Feeling healthy does not always mean everything is fine. Kidney cancer can develop without noticeable symptoms, which means some tumours are only found when a person has an ultrasound or other scan for an unrelated reason.
The following insights come from Dr Christopher Lee Kheng Siang, Consultant Urologist & Robotic Surgeon at Sunway Medical Centre, Sunway City, who explains what to look out for, how kidney cancer is diagnosed and why early detection matters.
Kidney cancer, also known as renal cell carcinoma (RCC), can develop as a solid tumour or a complex cyst. Some kidney tumours and cysts are benign, while others are cancerous and require treatment.
In Malaysia, 47% of kidney cancers are detected at a late stage, according to Dr Christopher. Early-stage RCC has a high cure rate, but treatment becomes more difficult once the disease has progressed.
The Warning Signs
Early kidney cancer often has no symptoms. This is one reason it can go undetected.
When symptoms do appear, they can include blood in the urine, pain in the abdomen or lower back, or swelling in the abdomen. More advanced cases may cause fatigue, loss of appetite or unexplained weight loss.
These symptoms can also be linked to other health conditions, so they do not automatically mean someone has kidney cancer. But persistent or unexplained symptoms should be checked by a doctor.
“Early kidney tumours and cysts are usually silent,” Dr Christopher says. He adds that many are found incidentally during abdominal ultrasound scans performed as part of health screening.
How is Kidney Cancer Diagnosed?
When a kidney tumour or suspicious cyst is found, patients are usually referred to a urologist for further assessment.
A contrast CT scan of the kidneys and urinary tract is commonly used to determine whether a growth is cancerous. CT scans can identify kidney cancer with an accuracy of 95 to 99%. In many cases, a biopsy is not needed before treatment.
Why Preserving the Kidney Matters
For early-stage RCC, surgery can often remove the cancer while preserving the rest of the kidney. This is known as a partial nephrectomy. In some cases, the entire kidney may need to be removed.
“Partial nephrectomy is always preferred when feasible, as it preserves a functioning kidney,” says Dr Christopher.
Keeping as much healthy kidney tissue as possible can be particularly important for younger patients, people with one functioning kidney or those at risk of chronic kidney disease.
Where Robotic Surgery Comes In
Kidney cancer surgery can be performed using open, laparoscopic or robotic-assisted techniques.
Laparoscopic and robotic procedures use smaller incisions than open surgery. They can result in less pain, shorter hospital stays and a faster return to normal activities.
For larger tumours that cannot be treated with a partial nephrectomy, laparoscopic removal of the kidney is now commonly used. Open surgery may still be required for more complex cases.
Robotic-assisted surgery has also expanded the options for some patients who might otherwise require removal of the entire kidney.
The system gives surgeons a three-dimensional, high-definition view and instruments designed for precise movement. This can help surgeons perform technically difficult partial nephrectomies while preserving the kidney.
Importantly, the robot does not operate independently. Every movement is controlled by the surgeon.
Should You Get Screened?
There is no routine population-wide screening programme for kidney cancer in Malaysia, and major medical guidance does not recommend routine screening for people at average risk. Kidney cancers are often found incidentally during imaging done for other reasons.
People with symptoms or risk factors should discuss their individual situation with a doctor. Risk factors can include smoking, obesity, high blood pressure, a family history of kidney cancer and certain inherited conditions.
For those who do develop symptoms, blood in the urine, persistent pain in the side or lower back, unexplained weight loss and ongoing fatigue are among the signs worth getting checked.
Kidney cancer can be difficult to spot early precisely because it may not cause any symptoms. That makes paying attention to changes in your health and seeking medical advice when something does not seem right especially important.
