Kidney cancer 101: symptoms, treatments new and old – and a mother’s journey to recovery
- Immunotherapy keeps mother-of-two Niki Ridge fighting fit after kidney cancer spread to her lungs, ribs, spine, breast – and brain
When Niki Ridge started having night sweats and a cough, she saw her doctor, thinking the sweats might be related to the hormone replacement therapy she was having for menopause. Her doctor agreed, but sent her for a chest X-ray to explore the cough.
“Kidney cancer can be a bit of a b****r,” says Ridge, a 57-year-old mother of two teenage boys living in the United Kingdom. “It is often found incidentally, when people are having other medical investigations.”
She pinpoints the big problem with kidney cancer: “Symptoms are usually associated with advanced disease.”
Kidney cancer is also referred to as renal cancer. Around 80 per cent of kidney cancers are renal cell cancers that start in cells in one of the kidneys’ nephrons, that filter the blood and make urine.
Early kidney cancers are generally asymptomatic, says Dr Ngo Chang-chung, a specialist in urology at Hong Kong’s CUHK Medical Centre.
“Many are discovered during ultrasound scans for routine check-ups or through CAT scans done as investigations for other complaints,” he says.
A study published in the peer-reviewed medical journal The BMJ found that 60 per cent of kidney cancer patients were diagnosed incidentally: 87 per cent of those with stage 1a – the earliest stage – were found incidentally, as were 36 per cent with stage 3 or 4 disease.
Patients who have symptoms usually have poorer outcomes, since symptoms do not usually occur until the disease is advanced. These may include kidney pain, hematuria (blood in the urine) and weight loss.
Lower back pain, tiredness, or a low-grade fever and sweating have also been cited as symptoms – all easily dismissed as signs of something else.
CAT scans of the abdomen and kidneys with contrast, like the one Ridge had, is the gold standard for kidney cancer diagnosis and treatment planning, says Ngo.
There are currently no reliable or evidence-based tumour markers for kidney cancer as there are for some other cancers, he says.
Kidney cancer is one of the most common cancers in the United States, with over 81,000 new diagnoses in 2023. A report published in February this year found that the disease is becoming more prevalent worldwide, with an estimated 400,000 new cases annually.
In the UK, rates have risen by 47 per cent over the past decade. Part of this rise can be attributed to an ageing population – according to the UK’s National Health Service, kidney cancer is most common in the over-60s. But obesity, which is also on the rise, is another suspect cause.
On a more hopeful note though, advances in testing and treatment mean that kidney cancer is much more treatable than it once was.
Surgical removal of the tumour remains the most effective means, says Ngo. The procedure has been fine-tuned over the years – now aided by robotics – so that as much of the kidney as possible is preserved.
The trend now, Ngo says, is towards a partial kidney removal, using a minimally invasive approach to preserve the normal kidney tissue to reduce the risks of further development of kidney failure because of loss of the affected kidney.
Ablation is another treatment option: using radiology to guide them, doctors stick needles into the tumour to either freeze it or microwave it. This kills the tumour while preserving the kidney.
Some people respond very well to immunotherapy, some do not, and some even have a complete response, Ridge’s doctor told her.
“Luckily, the side effects haven’t been too bad for me,” she says of her first four treatments.
The decision was made to leave the breast tumour untouched and for immunotherapy to continue uninterrupted. Within six months, the breast tumour had vanished. The tumour in Ridge’s brain was removed surgically and she was ready to go home 48 hours later.
Ridge describes her past year as “stable” – with no disease progression.
“I still have my main tumour and bone metastases, and some enlarged lymph nodes, but nothing that impacts me. I will keep on with the immunotherapy for as long as it keeps working. Usually there are four lines of treatment available, and I’m really happy to still be on my first.”
“Of course I have less good days, and the ‘scanxiety’ is real every three months, but I have strategies I can use to help stop the ‘what ifs’ and catastrophising,” she says. “I had some great counselling from the hospital. I have a good group of friends and my family are also amazing.”
While her life had felt like it was on hold for a bit, Ridge, who recently started cancer support group Swindon Cancer Connect on Facebook, has plans this year.
“I’ve got a couple of girlie trips to Spain soon, and we’re planning a family trip to Iceland in July.”
She will have treatments every four weeks, “for as long as possible”.
“I had no idea that people like me existed, that you could live with an advanced cancer, and be able to live well,” she says.
