Clinical update

Kidney cancer

The National Institute for Health and Care Excellence has helped people with advanced kidney cancer to benefit from a new treatment on the NHS.

Essential facts 

Kidney cancer is the seventh most common cancer in the UK, with around 12,500 cases diagnosed in the UK each year. Numbers are increasing, mainly due to lifestyle factors. There were 4,400 kidney cancer deaths in the UK in 2014.

Picture: Science Photo Library

There are a number of different types of kidney cancer; the most common is renal cell carcinoma which accounts for 90% of cases.  

What’s new 

People with advanced kidney cancer are set to benefit from a new treatment, after the National Institute for Health and Care Excellence (NICE) declared cabozantinib should be available on the NHS. The treatment is for those with advanced renal cell carcinoma, which starts in cells lining the small tubes that help to make urine. In the advanced stage of the disease, the tumour spreads to other parts of the kidney and in some cases to nearby lymph glands. Cabozantinib inhibits the growth of new blood vessels within a tumour, and so prevents it spreading. Around 1,000 patients a year could benefit from the drug, NICE says.  

Signs and symptoms 

Blood in the urine and a lump or mass in the kidney area are common symptoms. Weight loss, a high temperature and very heavy sweating, persistent back pain below the ribs, tiredness, loss of appetite and a general feeling of poor health are also reported.  

Causes and risk factors 

Half of cases are diagnosed in people aged over 70, and it is rare below 50 years of age. It is more common in men. Being obese, smoking, having long-term dialysis due to kidney disease, family history and some genes increase risk. High blood pressure and diabetes may increase risk. Radiotherapy for some other cancers, including prostate and cervix, increase risk.  

Helping patients

Refer people using a suspected cancer pathway referral (an appointment within two weeks) for renal cancer if they are over 45, and have unexplained visible haematuria without urinary tract infection or visible haematuria that persists or recurs after successful treatment of urinary tract infection. Nurses should signpost patients with kidney cancer to the urology nurse specialist in a general hospital. In oncology centres, the disease specific nurse specialist would be the point of contact.  

Expert comment 

 Andrea Spencer-Shaw, renal cancer clinical nurse specialist at Christie Hospital NHS Foundation Trust

‘Having a diagnosis of kidney cancer can be a life changing event especially if there is metastatic spread. Many patients remain relatively well despite being on treatment, and will be able to continue to lead a fairly normal life and continue to work.

'Side effects obviously have an impact, but the nurse specialist is important in the management of these and balancing dose with quality of life. Some patients can live many years with metastatic kidney cancer, while others do not respond to any treatment and can die within months of diagnosis.

'The renal cancer nurse specialist refers on to other services for benefits advice, psychological support, pain control, but we are the central point of all care, and coordinate care even if patients are admitted to other hospitals via the acute oncology teams.


Further information

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