Running head: Renal Cell Carcinoma1

A Study of Renal Cell Carcinoma

Nicole D. Numamoto
Platt College

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A Study of Renal Cell Carcinoma
Renal cell carcinoma (RCC) is the most common type of renal cancer. This type of tumor
arises in the renal cortex from cells of the proximal tubule and are usually unilateral. These
tumors are called adenocarcinomas, which is an epithelial neoplasia that is glandular in origin.
Two subtypes exist, sporadic and hereditary. Nearly 21% of all cases of kidney cancer in the
United States result in death (Lewis, Dirksen, Heitkemper, & Bucher, 2011). This paper contains
information regarding signs and symptoms, diagnosis, medical and nursing management of RCC,
and evidence based research that supports the idea that a higher body mass index (BMI) may
contribute to RCC incidence.
RCC often presents without symptoms until it has significantly progressed. When it does
become symptomatic, the most common signs and symptoms are flank pain or tenderness,
hematuria without sensation of pain, and a palpable abdominal mass. Additional manifestations
include fever, weight loss, anemia or hypertension (Copstead & Banasik, 2013). The most
substantial risk factors for developing RCC are tobacco smoking and obesity. Computed
tomography (CT), ultrasound, angiography, magnetic resonance imaging (MRI), and a positive
biopsy are used in diagnosis of renal cancer. Resection and chemotherapy are the most common
options for treatment. Drugs commonly used include 5-fluorouracil, floxuridine and gemcitabine.
RCC however, is often not manageable with chemotherapy drugs alone. Nursing care constitutes
prevention of infection, pain management and nutrition, especially for patients in chemotherapy
(Lewis et al., 2011).
Understanding all possible causes and risk factors for RCC helps toward finding better
and more effective treatments. New cases of kidney cancer in the United States alone, amount to
around 65,000. The incidence of cancer in the United States is increasing but the reason for this

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is not known (Lewis et al., 2011). Bobulescu et al. (2014) as published by the Public Library of
Science, hypothesized that increased accumulation of lipids occurs in humans with higher BMI
and that lipotoxicity and lipid accumulation plays a role in the development of kidney cancer.
They found there was a statistically significant correlation between BMI and total kidney cortex
triglyceride amount (specifically in the proximal tubule). The cohort (N=54) showed that BMI
increased through tertiles of increasing kidney cortex triglycerides, and there was a significant
positive correlation between triglycerides and BMI ( = 0.28 and P=0.041). This suggests that
lipid accumulation and lipotoxicity may prevent the normal function of the tubule epithelium and
progress to cancer. This is compelling evidence for patients who are at risk for developing kidney
cancer to obtain a healthy BMI. Nurses are responsible for educating patients about obesity with
reference to risk factors associated with renal cell carcinoma (Bobulescu et al., 2014).
Renal cell carcinomas often have poor prognoses. Important signs that constitute further
investigation to rule out RCC, include flank pain or tenderness, painless hematuria or a palpable
abdominal mass. Two important modifiable risk factors include smoking and obesity. Diagnosis
includes scans like CT, ultrasound and MRI but is definitively confirmed by biopsy. Nursing is
important in the prevention of kidney cancer. Educating patients about the risks of smoking and
obesity may improve the incidence and outcome of RCC. All cancer research needs to continue
and expand, funding for cancer exploration needs to be increased and further experimentation
regarding the implications of obesity on kidney cancer needs to be advanced. Finally, a cure
needs to be achieved for this deadly disease.

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References
Bobulescu, I. A., Lotan, Y., Zhang, J., Rosenthal, T. R., Rogers, J. T., Adams-Huet, B., & Moe,
O. W. (2014). Triglycerides in the human kidney cortex: Relationship with body
size. Plos ONE, 9(8), 1-8. doi:10.1371/journal.pone.0101285
Copstead, L., & Banasik, J. (2013). Intrarenal disorders. Pathophysiology (5th Ed.). St. Louis:
Elsevier Saunders.
Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., (2014). Medical surgical nursing:
Assessment and management of clinical problems, (9th Ed.). St. Louis: Mosby Elsevier.