Medically reviewed by
M.Ch. Urology (CMC Vellore) · Fellowship in Urologic Oncology & Robotic Surgery (University of Miami) · NMC Reg. No. NMC/2005020914
This page is for general health information and education only. It does not replace a consultation, diagnosis or treatment by a qualified doctor who has examined you.
Kidney cancer (most often renal cell carcinoma) is now commonly found by chance on an ultrasound or CT scan done for another reason. Many small kidney tumours can be treated by removing only the tumour and saving the rest of the kidney (partial nephrectomy).
Symptoms and incidental masses
Most kidney cancers cause no symptoms early on. When symptoms occur they can include blood in the urine, pain in the side, or a lump. A large share of kidney tumours are now detected incidentally on imaging.
Tests and staging
- Contrast CT or MRI of the abdomen to characterise the mass and check the veins and lymph nodes.
- Chest imaging to look for spread.
- Kidney function tests, because preserving kidney function is a key goal.
- Biopsy is used selectively, for example when imaging is unclear or before surveillance or ablation.
Fluid-filled kidney cysts are graded with the Bosniak system; Bosniak III and IV cysts carry a higher chance of cancer.
Treatment options at a glance
| Option | Who it usually suits | Notes |
|---|---|---|
| Active surveillance | Small tumours (often under 2–3 cm) in older patients or those with other health problems | Regular scans; treatment if the tumour grows |
| Robotic partial nephrectomy | Most tumours up to 4 cm (T1a) and selected tumours up to 7 cm (T1b) | Removes the tumour and preserves the rest of the kidney |
| Radical nephrectomy | Large or centrally placed tumours where the kidney cannot be safely preserved | Removes the whole kidney |
| Ablation | Selected small tumours in patients not suited to surgery | Needle-based heat or freezing treatment |
| Treatment for advanced cancer | Cancer that has spread | Immunotherapy and targeted therapy, sometimes with surgery |
Tumours of the drainage system (urothelial cancer of the renal pelvis or ureter) are treated differently; see surgery for ureteral cancer.
Frequently Asked Questions
Can kidney cancer be treated without removing the whole kidney?
Often, yes. Partial nephrectomy removes only the tumour and is the standard for most tumours under 4 cm and for selected tumours up to 7 cm when it is technically safe.
Is every kidney mass cancer?
No. Some solid masses are benign, and most simple cysts are harmless. Imaging features, and sometimes a biopsy, help decide.
Will I need dialysis after kidney surgery?
Most people with a normal other kidney do not need dialysis. Preserving kidney function is one reason partial nephrectomy is preferred when possible.
References
- EAU Guidelines on Renal Cell Carcinoma, European Association of Urology, 2025 edition. uroweb.org
- Campbell SC et al. Renal Mass and Localized Renal Cancer: AUA Guideline (2021 amendment). J Urol 2021;206:199–208.