Everything You Need to Know — From Diagnosis to Cure
A Patient Guide by Dr. Rohit Dadhwal
Urologist & Robotic Surgeon | Fortis Hospital, Mohali
Important:
Most kidney tumours today are discovered incidentally on scans done for other reasons — before any symptoms appear. This is actually good news, because early discovery means the best chance of cure with kidney-preserving surgery. Read on to understand what a kidney tumour means for you.
1. Understanding Your Kidneys
You have two kidneys, each about the size of a fist, located on either side of your spine just below your ribcage. The kidneys are remarkable organs — every single day, they filter about 200 litres of blood, removing waste products and excess fluid, which are then excreted as urine.
Beyond filtering blood, the kidneys also regulate blood pressure, control the balance of salts and minerals in your body, and produce hormones that stimulate the production of red blood cells. In short, healthy kidneys are vital for overall wellbeing.
A kidney tumour occurs when cells in the kidney begin to grow in an abnormal, uncontrolled way, forming a lump or mass. Not all kidney tumours are cancerous — some are benign (non-cancerous) — but all require proper evaluation by a specialist.
2. How Common are Kidney Tumours?
Worldwide
Kidney cancer (also called Renal Cell Carcinoma or RCC) is among the ten most common cancers in the world. Globally, approximately 431,000 new cases are diagnosed every year, with higher rates seen in North America, Europe, and Australia.
The incidence has been rising steadily over the past three decades, largely due to more widespread use of ultrasound and CT scans, which detect tumours that would otherwise go unnoticed.
In India
In India, kidney cancer accounts for roughly 2–3% of all cancers. While historically considered less common than in Western countries, the rates are rising — especially in urban populations.
The increased use of health check-up scans has led to a significant jump in incidental detection of small kidney tumours. Cities like Delhi, Mumbai, Chandigarh, and Bengaluru report the highest numbers.
Key Fact:
Nearly 60–70% of kidney tumours in India today are now detected incidentally — meaning the patient came in for an unrelated scan (for back pain, stomach check-up, etc.) and a kidney mass was found accidentally. This is a major shift from the past, when most patients came with advanced symptoms.
Why is Kidney Cancer Increasing?
• Greater use of ultrasound and CT scans — detecting more tumours early
• Rising rates of obesity — a strong risk factor for kidney cancer
• Increasing rates of high blood pressure and diabetes — both linked to kidney cancer
• Smoking — a well-established risk factor
• Ageing population — kidney cancer is more common in people above 50
3. Types of Kidney Tumours
Not all kidney tumours are the same. It is important to understand the different types.
| Type | Description | Nature |
|---|---|---|
| Clear Cell RCC | Most common type — about 75% of kidney cancers | Malignant (cancerous) |
| Papillary RCC | Second most common type | Malignant (cancerous) |
| Chromophobe RCC | Generally less aggressive | Malignant (cancerous) |
| Oncocytoma | Benign tumour — looks similar to RCC on scans | Benign (non-cancerous) |
| Angiomyolipoma (AML) | Contains fat — often diagnosed on CT scan | Usually benign |
| Transitional Cell Carcinoma | Arises from the lining of the kidney’s collecting system | Malignant (cancerous) |
| Wilms Tumour (Nephroblastoma) | Primarily occurs in children | Malignant (cancerous) |
The exact type and behaviour of a kidney tumour is determined by imaging and, when needed, biopsy. Your Urologist will guide you based on your specific findings.
4. Risk Factors for Kidney Cancer
| Risk Factor | Details |
|---|---|
| Smoking | Doubles the risk; responsible for about 30% of kidney cancers in men |
| Obesity | Excess body fat is a major and growing risk factor |
| High Blood Pressure | Both the condition and some BP medications are linked to higher risk |
| Diabetes | Associated with increased kidney cancer risk |
| Family History | Hereditary forms such as Von Hippel-Lindau (VHL) syndrome |
| Chronic Kidney Disease | Long-term dialysis patients have higher risk |
| Age | Most common between 60–70 years; rare below 40 |
| Gender | Men are nearly twice as likely to develop kidney cancer as women |
| Chemical Exposure | Prolonged exposure to trichloroethylene (industrial solvent) |
5. Symptoms — What Should Alert You?
The Silent Nature of Kidney Tumours:
Most small kidney tumours cause no symptoms at all. The classic ‘triad’ of symptoms — blood in urine, flank pain, and a lump in the abdomen — is now seen in only about 10% of patients, and usually indicates a more advanced tumour.
This is why routine health check-ups and scans are so important.
Symptoms That May Appear
• Blood in the urine (haematuria) — urine may appear pink, red, or cola-coloured
• Pain or aching in the side, back, or flank area
• A lump or mass that can be felt in the abdomen or side
• Unexplained weight loss
• Persistent fatigue and lack of energy
• Fever that comes and goes without any obvious infection
• Loss of appetite
• Swelling of the ankles and legs
• High blood pressure that is difficult to control
• Anaemia (low haemoglobin) without an obvious cause
Do not wait for symptoms.
If you are above 40 with risk factors such as obesity, smoking, or high blood pressure, a simple ultrasound abdomen as part of a routine health check-up can detect kidney tumours at a very early and curable stage.
6. How is a Kidney Tumour Diagnosed?
Step 1 — Ultrasound Abdomen
An ultrasound is usually the first investigation done. It is painless, quick, and uses no radiation. It can detect most kidney masses but may not give complete details about the nature of the tumour.
Step 2 — CT Scan (with and without contrast)
A CT scan of the abdomen and pelvis with contrast dye gives a very detailed picture of the kidney tumour — its size, location within the kidney, involvement of nearby blood vessels, lymph nodes, and other organs.
This is the most important scan for planning treatment.
Step 3 — MRI Scan
An MRI may be used when CT findings are unclear, when the patient cannot receive contrast dye, or to better assess involvement of the main renal vein or inferior vena cava.
Step 4 — Chest CT Scan
A CT scan of the chest is done to check if the cancer has spread to the lungs.
Step 5 — Biopsy (Selected Cases)
Kidney tumours are not routinely biopsied before surgery. CT scan characteristics are usually sufficient to diagnose the tumour.
Step 6 — Blood Tests and Kidney Function
Blood tests including complete blood count, kidney function tests, liver function, and calcium levels are important parts of the workup.
7. Understanding the Staging of Kidney Cancer
| Stage | What it means | Outlook |
|---|---|---|
| Stage I | Tumour 7 cm or less, confined to the kidney | Excellent — >90% cure rate with surgery |
| Stage II | Tumour more than 7 cm, still confined to kidney | Very good — surgery is curative |
| Stage III | Tumour has spread to nearby veins or lymph nodes | Good — surgery often still curative |
| Stage IV | Tumour has spread to distant organs | Advanced — requires systemic treatment |
Good News:
More than 65% of kidney cancers in India are now being detected at Stage I or II, when surgical cure is highly achievable.
8. Treatment Options for Kidney Tumours
Small Tumours (Below 2–3 cm) — Active Surveillance
For very small kidney tumours, active surveillance with regular scans may be a safe option.
Ablation — Burning the Tumour
Minimally invasive techniques such as radiofrequency ablation (RFA) or cryoablation can destroy the tumour without surgery.
Surgery — The Mainstay of Treatment
Surgery remains the cornerstone of treatment for kidney cancer. There are two main types of kidney surgery:
Radical Nephrectomy — Removal of the Entire Kidney
The entire kidney is removed along with surrounding fat and sometimes lymph nodes.
Partial Nephrectomy — Removing Only the Tumour
Only the tumour is removed while preserving the rest of the kidney.
The Golden Rule in Kidney Cancer Surgery:
Save as much healthy kidney as possible.
Treatment for Advanced (Metastatic) Kidney Cancer
• Targeted therapy: Sunitinib, Pazopanib, Cabozantinib
• Immunotherapy: Nivolumab, Pembrolizumab
• Combination therapy
• Cytoreductive nephrectomy
• Radiation therapy
9. Robotic Surgery for Kidney Cancer — Precision, Safety, and Kidney Preservation
At Fortis Hospital Mohali, robotic kidney surgery is performed using the 4th generation Da Vinci Xi robotic system.
Advantages of Robotic Surgery
| Parameter | Robotic Surgery Advantage |
|---|---|
| Incision Size | 4–5 tiny holes (<1 cm each) |
| Blood Loss | Significantly less |
| Post-op Pain | Much less |
| Hospital Stay | 2–3 days |
| Recovery Time | Return to normal life in 2–3 weeks |
| Kidney Preservation | Better preservation of healthy kidney tissue |
| Warm Ischaemia Time | Shorter clamping time |
| Tumour Margins | High rates of clear surgical margins |
| Complication Rate | Lower |
| Cosmesis | Minimal scarring |
10. Why Saving Your Kidney Matters — The Long-Term Picture
Patients who retain more kidney tissue have:
✓ Lower risk of chronic kidney disease
✓ Lower risk of dialysis
✓ Better blood pressure control
✓ Lower risk of cardiovascular disease
✓ Better quality of life
11. Recovery After Robotic Kidney Surgery
During Your Hospital Stay (Days 1-3)
• Wake up in recovery room
• Drain tube may be placed
• Pain well controlled
• Walking encouraged next day
• Food started early
• Discharge Day 2-3
First Two Weeks at Home
• Take short walks
• Avoid heavy lifting
• Keep wounds clean
• Drink plenty of water
Weeks 3-6
• Return to desk work in 2-3 weeks
• Full activity by 4-6 weeks
Monitoring After Surgery — Surveillance Scans
• Blood tests every 3-6 months
• CT scan at regular intervals
• Follow-up depends on tumour stage
12. Frequently Asked Questions
Q: I was told I have a kidney cyst — is that the same as a kidney tumour?
No. Simple kidney cysts are extremely common and usually benign.
Q: My tumour was found by accident. Does that mean it is not serious?
Incidental discovery usually means the tumour was detected early and is highly curable.
Q: Can I have surgery if I only have one kidney?
Yes. Kidney preservation becomes even more important.
Q: Will I need chemotherapy after kidney surgery?
Usually no for localised kidney cancer.
Q: How long does robotic kidney surgery take?
Approximately 2–3 hours.
Q: Is robotic surgery available in Mohali?
Yes. Fortis Hospital Mohali has the Da Vinci Xi robotic system.
Q: What if my cancer has spread to the vein?
Specialised surgery may be required.
A Message from Dr. Rohit Dadhwal
Kidney cancer, when detected early, is one of the most curable cancers we treat in urology. With modern robotic surgery, we can remove the tumour completely while preserving your kidney — protecting both your cancer outcome and your long-term kidney health.
If you or a family member has been told about a kidney mass, do not panic. Seek a specialist opinion early. In most cases, a single robotic operation is all that is needed for a complete cure.
For consultations and appointments:
Department of Urology & Robotic Surgery, Fortis Hospital, Mohali.
Dr. Rohit Dadhwal
MCh Urology (AIIMS, New Delhi) | Robotic Surgery | Uro-Oncology
Fortis Hospital, Mohali, Punjab, India