatment. Kidney cancer, whose attention we are called to especially during the month of March, is often treated with a surgical process called a partial nephrectomy. A partial nephrectomy means that the tumor is removed whilst sparing the kidney. A partial nephrectomy is a complex surgery that can only be done at an early stage. As most cases of kidney cancer are identified at early stages, the surgical procedure is the most common form of treatment. Unfortunately, some patients find that a nephrectomy may severely threaten their health. Individuals diagnosed with heart disease, kidney disease or other comorbidities may not be viable patients for the surgical procedure. Such diseases could greatly negatively impact the life expectancy of a patient who undergoes a nephrectomy. Being that small kidney tumors may be benign, patients that are not suitable candidates may avoid surgery by undergoing active surveillance. Active surveillance allows medical professionals to monitor the tumor. Periodic CT scans make it possible for medical professionals to track the growth of the tumor and delay surgery for at-risk patients. While a worthwhile effort, active surveillance is vastly underutilized. This is due, in part, to the lack of guidelines illustrating when to act if surgery is in fact needed. Medical professionals are often not equipped with proper decision-making tools when it comes to weighing the risk of comorbidities against surgery. At the beginning of this year, however, researchers developed a model that may bring more value to the decision-making process. New York University’s Stella Kang, M.D., and her teammates there, Memorial Sloan Kettering Cancer Center and Massachusetts General Hospital identified the need to effectively weigh the risks. They developed computer-based simulations to measure the impact of various methods of treatment for kidney cancer patients. Each of the simulations involved a patient with a small kidney tumor. The simulations accounted for variables such as severity of kidney disease and other comorbidities. After one million simulations, Dr. Kang and her research team discovered that partial nephrectomies were rarely the most effective way to extend the life expectancy in patients with chronic kidney disease. Personalized strategies, including active surveillance, extended life expectancy by more than two years when compared with surgery. The results from Dr. Kang’s study may greatly impact the decision-making process in clinical settings. Simulations using the patient’s data could aid in identifying the correct treatment for an individual. While the simulation does not suggest one specific course of action, it does allow doctors and patients to examine the risks of treatment options. In addition to benefiting individuals battling kidney cancer, these results could impact additional clinical areas. It is a great demonstration of the clinical significance in simulations. Simulations are not limited in time and expense unlike most clinical trial studies. They also offer individualized outcomes which cannot be provided by studies. References: • https://www.cancer.net/cancer-types/kidney-cancer • https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/surgery/about • https://pubs.rsna.org/doi/10.1148/radiol.2018181114 • https://www.sciencedaily.com/releases/2019/01/190115103533.htm

Kidney Cancer Intervention & Prevention

This month is Kidney Cancer Awareness Month, and March 8, is World Kidney Day. In this National Foundation for Cancer Research blog post, we will look at recent scientific advances in the battle against the most common form of the disease: Renal Cell Carcinoma (RCC). In 2018, just under 64,000 people will be diagnosed with kidney cancer in the United States. This staggering statistic places kidney cancer as one of the top 10 common cancers in the U.S. Luckily, we are starting to see groundbreaking medical intervention strategies for people suffering from RCC, its most prevalent iteration. We are also now able to identify major lifestyle approaches for RCC and other cancer risk mitigation efforts. Intervention Emerging research coming out of the Georgetown Lombardi Comprehensive Cancer Center has people in the RCC community excited. This research shows promising antitumor results with combining immunotherapy agents with anti-angiogenesis agents without adverse effects. This approach has been taken before but with much less success, due to the toxicities which developed from the combined treatments. However, the combination of axitinib (Inlyta) and pembrolizumab (Keytruda) has now shown significant antitumor results in people with advanced kidney (also known as renal) cancers, without the toxicities that were previously experienced. Axitinib is a small molecule tyrosine-kinase inhibitor which inhibits a protein growth factor that is crucial for the growth of new blood vessels (angiogenesis). This helps shrink tumors by reducing their nutrient supply through the bloodstream. Pembrolizumab is an antibody which binds to our immune cells and allows them to better recognize cancer cells as “foreign” and pathogenic. Often times, cancer cells have proteins which block our immune system cell’s recognition of cancer cells as pathological. With this immunotherapy agent, the immune system can identify and attack cancer cells more effectively. These two drugs combined are proving to be safer, more effective and better tolerated for people with advanced kidney cancers. New immunotherapy agent and anti-angiogenesis agents, including atezolizumab and bevacizumab, are also being actively researched. The current standard treatment option for patients with early detected lung cancer and comorbidities (other medical conditions), has now been proven to be effective and safe for those with RCC. This treatment is stereotactic ablative radiotherapy (SABR). Stereotactic ablative radiotherapy (SABR) is a highly focused radiation treatment that gives an intense dose of radiation concentrated on a tumor, while limiting the dose to the surrounding organs. The recent research in the use of this treatment towards RCC has provided important information showing that it is effective, safe, well-tolerated and can preserve kidney function. Kidney Cancer Prevention Although treatments for kidney cancer are swiftly progressing, it is still of great importance to focus on prevention. The major risk factors for kidney cancer are smoking, obesity and high-blood pressure. Interestingly, there is a question of if antihypertensive medications (which reduce blood pressure) may actually be a risk factor for kidney cancer. The evidence is polarized and inconclusive in this area. Regardless, it is advised to address these three areas of health with a holistic approach. Finding the time to exercise, reducing stress, improving diet and taking the necessary steps to quit smoking will […]