Kidney Cancer: The Silent Disease You May Not Know You Have

Kidney cancer is probably not something most people think about when they feel healthy. Hence, it is one of the reasons many of them are diagnosed in advanced stages.

According to Dr Christopher Lee Kheng Siang, Consultant Urologist & Robotic Surgeon at Sunway Medical Centre, Sunway City, kidney cancer, also known as renal cell carcinoma (RCC), can develop without obvious symptoms in its early stages. Kidney tumors can appear as solid growths or complex cysts. Some are benign, while others are cancerous and require prompt treatment.

Although kidney cancer is relatively uncommon, late diagnosis remains a concern in Malaysia. “In Malaysia, 47 per cent of kidney cancers are detected late. While early RCC has a high cure rate, late-stage disease is often not curable, and treatment is mainly aimed at prolonging survival,” Dr Christopher explains.

Why Kidney Cancer Can Be Hard to Detect

Early kidney cancer often causes no symptoms. Many tumours are discovered by chance during an abdominal ultrasound or health screening.
Symptoms may only appear as the tumour becomes larger.

These can include:

-Pain in the abdomen or lower back
-Blood in the urine
-A swelling or lump in the abdomen
-Persistent tiredness
-Loss of appetite
-Unexplained weight loss

Having these symptoms does not necessarily mean someone has kidney cancer. However, they should not be ignored, especially if they persist.

How Is Kidney Cancer Diagnosed?

If a kidney tumour or suspicious cyst is found, the patient will usually be referred to a urologist for further assessment. A contrast CT scan of the kidneys and urinary tract is commonly used to examine the tumour more closely.

“CT scans can diagnose kidney cancers with an accuracy of 95 to 99 per cent, and in most cases, a biopsy is not required before treatment,” Dr Christopher says. The next step depends on the size, location and characteristics of the tumour.

Early Detection Can Make a Difference

The good news is that kidney cancer can often be successfully treated when found early. Surgery may be recommended to remove the cancer. Depending on the tumour, doctors may perform a partial nephrectomy, which removes the tumour while leaving the rest of the kidney intact. In other cases, the entire kidney may need to be removed. “Partial nephrectomy is always preferred when feasible, as it preserves a functioning kidney,” says Dr Christopher.

Preserving kidney function is particularly important for younger patients, people with only one functioning kidney, or those who may be at risk of chronic kidney disease.

Smaller Incisions, Faster Recovery

Kidney surgery can be performed through open surgery, laparoscopic surgery or robotic-assisted techniques. Minimally invasive approaches use smaller incisions. This can mean less pain, shorter hospital stays and a quicker return to normal activities.

For larger kidney tumours that cannot be treated with partial nephrectomy, laparoscopic removal of the kidney is now commonly used. Open surgery may still be needed for more complex cases.

How Robotic Surgery Helps

Robotic-assisted surgery has also expanded the options available for kidney cancer treatment. The technology gives surgeons a magnified, three-dimensional view of the surgical area. It also provides precise instruments that can make delicate movements easier.

This can allow surgeons to perform complex partial nephrectomies while preserving as much healthy kidney tissue as possible. However, the robot does not perform the operation independently.

“The robot does not operate on its own. All movements are completely controlled by the surgeon, without any automated or artificial intelligence-driven actions,” Dr Christopher explains.

Why Regular Health Screening Matters

One of the biggest challenges with kidney cancer is that it can remain silent for a long time. By the time symptoms appear, the disease may already be more advanced. This is why kidney abnormalities are sometimes discovered during routine health checks before symptoms develop.

“RCC is a highly curable disease when detected early. Comprehensive annual health screening is the only reliable way to diagnose kidney cancer early, as it is often silent,” says Dr Christopher.

Early detection may allow doctors to remove only the tumour and preserve more of the kidney. For Malaysians who feel perfectly well, regular health screening can therefore be more than a routine check-up. It could help detect a problem before it has a chance to become more serious.