Chromophobe renal cell carcinoma (chromophobe RCC) is a rare type of kidney cancer that starts in the lining cells of the tiny tubes in the kidney that help clean the blood and make urine. It makes up about 5% of all kidney cancers, so it is much less common than clear cell kidney cancer.
Chromophobe renal cell carcinoma (chRCC) is a rare type of kidney cancer that starts in the tiny tubes that filter the blood inside the kidney. It usually grows more slowly and often has a better outlook than the most common type, “clear-cell” kidney cancer.[1][2] Under the microscope, the cancer cells look pale and “chromophobic,” which means they do not pick up certain stains used in the lab. Because this cancer is rare, doctors often use treatment plans that are based on large kidney-cancer studies in general, and then adjust them to fit chromophobe disease as well as possible.[1][2][3]
In this cancer, the tumor cells look big, pale, and “washed out” under the microscope, with clear borders around each cell. Doctors can tell chromophobe RCC from other kidney cancers by this special look and by special color stains (immunohistochemistry) used in the lab.
Chromophobe RCC usually grows slower and is less aggressive than many other kidney cancers. This means people with this tumor often have a better chance of long-term survival, especially when the cancer is found early and removed by surgery.
Chromophobe RCC can appear alone (sporadic) or as part of some rare inherited syndromes, especially Birt-Hogg-Dubé (BHD) syndrome, which raises the risk of several types of kidney tumors.
Other names
Chromophobe renal cell carcinoma can also be described with other names or phrases. These names all point to the same main tumor type or very closely related tumors.
Chromophobe kidney cancer – a simpler name often used for patients.
Chromophobe RCC – short form used in medical papers and reports.
Non-clear cell renal cell carcinoma, chromophobe subtype – used when listing kidney cancers by main group.
Birt-Hogg-Dubé–associated chromophobe RCC – when the tumor occurs in people with BHD syndrome.
Hybrid oncocytic/chromophobe tumor – a related tumor type that has features of both chromophobe RCC and renal oncocytoma; sometimes discussed together with chromophobe RCC.
Types of chromophobe renal cell carcinoma
Doctors and pathologists describe a few main patterns of chromophobe RCC. These patterns are based on how the cells look under the microscope and on special stains.
Classical (typical) chromophobe RCC
In this type, the tumor cells are large, pale, and polygonal (many-sided), with clear borders and a “raisin-like” wrinkled nucleus in the center. This is the most common pattern and is usually easier for the pathologist to recognize.Eosinophilic (oncocytic) variant
In this type, the cells have more pink or red (eosinophilic) cytoplasm instead of very pale cytoplasm. The tumor can look similar to a benign oncocytoma, so extra tests are needed to separate the two.Mixed classical and eosinophilic type
Some tumors show both the pale classical cells and eosinophilic cells in different parts of the same tumor. This “mixed” pattern still belongs to chromophobe RCC but can make diagnosis more complex.Hybrid oncocytic/chromophobe tumors
These tumors have areas that look like oncocytoma and areas that look like chromophobe RCC. They are especially common in people with Birt-Hogg-Dubé syndrome and may behave less aggressively than typical kidney cancers, but careful follow-up is still needed.Chromophobe RCC with sarcomatoid change
In a small number of tumors, some parts change into a spindle-cell or sarcoma-like pattern called “sarcomatoid” change. When this happens, the cancer usually behaves more aggressively and has a worse outlook.
Causes and risk factors
For most people, doctors cannot point to a single clear cause for chromophobe RCC. Instead, several risk factors make this cancer more likely. Having one or more risk factors does not mean a person will definitely get this cancer, but it raises the chance.
Age (getting older)
Kidney cancers, including chromophobe RCC, are more common in adults over 50. As we age, our cells collect more DNA damage, and this damage can sometimes lead to cancer.Male sex
Kidney cancer overall is more common in men than in women. Hormones, lifestyle factors, and job exposures may all play a role in this difference.Family history of kidney cancer
Having a close relative (parent, brother, sister) with kidney cancer slightly raises a person’s risk. This may be due to shared genes, shared environment, or both.Birt-Hogg-Dubé (BHD) syndrome
This rare inherited condition is caused by harmful changes in the FLCN gene. People with BHD have a higher risk of chromophobe RCC and hybrid oncocytic/chromophobe tumors, often in both kidneys.Other hereditary RCC syndromes
Some other inherited kidney cancer syndromes, such as von Hippel-Lindau disease or hereditary leiomyomatosis and RCC, can also increase kidney cancer risk, although they are more strongly linked with other RCC subtypes.Smoking
Smoking is a well-known risk factor for kidney cancer. Harmful chemicals in tobacco smoke enter the blood, reach the kidneys, and can damage the DNA in kidney cells over time.High blood pressure (hypertension)
Long-term high blood pressure stresses the blood vessels and kidney tissues. People with long-standing or poorly controlled hypertension have a higher risk of RCC.Obesity (high body weight)
Extra body fat changes hormone levels and increases chronic low-grade inflammation in the body. Both of these can promote the growth and survival of abnormal cells, raising kidney cancer risk.Long-term misuse of certain pain medicines
Heavy, long-term use of some pain pills (especially older types of phenacetin-containing drugs) has been linked to kidney problems and a higher risk of kidney cancer.Long-term dialysis and acquired cystic kidney disease
People on dialysis for many years often develop many small cysts in their kidneys. This “acquired cystic kidney disease” raises the risk of several types of RCC, including chromophobe RCC.Occupational exposure to certain chemicals
Some workers, such as those who handle trichloroethylene or certain heavy metals, may have a higher risk of kidney cancer, possibly because these chemicals damage kidney cells.Chronic kidney disease (CKD)
People with long-lasting kidney damage have a higher risk of kidney tumors. Damaged kidney tissue is more likely to develop abnormal growths.Previous radiation to the abdomen
High-dose radiation to the belly area for another cancer may slightly raise the chance of kidney cancer years later, as radiation can alter DNA in kidney cells.Metabolic syndrome
A combination of obesity, high blood pressure, high blood sugar, and abnormal cholesterol (metabolic syndrome) has been linked to increased kidney cancer risk.Diabetes
Some studies suggest that people with diabetes may have a higher chance of RCC, possibly related to insulin resistance, inflammation, or kidney damage from high blood sugar.Male hormones and lifestyle patterns
Lifestyle factors more common in men (such as higher rates of smoking and some jobs) and differences in sex hormones may partly explain the higher risk in males.Unhealthy diet and low physical activity
Diets high in processed meats, high salt, and low in fruits and vegetables, together with little physical activity, may increase the risk of kidney cancer over time.Immune system problems
People who take strong immune-suppressing medicines, such as organ transplant patients, can have a higher risk of several cancers, including RCC.Genetic changes in tumor-suppressor genes
In chromophobe RCC, common changes include losses of entire chromosomes and mutations in genes like TP53 and PTEN. These changes reduce the cell’s ability to repair damage and control growth.Birt-Hogg-Dubé FLCN gene mutation (specific genetic cause)
In people with BHD, a germline mutation in the FLCN gene is a direct cause of their higher risk of chromophobe-type kidney tumors and hybrid tumors.
Symptoms and signs
Many people with chromophobe RCC have no symptoms at first. The tumor is often found by chance on an ultrasound or CT scan done for another reason. When symptoms do occur, they are usually similar to those of other kidney cancers.
Blood in the urine (hematuria)
The urine may look pink, red, or cola-colored, or the blood may be seen only on a lab test. Blood appears because the tumor breaks tiny blood vessels inside the kidney.Pain in the side or back (flank pain)
Dull, constant pain on one side of the lower back or side can occur when the tumor stretches the kidney capsule or presses on nearby nerves and tissues.A lump or mass in the belly or side
Sometimes a doctor or the patient can feel a firm lump in the abdomen or flank. This usually happens when the tumor has grown large.Unexplained weight loss
A person may lose weight without trying. Cancer cells use a lot of energy and release substances that change how the body uses food and muscle, leading to weight loss.Tiredness and weakness (fatigue)
Many people with kidney cancer feel very tired. This can be caused by anemia (low red blood cells), poor sleep, or the body’s response to the tumor.Fever without clear infection
Some people have frequent or long-lasting fevers without signs of infection. This happens because the tumor releases chemicals that reset the body’s temperature control.Night sweats
Heavy sweating at night can go along with fever and weight loss as part of a general “cancer-related” symptom group.High blood pressure
The tumor or reduced kidney function can change hormone levels that control blood pressure, leading to new or worsening hypertension.Swelling of legs or ankles (edema)
If kidney function is reduced, the body may hold on to salt and water, causing swelling in the lower legs or around the eyes.Anemia (low red blood cells)
Many kidney cancer patients have anemia, which causes pale skin, shortness of breath on exertion, and feeling dizzy or tired. This happens because the tumor and kidney damage change hormone signals that control red blood cell production.Varicocele in men (especially on the left side)
A new or worsening cluster of enlarged veins in the scrotum (varicocele), especially on the left, can be caused by a kidney tumor pressing on the testicular vein.Bone pain (if cancer spreads to bone)
If the cancer has spread to bones, a person may feel deep, persistent pain in the spine, hips, or ribs, and sometimes be at higher risk for fractures.Shortness of breath or cough (if cancer spreads to lungs)
Metastases in the lungs can cause ongoing cough, chest discomfort, or breathlessness, especially with activity.Loss of appetite
Many people with kidney cancer feel less hungry or feel full quickly. The body’s inflammatory response and tumor-related substances reduce the appetite.General feeling of being unwell
People often describe a vague feeling that “something is wrong”: low energy, mild aches, and not feeling like themselves, even before clear symptoms appear.
Diagnostic tests
Doctors use a mix of physical examination, manual measurements, lab and pathology tests, electrodiagnostic tests, and imaging to diagnose chromophobe RCC, see how far it has spread, and plan treatment. Imaging and tissue examination are the most important for confirming the diagnosis.
1. General physical examination (Physical exam)
The doctor checks overall health, vital signs (pulse, temperature, breathing), weight, and body build. They look for signs like pale skin, fever, weight loss, or weakness, which may suggest chronic illness or cancer.
2. Abdominal examination (Physical exam)
The doctor inspects and gently presses on the belly and flank areas to feel for any masses, tenderness, or asymmetry. A large kidney tumor may be felt as a firm, non-tender lump in the upper abdomen or side.
3. Costovertebral angle (CVA) tenderness test (Physical exam)
The doctor taps gently over the area where the lower ribs meet the spine to check for pain. Pain here can suggest kidney problems such as infection, stones, or a mass, and prompts imaging of the kidneys.
4. Examination for leg swelling and varicocele (Physical exam)
The doctor looks for swelling in the legs and ankles and checks the scrotum in men for an enlarged cluster of veins (varicocele). These signs may point to kidney or vein blockage from a tumor.
5. Blood pressure measurement with sphygmomanometer (Manual test)
Using a cuff on the arm, the doctor or nurse measures blood pressure. High blood pressure is common in people with kidney disease and kidney tumors, and it also affects treatment planning.
6. Manual weight and body mass index (BMI) check (Manual test)
The patient is weighed on a scale, and height is measured to calculate BMI. This helps assess obesity as a risk factor and detect unplanned weight loss related to cancer.
7. Manual palpation of lymph nodes (Manual test)
The doctor feels for enlarged lymph nodes in the neck, armpits, and groin. Enlarged nodes can sometimes indicate spread of cancer or other serious disease and help guide further imaging and staging.
8. Urinalysis (Lab test)
A urine sample is tested with dipsticks and a microscope to look for blood, protein, or abnormal cells. Hidden blood in the urine (microscopic hematuria) can be an early sign of kidney or urinary tract tumors.
9. Urine cytology (Lab/pathological test)
In this test, urine is examined under a microscope by a pathologist to look for cancer cells. It is more helpful for cancers of the bladder and ureter but can sometimes give clues when blood in the urine is present.
10. Complete blood count (CBC) (Lab test)
A blood sample is tested to measure red blood cells, white blood cells, and platelets. Kidney cancer can cause anemia, changes in white cells, or abnormal platelets, which may affect symptoms and treatment decisions.
11. Kidney function tests: creatinine and eGFR (Lab test)
Blood levels of creatinine and the estimated glomerular filtration rate (eGFR) show how well the kidneys are working. Knowing kidney function is critical before deciding on surgery or other treatments that may affect the only remaining kidney tissue.
12. Serum electrolytes and calcium (Lab test)
Blood tests measure electrolytes such as sodium, potassium, and calcium. Some kidney cancers cause high calcium levels (hypercalcemia), which can produce confusion, constipation, or heart rhythm problems and must be managed promptly.
13. Liver function tests (Lab test)
These blood tests look at liver enzymes and proteins. They help assess general health and can show if cancer has spread to the liver or if the liver can handle certain medicines.
14. Coagulation profile (Lab test)
Tests such as PT, aPTT, and INR measure how well the blood clots. They are important before surgery or biopsy to reduce bleeding risk and may be influenced by liver function or tumor-related changes.
15. Histopathological examination of tumor tissue (Pathological test)
A sample of the tumor, obtained by needle biopsy or after surgery, is examined under the microscope by a pathologist. This is the gold standard test that confirms chromophobe RCC by its cell features and growth patterns.
16. Immunohistochemistry (IHC) panel (Pathological test)
Special stains are used on the tumor tissue to detect proteins such as CK7, CD117, and others. Chromophobe RCC has a characteristic staining pattern that helps distinguish it from clear cell RCC and oncocytoma.
17. Electrocardiogram (ECG) (Electrodiagnostic test)
An ECG records the heart’s electrical activity and is often done before major surgery or certain medicines. It checks for heart rhythm problems and overall heart health to be sure the patient is fit for anesthesia and treatment.
18. Renal ultrasound (Imaging test)
Ultrasound uses sound waves to create images of the kidneys. It can show a solid mass, its size, and whether it is cystic or solid. It is often the first imaging test done when there is blood in the urine or flank pain.
19. Contrast-enhanced CT scan of abdomen and pelvis (Imaging test)
CT scans use X-rays and computer processing to give detailed cross-section pictures. With contrast dye, CT can show the exact size, location, blood supply, and spread of the kidney tumor and nearby lymph nodes, and is central in staging RCC.
20. MRI of abdomen (and sometimes chest) (Imaging test)
MRI uses strong magnets and radio waves to create detailed images without radiation. It is especially useful in patients who cannot receive CT contrast or when doctors need a closer view of blood vessels, the renal vein, or the inferior vena cava for tumor extension.
Non-Pharmacological Treatments (Therapies and Other Approaches)
Below are 20 helpful non-drug strategies often used around chromophobe renal cell carcinoma care. They support medical treatments, reduce side effects, and improve quality of life.[1][4][5]
1. Education and shared decision-making
Your cancer team explains the type of cancer, stage, and treatment options in clear language. You are invited to ask questions and say what matters most to you. The purpose is to help you feel informed and involved in choices such as surgery, drugs, or surveillance. The mechanism is simple: when people understand their disease and options, they are more likely to follow the plan, notice side effects early, and feel less fear and confusion.[1]
2. Active surveillance and close monitoring
For small, slow-growing chromophobe tumors or in very frail patients, doctors may watch carefully instead of treating right away. You have regular scans, blood tests, and check-ups. The purpose is to avoid overtreatment when the tumor is not changing. The mechanism is early detection of growth or spread so treatment can start at the right time, not too early and not too late.[1][2]
3. Smoking-cessation support
Tobacco is a strong risk factor for kidney cancer and can worsen heart and lung health. Stopping smoking with counseling, phone support, and nicotine-replacement or prescription aids lowers the chance of new cancers and complications from surgery or drugs. The mechanism is reduced exposure to cancer-causing chemicals and improved oxygen delivery and blood flow, which helps healing and treatment tolerance.[1][6]
4. Physical-activity and exercise programs
Light to moderate exercise (walking, cycling, stretching) is usually safe during and after treatment when approved by your doctor. The purpose is to maintain muscle strength, heart fitness, and mood, and to reduce cancer-related fatigue. The mechanism is better blood flow, hormone balance, and reduced inflammation; large studies show more activity is linked with better outcomes in many cancers.[4][6][13]
5. Healthy, mostly plant-based diet counselling
A diet rich in vegetables, fruits, whole grains, beans, nuts, and healthy fats, with limited red and processed meat, sugar, and ultra-processed food, is encouraged for many cancer patients. The purpose is to support weight control, gut health, and immune function. The mechanism is that plant foods bring fiber, vitamins, and phytochemicals that lower inflammation and may reduce cancer risk and recurrence.[4][5][7][14]
6. Weight management and body-composition support
Being very underweight or very overweight can both worsen outcomes. Dietitians and physical-activity specialists help you avoid unplanned weight loss and also avoid unhealthy weight gain from inactivity or steroids. The mechanism is better hormone balance, blood-pressure control, and heart health, which supports long-term kidney-cancer survival.[4][11]
7. Blood-pressure and heart-health lifestyle changes
High blood pressure is common in kidney-cancer patients and can be worsened by some targeted drugs. Lifestyle steps like reducing salt, staying active, losing extra weight, and limiting alcohol help control blood pressure. The mechanism is reduced strain on blood vessels and kidneys and lower risk of heart attack or stroke during treatment.[1][6]
8. Stress-management and mind-body therapies
Simple tools like breathing exercises, mindfulness, yoga, or guided imagery can lower stress, anxiety, and insomnia. The purpose is to help you cope emotionally with diagnosis and treatment. The mechanism is activation of the body’s “rest and relax” system, lowering stress hormones, heart rate, and muscle tension; this may indirectly support immunity and healing.[4]
9. Psycho-oncology and counselling
Professional counsellors and psychologists who understand cancer help with sadness, fear, body-image concerns, and family stress. The purpose is to reduce depression and anxiety and improve coping skills. The mechanism is giving safe space to process emotions and learn practical tools for communication, problem-solving, and resilience.[4]
10. Non-drug pain-management strategies
Techniques such as gentle physiotherapy, massage by trained providers, heat or cold packs, positioning, and relaxation exercises can reduce pain. The purpose is to minimize the need for high-dose pain medicines where possible. These methods work by relaxing muscles, improving blood flow, and reducing the brain’s focus on pain signals.[4][5]
11. Fatigue-management and energy-conservation training
Cancer-related fatigue is very common. Occupational therapists teach you how to pace activities, plan rest breaks, and prioritize tasks. The purpose is to help you still do meaningful daily activities without “crashing.” The mechanism is smarter use of limited energy and prevention of de-conditioning from over-resting.[4]
12. Physical therapy and post-surgery rehabilitation
After kidney surgery, you may have weakness, stiffness, or trouble with bending and lifting. Physical therapists guide safe exercises for the core, back, and legs, plus breathing exercises. The mechanism is rebuilding muscle strength and flexibility, improving balance, and lowering the risk of blood clots and chest infections.[1]
13. Occupational therapy and return-to-work planning
Occupational therapists help you adjust daily tasks, workplace demands, and tools if you have pain, fatigue, or physical limits. The purpose is to safely return to work or study when possible. The mechanism is adapting the environment and tasks instead of expecting your body to do everything the same way as before.[4]
14. Sleep-hygiene support
Cancer anxiety, steroids, and pain can disturb sleep. Simple rules like a regular bedtime, limiting caffeine and screens at night, and keeping the bedroom dark and quiet can help. The mechanism is supporting the brain’s natural sleep-wake cycle, which improves mood, memory, and immune function.[4]
15. Social-work and financial-counselling support
Cancer treatment is expensive and stressful. Social workers help with insurance, transport, disability forms, and connecting with community resources. The mechanism is reducing money and logistics stress so you can focus more on recovery and less on paperwork and bills.[4]
16. Palliative-care consultation (at any stage)
Palliative care is not only for end of life. Specialists in this field focus on relief of pain, breathlessness, nausea, and emotional distress from the time of diagnosis. The purpose is to improve quality of life alongside active cancer treatment. The mechanism is skilled symptom control and whole-person support, which can even help people live longer in some cancers.[4]
17. Infection-prevention education and vaccination review
Some drugs for kidney cancer can weaken the immune system. Nurses review hand-washing, food safety, dental care, and vaccine status (like flu and COVID-19 vaccines). The mechanism is lowering the chance of serious infections that can interrupt or delay treatment.[1][4]
18. Kidney-function monitoring and nephrology co-care
Even one removed kidney can work well, but kidney function must be checked with blood and urine tests. In people with reduced kidney function, a nephrologist (kidney specialist) may help adjust blood-pressure and diabetes medicines. The purpose is to protect the remaining kidney tissue and avoid dialysis if possible.[1]
19. Telehealth and remote-monitoring visits
Video or phone visits and remote symptom reports can reduce hospital trips while keeping close contact with the team. The purpose is tracking side effects early and avoiding emergency visits. The mechanism is earlier intervention when lab results or symptoms start to change.[1][4]
20. Support groups, peer-mentors, and spiritual care
Talking with others who have kidney cancer or with trusted spiritual leaders can provide comfort and hope. The mechanism is reducing loneliness, sharing coping strategies, and supporting meaning and purpose during and after treatment.[4]
Drug Treatments
Many drug regimens used for chromophobe RCC are based on medicines that were tested mainly in clear-cell RCC but are approved for “advanced renal cell carcinoma” in general. Final choice always depends on your exact case, lab results, and guidelines your oncologist follows.[1][2]
Note: Drug details below are simplified and not dosing instructions for self-use. Doses come from FDA prescribing information on accessdata.fda.gov and must always be adjusted by your oncology team.[7][8][9][10][11][12][13][14][15][16][17][18][19]
1. Sunitinib (SUTENT)
Sunitinib is an oral targeted drug (kinase inhibitor) that blocks signals (VEGFR, PDGFR and others) that tumors use to grow new blood vessels.[7] It is used for advanced RCC as a first-line or later-line therapy. A common starting pattern in RCC is 50 mg once daily for 4 weeks followed by 2 weeks off, in repeating 6-week cycles, under close monitoring.[7][30][1] Side effects can include fatigue, mouth sores, high blood pressure, hand-foot skin reaction, and low blood counts.[7]
2. Pazopanib (VOTRIENT)
Pazopanib is another oral VEGF-targeted kinase inhibitor approved for adults with advanced RCC.[8][12] Usual starting dose is 800 mg once daily on an empty stomach, with dose changes for side effects or interactions.[12][16] It works by blocking several growth-factor receptors, slowing new vessel formation that feeds the tumor.[1] Important side effects include liver toxicity, high blood pressure, diarrhea, hair color changes, and heart-rhythm changes, so liver and heart tests are needed.[8][20]
3. Cabozantinib (CABOMETYX)
Cabozantinib is an oral kinase inhibitor for advanced RCC, including use after other targeted drug therapy and in combinations.[9][17] A usual recommended dose for monotherapy is 60 mg once daily, taken on an empty stomach.[17] It blocks MET, AXL, and VEGFR pathways to reduce tumor growth and spread.[1][9] Side effects include diarrhea, mouth sores, fatigue, high blood pressure, hand-foot syndrome, and risk of bleeding or bowel perforation.[17]
4. Axitinib (INLYTA)
Axitinib is a VEGFR-targeted oral drug approved for advanced RCC after failure of one prior systemic therapy and in combinations as first-line therapy.[10][1] A common starting dose is 5 mg twice daily, with careful dose adjustments based on tolerance and blood pressure.[10][14] It slows growth of blood vessels feeding the cancer. Common side effects include diarrhea, high blood pressure, fatigue, hand-foot syndrome, and changes in thyroid function.[10]
5. Everolimus (AFINITOR)
Everolimus is an oral mTOR inhibitor used in adults with advanced RCC after treatment with sunitinib or sorafenib.[11][23] Typical dose is 10 mg once daily, continued as long as benefit and tolerable side effects.[11][15][19] It works by blocking mTOR, a key signaling pathway that controls cell growth and metabolism. Side effects include mouth ulcers, infections, lung inflammation (pneumonitis), high blood sugar and lipids, and low blood counts, so regular lab monitoring is needed.[11]
6. Temsirolimus (TORISEL)
Temsirolimus is an mTOR inhibitor given as a weekly intravenous infusion for advanced RCC.[17][6] A standard RCC dose is 25 mg IV over 30–60 minutes once weekly, with premedication such as IV antihistamine.[3][6] It slows tumor-cell growth and proliferation by blocking mTOR signaling.[17][21] Side effects include rash, mouth ulcers, lung inflammation, high blood sugar and lipids, and increased risk of infections.[3][6]
7. Sorafenib (NEXAVAR)
Sorafenib is an oral multi-kinase inhibitor that targets VEGFR, RAF, and other kinases. It is approved for advanced RCC and some liver and thyroid cancers.[13][23] A usual RCC dose is 400 mg twice daily, away from food, continued until disease progression or severe toxicity.[2][7][15] Its mechanism is to reduce tumor blood vessels and directly slow tumor-cell signaling. Common side effects include hand-foot skin reaction, diarrhea, rash, high blood pressure, and fatigue.[13]
8. Nivolumab (OPDIVO)
Nivolumab is an immune checkpoint inhibitor (anti-PD-1 antibody) used in advanced RCC, often after prior anti-angiogenic therapy and in combination regimens.[14][15] It is given as an IV infusion every 2–4 weeks at fixed dosing schedules. The drug works by blocking the PD-1 “brake” on T-cells, letting the immune system recognize and attack cancer cells more strongly.[14][3] Side effects are immune-related, such as inflammation of lungs, colon, liver, skin, or endocrine glands, and must be treated quickly with steroids.[14][15]
9. Ipilimumab + Nivolumab (YERVOY + OPDIVO) combination
This combination uses ipilimumab (anti-CTLA-4) plus nivolumab (anti-PD-1) as dual immune checkpoint blockade. In RCC, it is used in certain intermediate- or poor-risk advanced cases.[1][14] The purpose is deeper immune activation than with a single agent. Ipilimumab is given at specific doses every 3 weeks for a limited number of cycles, together with nivolumab, then nivolumab alone is continued. The mechanism is removing two different immune “brakes,” but this also raises the risk of serious immune-related side effects affecting organs such as colon, liver, skin, and endocrine glands.[14][19]
10. Nivolumab + Cabozantinib
This regimen combines nivolumab IV with oral cabozantinib and is approved as first-line treatment for advanced RCC.[9][21] Cabozantinib targets tumor blood vessels and growth signals, while nivolumab activates T-cells. The purpose is to attack the cancer through both blood-vessel and immune pathways at the same time. Side effects overlap and include diarrhea, fatigue, high blood pressure, rash, and immune-related organ inflammation, so close monitoring and dose changes are common.[9][14][21]
11. Pembrolizumab + Axitinib (KEYTRUDA + INLYTA)
Pembrolizumab (KEYTRUDA) is an anti-PD-1 antibody. Together with axitinib, it is approved as first-line therapy for advanced RCC.[10][16] Pembrolizumab is given IV every 3–6 weeks, and axitinib is taken orally twice daily. The mechanism combines immune activation with VEGFR blockade. The purpose is to improve survival and delay progression compared with sunitinib alone.[2][21] Main side effects include diarrhea, liver-test changes, high blood pressure, fatigue, and immune-related inflammation in different organs.[10][16]
12. Pembrolizumab + Lenvatinib (KEYTRUDA + LENVIMA)
Pembrolizumab with lenvatinib is another approved first-line option for advanced RCC.[2][21] Lenvatinib is taken orally (often 20 mg once daily when combined), and pembrolizumab is given IV on a set schedule.[2][5][21] The mechanism is similar to other ICI+TKI combinations: boosting the immune system and starving the tumor of blood supply. Side effects include high blood pressure, diarrhea, fatigue, loss of appetite, and immune-related organ inflammation, so regular blood-pressure and lab checks are essential.[2][21]
13. Lenvatinib + Everolimus
Lenvatinib in combination with everolimus is approved for patients with advanced RCC after one prior anti-angiogenic therapy.[2][5][9] Lenvatinib targets VEGFR and other kinases, while everolimus targets mTOR. The purpose is to attack both blood-vessel growth and internal tumor-cell growth signaling at the same time. This combination can improve outcomes but has notable side effects, such as diarrhea, mouth sores, fatigue, high blood pressure, and lab abnormalities (lipids, glucose, kidney tests), requiring frequent dose adjustments.[2][5][11]
14. Avelumab + Axitinib (BAVENCIO + INLYTA)
Avelumab is a PD-L1 inhibitor antibody. Together with axitinib, it is approved as first-line therapy for advanced RCC.[10][22] Avelumab is given IV every 2 weeks at a fixed dose, while axitinib is oral twice daily. The mechanism is immune activation plus VEGFR blockade, similar to other ICI+TKI pairs. Common side effects include infusion reactions, thyroid changes, diarrhea, high blood pressure, fatigue, and immune-related inflammation of organs such as lungs or liver.[2][10][22]
15. Bevacizumab (or biosimilars like MVASI) + Interferon-alpha
Bevacizumab is an IV antibody against VEGF-A and has been used with interferon-alpha in metastatic RCC.[19][22] It blocks VEGF, directly reducing formation of new blood vessels in tumors. Interferon-alpha is an immune cytokine that can slow tumor growth but has significant side effects like flu-like symptoms and fatigue. While used less often now because of newer options, this regimen may still be considered in some settings. Main side effects include high blood pressure, bleeding, protein in urine, and fatigue.[19][12]
16. Aldesleukin (PROLEUKIN, high-dose IL-2)
Aldesleukin is a form of interleukin-2, a strong immune-stimulating cytokine. It is approved for metastatic RCC in carefully selected patients.[18][1] It is given as high-dose IV infusions in the hospital and can cause serious side effects like low blood pressure, fluid leakage, heart stress, and infections. The mechanism is powerful activation of T-cells and NK cells, which in a small group of patients can produce long-lasting complete responses, but toxicity limits its use.[18]
17. Other TKIs used in RCC (e.g., older or regional options)
Depending on the country and time, other VEGFR-targeted TKIs and combinations may be used for RCC in general. These include agents similar in mechanism to the drugs above, focusing on blocking VEGFR and related kinases to limit blood-vessel growth and tumor signaling.[1][2] Each has its own dosing schedule and side-effect pattern, but common issues include high blood pressure, hand-foot reaction, diarrhea, and fatigue.
18. Clinical-trial targeted therapies
Because chromophobe RCC is rare, clinical trials are very important. Trials may include new TKIs, MET/FGFR inhibitors, or antibody-drug conjugates tested in non-clear-cell RCC. The purpose is to find safer and more effective options for this specific subtype. Mechanisms vary but often focus on pathways that are especially active in chromophobe tumors.
19. Clinical-trial immunotherapy combinations
Trials may test novel immune combinations, vaccines, or cellular therapies in rare RCC subtypes. These regimens aim to boost or redirect the immune system against chromophobe tumor cells. Side effects can be similar to other immune checkpoint drugs, including risk of autoimmune-type inflammation of organs, requiring close monitoring.
20. Supportive medicines (anti-nausea, bone health, blood-pressure drugs)
Alongside cancer-directed drugs, many supportive drugs are used: anti-nausea pills, stomach protectants, blood-pressure medications, bone-strengthening agents, and growth factors for blood counts. These do not treat the tumor directly but are essential to keep treatment safe and tolerable. They work by controlling side effects so you can stay on effective doses of the main cancer drugs.[4][5]
Dietary Molecular Supplements (Supportive, Not Cures)
None of these supplements can “cure” chromophobe RCC. They may support general health when used carefully under medical supervision. High doses or mixing many products can be harmful, especially to the kidneys.[4][5]
1. Vitamin D
Many cancer patients have low vitamin D levels. Supplementing to reach a normal blood level can support bone and muscle health. A typical replacement dose (for deficiency) might be 800–2000 IU/day, adjusted by your doctor. The functional role is helping calcium balance and bone strength. Mechanistically, vitamin D affects cell growth and immune function, but its direct effect on kidney-cancer outcomes is still under study.[4]
2. Omega-3 fatty acids (fish-oil or algae-oil)
Omega-3 fats from EPA and DHA can help reduce inflammation and may support heart and brain health. Doses often range around 1–2 g/day of combined EPA+DHA, but must be discussed with your doctor because of bleeding risk. Functionally they may reduce triglycerides and mild inflammation. Mechanism involves modulation of cell membranes and inflammatory signaling molecules called eicosanoids.[4][5]
3. Probiotics
Probiotics are “good bacteria” in capsules or fermented foods. They may help with diarrhea from TKIs or antibiotics, and support gut and immune health. Common doses are billions of CFU per day, but the exact strain matters. Functionally, they restore a healthy gut microbiome. Mechanism is balancing gut flora, improving barrier function, and influencing immune signaling in the gut.[5]
4. Soluble fiber (psyllium, oats, inulin)
Soluble fiber supplements help with bowel regularity and blood-sugar control. Small doses (for example 5–10 g/day) are usually started, with plenty of water. Functionally, they slow digestion, soften stool, and help cholesterol and glucose levels. Mechanism is forming a gel in the gut that feeds good bacteria and slows absorption of sugars and fats.[4][5]
5. Curcumin (turmeric extract)
Curcumin is a plant compound from turmeric. Lab studies show anti-inflammatory and antioxidant effects, but human data in RCC are limited. Doses in supplements often range 500–1000 mg/day with black-pepper extract to improve absorption; this must be discussed with your oncologist because of bleeding and liver concerns. Functionally, it may help joint pain and inflammation. Mechanism involves blocking NF-κB and other inflammatory pathways.[4][7]
6. Green-tea extract (EGCG)
Green tea contains catechins such as EGCG, which have antioxidant and anti-inflammatory effects in lab studies. Low to moderate intake as brewed tea is usually safer than high-dose pills, which can harm the liver. Functionally, it may support cardiovascular and metabolic health. Mechanism involves scavenging free radicals and modulating signaling pathways related to cell growth; it should not be seen as a cancer cure.[4][7]
7. Selenium (within safe range)
Selenium is a trace mineral involved in antioxidant enzymes. In regions with low selenium intake, modest supplementation may be useful, but high doses can be toxic to nerves, hair, and nails. A typical safe supplement dose is often around 50–100 mcg/day, if you truly need it. Functionally, it supports antioxidant defenses. Mechanism is as a cofactor in glutathione peroxidase and other enzymes.[4]
8. Magnesium (if low)
Certain cancer drugs and poor intake can lower magnesium. Replacement under lab guidance can support heart rhythm, muscles, and bowel regularity. Dosage depends on lab results; too much can cause diarrhea or affect kidney function. Functionally, magnesium supports hundreds of enzyme reactions. Mechanism relates to stabilizing ATP and nerve-muscle signaling.[4][5]
9. Multivitamin at standard dose
A simple daily multivitamin at normal doses (not “megavitamin” products) may help cover small gaps in intake. The purpose is to avoid minor vitamin and mineral deficiencies in people with poor appetite. Mechanism is straightforward replacement, not cancer treatment. High-dose antioxidant formulas are usually avoided during active immunotherapy or chemotherapy unless your oncologist approves.[4]
10. Medical nutrition drinks (high-protein, kidney-friendly formulas)
When appetite is poor, ready-to-drink medical shakes or powders can provide balanced calories and protein. Kidney-adjusted formulas may be used in people with reduced kidney function. The purpose is to prevent weight and muscle loss (sarcopenia). Mechanism is easy delivery of energy, protein, and micronutrients in small volumes that are easier to sip than full meals.[4][5]
Immunity-Booster / Regenerative / Stem-Cell–Related Drugs
There are no approved “stem-cell pills” that regenerate the kidney or cure chromophobe RCC. However, some drugs and approaches support the immune system or help the body recover from treatment side effects. These are always specialist-prescribed.
1. Immune checkpoint inhibitors (nivolumab, pembrolizumab, avelumab)
These drugs “release the brakes” on T-cells so they can better recognize and attack cancer cells.[14][15][16][22] They do not boost immunity in a general way; they redirect it against tumors. Mechanism is blocking PD-1 or PD-L1 signals that normally dampen immune responses. They can cause serious immune-related side effects, so they must be used only under oncology care.
2. Interleukin-2 (aldesleukin)
High-dose IL-2 strongly activates T-cells and NK cells and can sometimes lead to long-lasting remission in metastatic RCC, but only in a small number of carefully selected patients.[18] It is very toxic and requires intensive-care-level monitoring. Mechanism is powerful stimulation of immune cell growth and activity. It is not a general “immune vitamin,” and it is not used for early-stage disease.[18]
3. Granulocyte-colony stimulating factors (G-CSF)
In some cases, supportive drugs like filgrastim may be given if other treatments cause very low white-blood-cell counts. They are injections that help the bone marrow make more neutrophils. Mechanism is stimulating specific receptors on bone-marrow cells. They lower infection risk but do not fight the kidney tumor directly.[4]
4. Erythropoiesis-stimulating agents (ESAs)
In selected people with treatment-related anemia, ESAs like epoetin may be used to increase red-blood-cell production, after careful risk–benefit discussion. Mechanism is mimicking erythropoietin hormone to stimulate the bone marrow. They can improve fatigue but also carry risks of blood clots and possible effects on tumor control, so they are used cautiously.[4]
5. Bone-protective agents (bisphosphonates or denosumab)
If chromophobe RCC spreads to bone, these drugs may be used to strengthen bones and reduce fractures. Mechanism is slowing bone breakdown (bisphosphonates) or blocking RANKL (denosumab), which helps keep bones stronger. They support the skeleton but do not cure the cancer. Side effects can include jaw-bone problems and low calcium, so dental checks and lab monitoring are required.[4]
6. Clinical-trial cellular therapies (experimental)
In some research centers, people with advanced RCC may be offered trials of adoptive T-cell therapy or other cell-based treatments. These aim to engineer or expand immune cells to better recognize tumor targets. Mechanism varies (CAR-T, TCR-modified cells, tumor-infiltrating lymphocytes). These are experimental, can have serious side effects, and are only given within controlled trials.
Key Surgeries (Procedures and Why They Are Done)
1. Partial nephrectomy (kidney-sparing surgery)
The surgeon removes only the tumor and a small rim of normal tissue, keeping the rest of the kidney. This is often used for small or favorably located chromophobe tumors. The main purpose is to cure or control the cancer while protecting kidney function.
2. Radical nephrectomy
The whole kidney with the tumor is removed; sometimes nearby fat and adrenal gland are also taken. This may be needed when the tumor is large or badly placed. The purpose is complete removal of visible disease when possible.
3. Lymph-node dissection
If imaging suggests enlarged nearby lymph nodes, the surgeon may remove them during nephrectomy. The purpose is to remove possible spread and to get accurate staging information, which helps in planning further treatment.
4. Metastasectomy (removal of metastases)
If there are a small number of metastases (for example, in lung or liver), surgery or focused local treatments (like ablation) may be used. The purpose is to reduce tumor burden and sometimes achieve long-term control in selected patients.
5. Cytoreductive nephrectomy in metastatic disease
In some people with metastatic RCC who are otherwise fit, removing the main kidney tumor before or during systemic therapy can be helpful. The purpose is to lower total tumor mass, which may improve symptom control and sometimes survival, but it is not right for everyone.[1][2]
Preventions and Risk-Reduction Tips
These steps cannot guarantee that chromophobe RCC will not occur or recur, but they support overall kidney and cancer health:[1][4][6][21]
Avoid tobacco: Do not smoke or vape; if you do, get help to quit.
Maintain healthy weight: Aim for a body-mass index in the healthy range with a balanced diet and regular movement.
Stay physically active: Target at least 150–300 minutes of moderate-intensity activity per week if your doctor allows.[6][13]
Follow a plant-forward diet: Emphasize vegetables, fruits, whole grains, beans, and nuts; limit red and processed meats and sugary drinks.[4][7]
Control blood pressure: Check it regularly and follow lifestyle and medicine plans to keep it in target range.
Manage diabetes and heart disease well: Good control protects blood vessels and kidneys.
Limit unnecessary pain-killer use: Avoid long-term high-dose NSAIDs (like ibuprofen) unless your doctor says they are safe for your kidneys.
Protect from chemical exposure: Follow safety rules if you work with solvents, heavy metals, or other industrial chemicals.
Stay up-to-date with check-ups and imaging: Follow your oncologist’s schedule after treatment; early detection of recurrence matters.
Limit alcohol and avoid illicit drugs: Excess alcohol and unregulated drugs can harm the liver and kidneys and interact with cancer medicines.
When to See Doctors
You should see or contact your doctor or oncology team promptly if you notice any of the following:[1][4][5]
New blood in urine, darker urine, or clots.
New or worsening pain in the side, back, or abdomen.
Unexplained weight loss, loss of appetite, or strong fatigue.
Fever, chills, or signs of infection, especially if you are on immunotherapy or targeted drugs.
New shortness of breath, chest pain, or severe cough.
Swelling of legs, sudden severe headache, or vision changes (possible clot or blood-pressure problems).
Yellowing of eyes or skin, severe diarrhea, or abdominal pain (possible immune-related reaction or liver problem).
Any strong or rapidly worsening symptom that worries you.
If symptoms are severe (for example, trouble breathing, chest pain, confusion), emergency care is needed.
What to Eat and What to Avoid
Based on cancer-nutrition guidance, here are ten simple points:[4][5][6][21]
Eat plenty of vegetables and fruits: Aim for at least 5 servings daily; choose many colors (green, orange, red, purple).
Choose whole grains instead of refined grains: Prefer brown rice, oats, whole-wheat bread over white rice and white bread.
Include plant proteins often: Beans, lentils, chickpeas, tofu, and nuts can replace some red meat.
Limit red and processed meat: Keep red meat small and occasional; avoid processed meats like sausages and bacon as much as you can.
Use healthy fats: Choose olive oil, nuts, seeds, and avocado instead of deep-fried foods and trans-fat snacks.
Avoid sugary drinks: Replace soda and sweet juices with water, herbal tea, or water flavored with fruit slices.
Limit salty and ultra-processed foods: Packaged snacks, instant noodles, and fast food are often high in salt and additives; keep them rare.
Be careful with herbal supplements and “miracle” tonics: Do not start any new supplement without checking with your oncologist and kidney doctor.
Drink enough fluids (as your doctor allows): In many people a steady intake of water helps kidney function, but in advanced kidney disease your doctor may limit fluids.
Adapt diet to kidney function: If your kidney function is reduced, you may need to limit certain minerals (like potassium or phosphorus); follow your dietitian’s kidney-friendly plan.
Frequently Asked Questions (FAQs)
1. Is chromophobe renal cell carcinoma less dangerous than other kidney cancers?
Chromophobe RCC often has a better outlook than clear-cell RCC when found early and completely removed by surgery.[1][2][3] However, it can still spread and become serious, especially if large or with sarcomatoid change, so careful follow-up is essential.
2. Can chromophobe RCC be cured with surgery alone?
If the tumor is limited to the kidney and fully removed (clear margins), many people do very well and may never have recurrence.[1] Cure is much harder if the cancer has already spread outside the kidney at diagnosis.
3. Are the same medicines used for clear-cell RCC also used for chromophobe RCC?
Yes, many targeted drugs and immunotherapies approved for “advanced RCC” are used for chromophobe RCC because there are few large trials specific to this subtype.[1][2][23] Your team chooses regimens based on overall RCC data and your individual situation.
4. Do I always need drug therapy after surgery?
Not always. Some people with small, low-risk tumors may only need surgery and regular follow-up. Others with higher-risk features may be offered adjuvant (after-surgery) drug therapy or placed on trials. The decision depends on stage, grade, and pathology details.
5. Are non-drug therapies enough by themselves?
Non-pharmacological treatments like exercise, diet, and counselling are very important, but they do not replace surgery or drug therapy for active, significant cancer. They work best as partners that improve strength, mood, and treatment tolerance.[4][5]
6. Can diet or supplements cure chromophobe RCC?
No. A healthy, mostly plant-based diet and selected supplements may support overall health and possibly lower risk of other diseases, but they do not “melt” an existing kidney tumor.[4][7][14] Any product claiming to cure cancer by diet alone should be viewed with great caution.
7. Is immunotherapy safer than targeted therapy?
Each has different risks. Immunotherapy can cause serious inflammation of organs (like lungs, colon, liver, thyroid), while TKIs often cause high blood pressure, diarrhea, and skin and lab changes.[1][14][15] Your oncologist weighs these for you.
8. Will I need dialysis after kidney surgery?
Most people with one healthy remaining kidney do not need dialysis.[1] Dialysis is usually needed only if both kidneys are badly damaged or removed, or if there is serious pre-existing kidney disease.
9. Can I become pregnant after treatment for chromophobe RCC?
Fertility depends on your age, type of treatment, and kidney function. Many drugs used for RCC can harm a developing baby and must not be used in pregnancy. If pregnancy is important to you, talk early with your team about fertility preservation and safe timing.
10. Should my family members be tested or screened?
Most chromophobe RCC cases are not strongly inherited. However, sometimes kidney cancers can be part of genetic syndromes. Your doctor may suggest genetic counselling if there is a strong family history or other unusual features.
11. How often will I need scans after treatment?
Follow-up schedules vary, but typically include CT or MRI and blood tests at regular intervals for several years, then less often if all remains stable. This helps find recurrences early when they may be easier to treat.
12. Can I still exercise with one kidney and a history of RCC?
In many cases, yes, and it is encouraged with your doctor’s approval.[4][6][13] Extremely high-impact or contact sports may be discouraged to protect the remaining kidney, but walking, swimming, cycling, and light strength training are often safe.
13. Are complementary therapies like acupuncture allowed?
Some complementary therapies (for example, acupuncture for pain or nausea) may be safe and helpful when provided by trained professionals and coordinated with your oncology team. Always tell your doctors about any therapy you are using so they can check for interactions or risks.
14. What is the role of clinical trials for chromophobe RCC?
Because chromophobe RCC is rare, trials are very important to discover better treatments. Trials may offer access to promising new targeted or immune therapies. Your oncologist can check if there are studies suitable for your stage and health.
15. What is the most important thing I can do for myself right now?
Stay closely connected with your care team, keep all appointments, take medicines exactly as prescribed, and report new symptoms early. Alongside this, focus on simple health foundations: do not smoke, move your body regularly, eat a mostly plant-based diet, protect your kidney function, and ask for emotional and practical support when you need it.[1][4][5]
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: January 15, 2026.
