Clear cell kidney carcinoma is a type of kidney cancer that starts from the tiny tubes in the kidney that clean the blood. These tubes are called the proximal tubules. This cancer grows from the lining (epithelial cells) of those tubules. It is the most common kind of kidney cancer. Clear cell kidney carcinoma makes up about 70–80% of all renal cell carcinomas, which themselves are about 90–95% of all kidney cancers.
Clear cell kidney carcinoma (also called clear cell renal cell carcinoma, ccRCC) is the most common type of kidney cancer in adults. It starts in the tiny filtering units of the kidney called tubules and looks “clear” under the microscope because the cancer cells are full of fat and sugar. Doctors usually find it when someone has blood in the urine, pain in the side, or when a scan is done for another reason. Treatment can include surgery, targeted drug therapy, immunotherapy, and other supportive care depending on how big the tumor is and whether it has spread.
Clear cell kidney carcinoma (also called clear cell renal cell carcinoma) is the most common type of kidney cancer in adults. It starts in the tiny filtering units of the kidney and gets its name because the cancer cells look “clear” under the microscope. In early stages it may cause no symptoms, but later it can lead to blood in the urine, side pain, tiredness, weight loss, or swelling in the legs. Treatment often includes surgery, targeted drugs, and immune-based drugs, chosen by a cancer specialist based on stage and overall health. [1]
Under the microscope, the tumor cells often look pale or “clear” because they contain fat and glycogen that get washed out during processing. This “clear” look is why it is called clear cell cancer.
Types
Doctors also use several other names for this tumor, including:
Clear cell renal cell carcinoma (ccRCC)
Clear cell RCC
Conventional renal cell carcinoma (older term)
Hypernephroma or Grawitz tumor (historic names, now rarely used)
Clear cell kidney carcinoma can stay only in the kidney (localized), can grow into nearby veins and tissues (locally advanced), or can spread to other organs such as lungs, bones, or brain (metastatic disease).
Types of clear cell kidney carcinoma
Doctors may describe “types” of clear cell kidney carcinoma in different ways. Here are common ways to group it:
Sporadic clear cell kidney carcinoma
This is the most common type. It happens by chance in one person with no strong family history. The cancer usually affects one kidney only.Hereditary (familial) clear cell kidney carcinoma
In some families, changes in certain genes, especially the VHL (von Hippel–Lindau) gene, are passed down. These people can develop kidney cysts and multiple clear cell tumors in both kidneys.Localized clear cell kidney carcinoma
The cancer is only inside the kidney and has not spread to vessels, lymph nodes, or distant organs. Surgery can often cure it at this stage.Locally advanced clear cell kidney carcinoma
The tumor has grown into nearby tissues, such as the fat around the kidney, the adrenal gland, or large veins like the renal vein or inferior vena cava, but has not yet spread far away.Metastatic clear cell kidney carcinoma
The cancer has spread from the kidney to other organs, commonly the lungs, bones, liver, or brain. At this stage, doctors use medicines like targeted therapy and immunotherapy, often together with or after surgery.
Causes and risk factors
In most patients, doctors cannot point to one single cause. Instead, many “risk factors” increase the chance of getting clear cell kidney carcinoma.
Cigarette smoking
Smoking is one of the strongest known risks. Harmful chemicals from tobacco go into the blood, pass through the kidneys, and can damage kidney cells, leading to cancer over time.Obesity (being very overweight)
Extra body fat changes hormone levels and causes long-term inflammation. These changes can make kidney cells grow and divide in an abnormal way and increase the risk of renal cell carcinoma.High blood pressure (hypertension)
Long-term high blood pressure can damage small blood vessels and kidney tissue. Some blood pressure medicines may also add a small extra risk, although the main problem is the high pressure itself.Chronic kidney disease
When kidneys are damaged for a long time, the tissue can scar and form cysts. These changes can increase the chance that some cells become cancer cells, especially in the cortex where clear cell tumors start.Long-term dialysis and acquired cystic kidney disease
People who have been on dialysis for many years often develop many kidney cysts. These cysts can sometimes turn into clear cell kidney carcinoma.Von Hippel–Lindau (VHL) syndrome
This inherited disorder comes from a change in the VHL gene. It causes multiple tumors and cysts in many organs, including multiple clear cell kidney cancers, often at a young age.Other hereditary kidney cancer syndromes
Conditions such as hereditary leiomyomatosis and RCC, Birt–Hogg–Dubé syndrome, tuberous sclerosis, and some familial RCC syndromes also increase risk, though they are rarer than VHL.Male sex
Kidney cancer, especially RCC, is about twice as common in men as in women. This may relate to higher smoking rates, different hormone patterns, and some job exposures.Older age
Clear cell kidney carcinoma is more common in people between 50 and 75 years. With age, there is more time for DNA damage to build up in kidney cells.Occupational exposure to trichloroethylene (TCE)
Some workers who are exposed to this cleaning solvent (for example in degreasing or metal work) have a higher risk of kidney cancer, including clear cell type.Exposure to heavy metals (cadmium, lead)
Jobs that expose workers to cadmium, lead, or other nephrotoxic metals can damage kidney tissue and slightly raise kidney cancer risk.Exposure to other industrial chemicals
Contact with some petrochemicals, chlorinated solvents, and certain wood preservatives has been linked with a higher risk in some studies, though the evidence is not as strong as for smoking or obesity.Long-term use of some pain medicines (NSAIDs)
Very long use of some non-steroidal anti-inflammatory drugs may harm kidney tissue and may slightly increase RCC risk. Not every study agrees, but doctors advise careful use, especially in patients with kidney disease.Diabetes and metabolic syndrome
People with diabetes often have obesity, high blood pressure, and abnormal lipids. Together these can increase kidney stress and are linked to higher RCC risk.Low physical activity
A sedentary lifestyle is linked with obesity, insulin resistance, and chronic inflammation, all of which can raise kidney cancer risk.History of kidney stones or recurrent kidney infections
These problems may cause repeated inflammation or scarring of kidney tissue, and some studies show a small increase in RCC risk in such patients.Previous radiation to the kidney area
Radiation used years before to treat another cancer can rarely damage DNA in kidney cells and later lead to kidney tumors.Family history of kidney cancer (without a known syndrome)
Even without a named hereditary syndrome, having a first-degree relative with kidney cancer slightly raises a person’s risk, showing that shared genes and lifestyle may both play a part.Unhealthy diet (high in processed meat, low in fruits and vegetables)
Diets rich in processed meats, salt, and refined foods and poor in plant foods are linked to higher overall cancer risk, including kidney cancer, likely through inflammation and oxidative stress.General environmental pollution
Long-term exposure to polluted air and water containing carcinogens may contribute to kidney cancer risk, though the exact size of this risk is still being studied.
Symptoms and signs
Many people with clear cell kidney carcinoma 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 appear, they can include:
Blood in the urine (hematuria)
The urine may look pink, red, or cola-colored, or blood may be seen only under a microscope. This happens when the tumor bleeds into the urine collecting system.Pain in the side or back (flank pain)
Dull or aching pain on one side of the back or upper abdomen can occur when the tumor stretches the kidney capsule or presses on nearby structures.A lump or mass in the abdomen or side
Sometimes the doctor or the patient can feel a firm swelling in the flank. This “classic triad” sign with pain and blood in urine is now uncommon and usually means advanced disease.Unexplained weight loss
Patients may lose weight even if they are not dieting. The cancer uses energy and releases substances that change metabolism and reduce appetite.Fever not due to infection
Some patients have repeated low-grade fever without any clear infection. This may be a paraneoplastic effect, meaning it is caused by chemicals released by the tumor.Tiredness and weakness (fatigue)
Long-lasting tiredness is common and may be due to anemia, inflammation, poor sleep, or the general effect of cancer on the body.Anemia (low hemoglobin)
Many patients have low red blood cells. This can cause shortness of breath, pale skin, and feeling very tired. It happens because the tumor or the body’s response affects blood production.High blood pressure
Some tumors produce hormones or press on the kidney blood vessels, leading to raised blood pressure, which may cause headache, dizziness, or blurred vision.Swelling of legs or ankles (edema)
Kidney function problems or blockage of veins can cause fluid build-up in the legs, feet, or around the eyes.New left-sided varicocele in a man
A varicocele is a group of swollen veins in the scrotum, like “varicose veins.” If it appears suddenly on the left side in an older man, it may be due to a tumor blocking the left kidney vein.Bone pain or fractures
If the cancer spreads to the bones, patients may feel deep bone pain or may break a bone after only a small injury.Cough or shortness of breath
Spread to the lungs can cause a dry cough, chest pain, or breathlessness, especially in advanced disease.Swollen lymph nodes
Lymph nodes in the neck, armpit, or groin may grow bigger when tumor cells spread to them or when the immune system reacts to the cancer.Very high calcium in the blood (hypercalcemia)
Some tumors produce substances that raise blood calcium. This can cause thirst, constipation, confusion, nausea, and sometimes serious heart rhythm problems.Night sweats and general feeling of illness
Many patients describe drenching night sweats and a feeling of “just not being well.” These are general cancer or paraneoplastic symptoms and are not specific but are common in RCC.
Diagnostic tests –
Physical examination (first clinical checks)
Physical exam cannot by itself prove clear cell kidney carcinoma, but it helps the doctor look for signs, plan tests, and check overall health.
General physical exam and vital signs
The doctor checks weight, temperature, blood pressure, pulse, and breathing. They look for signs such as weight loss, fever, or signs of anemia like pale skin. These clues suggest serious illness and guide next tests.Abdominal and flank palpation
The doctor gently presses (palpates) the abdomen and sides to feel for a lump where the kidney lies. A large tumor may feel like a firm, uneven mass in the flank or upper abdomen.Examination for leg swelling and fluid
The doctor looks for ankle or leg swelling and may press on the skin to see if a dent remains. Swelling can suggest kidney function problems or blockage of major veins by a tumor.Scrotal exam in men (checking for varicocele)
In men, the doctor may examine the scrotum for swollen veins, especially on the left side. A new or severe varicocele can be a clue to a tumor pressing on the left renal vein.
Manual bedside tests
Manual tests are simple tests done with the doctor’s hands or with very basic tools. They support the diagnosis but do not replace imaging or lab tests.
Costovertebral angle (CVA) tenderness test
The doctor gently taps or presses over the area where the ribs meet the spine at the back (the kidney area). Pain there may suggest a problem in the kidney, such as a tumor, infection, or stone.Palpation of lymph nodes
The doctor feels the neck, armpit, and groin for enlarged lymph nodes. Enlarged nodes can mean spread of cancer or a strong immune reaction to a tumor.Performance status assessment (ECOG or Karnofsky)
The doctor asks simple questions about how well the patient can walk, work, and care for themselves. This “manual test” helps rate performance status, which is very important for treatment planning and prognosis.
Lab and pathological tests
Lab and pathology tests check urine, blood, and tissue. They help confirm the disease, check kidney function, and guide treatment choices.
Urinalysis (urine test)
A simple urine sample is checked for blood, protein, and other changes. Blood or abnormal cells in the urine may be the first sign that leads to imaging tests for kidney cancer.Urine cytology
This test looks at urine under a microscope to find cancer cells. It is more useful for cancers of the urinary tract lining, but may sometimes show abnormal cells with kidney tumors as well.Complete blood count (CBC)
This blood test checks red cells, white cells, and platelets. Many patients with RCC have anemia or sometimes high red cell counts, and some have abnormal platelets. These findings help with staging and treatment decisions.Kidney function tests (serum creatinine, urea, eGFR)
These tests show how well the kidneys filter blood. They are vital before giving contrast dye for CT scans or before surgery, to protect kidney function and choose the safest plan.Liver function tests (LFTs)
These blood tests look at enzymes and proteins made by the liver. RCC can sometimes spread to the liver or cause paraneoplastic changes, so abnormal LFTs may suggest more disease.Serum calcium and other electrolytes
High calcium is a common paraneoplastic problem in RCC. Checking calcium helps explain symptoms like confusion, constipation, or bone pain and may affect how quickly treatment is started.LDH and other prognostic markers
Lactate dehydrogenase (LDH) and some other blood markers are used in scoring systems to estimate prognosis in metastatic clear cell kidney carcinoma. High LDH can mean more aggressive disease.Tissue biopsy of the kidney mass or metastasis
A small core of tissue is taken with a needle guided by imaging. A pathologist examines it under the microscope to confirm that the tumor is clear cell RCC and to determine grade and other features. In some clear cases planned for surgery, biopsy may be skipped, but it is essential when diagnosis is uncertain or systemic therapy is planned first.
Electrodiagnostic test
Electrodiagnostic tests measure the electrical activity of the heart, brain, or nerves. They do not directly diagnose clear cell kidney carcinoma but help check if the body is fit for surgery or medicine.
Electrocardiogram (ECG or EKG)
An ECG records the heart’s electrical activity. It is done before major surgery and before some cancer drugs, especially if the patient is older or has high blood pressure or high calcium. It helps find rhythm problems or heart disease that could make treatment risky.
Imaging tests
Imaging tests are the main way to find and stage clear cell kidney carcinoma. Most renal masses can be diagnosed and staged based mainly on imaging.
Renal ultrasound
Ultrasound uses sound waves to make pictures of the kidney. It is often the first test when a lump is suspected or when blood is seen in the urine. It can show if a mass is solid or cystic and can guide biopsy.Contrast-enhanced CT scan of abdomen and pelvis
CT scan with contrast dye is the key test for diagnosing and staging RCC. It shows the size and shape of the mass, whether it enhances with contrast, and whether it has spread to nearby organs, veins, or lymph nodes. It is considered the imaging method of choice for RCC.MRI of kidneys and renal veins
MRI gives very detailed images and is used when CT results are unclear or when the patient cannot receive contrast dye because of poor kidney function. It is especially helpful to see tumor growth into the renal vein or inferior vena cava.Chest imaging and bone imaging (chest CT or X-ray, bone scan or PET-CT)
Once a kidney tumor is found, imaging of the chest and sometimes bones is done to look for spread. A chest CT or X-ray can show lung nodules, and a bone scan or PET-CT can show bone metastases, which are common sites in advanced clear cell kidney carcinoma.
Non-pharmacological treatments
1. Patient education and shared decision-making
Patient education means the health team explains the disease, stage, treatment options, and side effects in clear language. The purpose is to help the person understand what is happening and take part in decisions. The mechanism is simple: when people know their choices, they can ask better questions, follow plans more closely, and notice side effects early, which can improve safety and quality of life.
2. Smoking cessation programs
Stopping smoking is one of the best lifestyle changes for people with kidney cancer because smoking is a strong risk factor for kidney cancer and can worsen heart and lung health. The purpose is to protect remaining kidney tissue and overall health. The mechanism includes lowering exposure to toxins that damage blood vessels and kidney cells, which may reduce complications and improve tolerance of surgery and systemic therapy.
3. Healthy weight management
Working with a dietitian and exercise team to reach or stay at a healthy body weight can help people with clear cell kidney carcinoma feel stronger. The purpose is to reduce strain on the heart and kidneys and lower inflammation. The mechanism is that gradual weight control improves blood pressure, blood sugar, and hormone balance, which may support cancer treatment and reduce other disease risks.
4. Individualized physical activity programs
Gentle, planned physical activity such as walking, light cycling, or supervised strength training can help with fatigue, mood, and muscle loss. The purpose is to keep the body as active and independent as possible during and after treatment. The mechanism includes better blood flow, improved muscle strength, and release of natural chemicals in the brain that support mood and sleep.
5. Renal-friendly nutrition counseling
A renal-friendly eating plan is designed by a dietitian to protect kidney function while meeting calorie and protein needs. The purpose is to support the body during surgery, targeted therapy, and immunotherapy. The mechanism includes adjusting protein, salt, potassium, and fluid to reduce workload on the kidney, while avoiding malnutrition and muscle wasting.
6. Blood pressure and cardiovascular risk management
Kidney cancer patients often have high blood pressure or heart disease, which can be worsened by some targeted therapies. The purpose of non-drug steps such as low-salt diet, weight control, stress control, and regular monitoring is to reduce these risks. The mechanism is that controlled blood pressure and healthier blood vessels help protect the remaining kidney and lower the chance of heart attack or stroke during treatment.
7. Structured fatigue management and energy-saving strategies
Many patients feel very tired because of cancer, anemia, or treatment. Fatigue management teaches people how to plan the day, rest between tasks, and keep the most important activities. The purpose is to maintain function without over-exertion. The mechanism is to balance activity and rest so that limited energy is used wisely and muscles do not weaken more than necessary.
8. Psychological counseling and psycho-oncology support
Talking with a psychologist, counselor, or psycho-oncology team helps with fear, sadness, and anxiety about cancer. The purpose is to protect mental health and support coping skills. The mechanism includes teaching tools such as relaxation, reframing thoughts, and problem-solving, which can reduce distress, improve sleep, and help people follow treatment plans.
9. Support groups and peer support (in-person or online)
Support groups bring together people living with kidney cancer and their families to share experiences. The purpose is to reduce feelings of isolation and provide practical tips from others. The mechanism works through social connection, emotional validation, and learning from peers who have gone through similar treatments or side effects.
10. Mind-body therapies (relaxation, breathing, mindfulness)
Simple mind-body techniques such as deep breathing, guided imagery, or mindfulness can be used alongside medical care. The purpose is to lower stress, muscle tension, and pain perception. The mechanism involves calming the stress system in the brain and body, which may help with sleep, reduce heart rate and blood pressure, and improve overall well-being.
11. Sleep hygiene and routine building
Good sleep habits include regular bedtimes, limiting screens at night, and creating a dark, quiet bedroom. The purpose is to support energy, immune function, and mood. The mechanism is that consistent sleep helps regulate hormones, reduces inflammation, and improves the ability to cope with pain and treatment-related stress.
12. Non-drug pain management (heat, cold, massage, relaxation)
Alongside prescribed medicines, people can use heat pads, ice packs, gentle massage, or relaxation tapes to help manage pain. The purpose is to give extra pain control and sometimes lower the amount of pain medicine needed. The mechanism is to distract the brain, relax tight muscles, and change nerve signals from the painful area.
13. Occupational therapy for daily-life support
Occupational therapists help patients adjust how they do daily tasks like washing, cooking, or working, using tools or new methods. The purpose is to keep independence and safety at home and work. The mechanism includes teaching energy-saving techniques, suggesting equipment, and adapting the environment to the person’s current strength and mobility.
14. Physical therapy and mobility training
Physical therapists design stretching, balance, and strengthening exercises, especially after surgery or if there is bone pain from spread disease. The purpose is to improve walking, balance, and muscle power. The mechanism is to safely challenge muscles and joints so they recover function and reduce risk of falls or stiffness.
15. Palliative care and symptom-focused clinics
Palliative care is not only for end of life; it can start early to control pain, nausea, breathlessness, or anxiety. The purpose is to improve quality of life at any stage of cancer. The mechanism is a team approach that looks at physical, emotional, social, and spiritual needs and uses many tools, not just strong pain medicines.
16. Early rehabilitation after surgery (ERAS programs)
Enhanced recovery after surgery (ERAS) programs use early walking, careful fluid control, and pain plans to speed recovery after nephrectomy. The purpose is to shorten hospital stay and reduce complications. The mechanism is to keep the gut, lungs, and muscles active soon after surgery, helping the body return to normal more quickly.
17. Telemedicine and remote monitoring
Video visits, phone calls, and symptom apps let patients report side effects from home and get advice quickly. The purpose is to catch problems early, especially during immunotherapy or targeted therapy. The mechanism is faster communication with the cancer team, which can prevent minor issues from becoming serious emergencies.
18. Nutritional symptom management (nausea, taste change, appetite)
Dietitians can suggest small, frequent meals, high-calorie snacks, or texture changes when treatment affects appetite or taste. The purpose is to prevent weight loss and weakness. The mechanism is to adapt foods and eating patterns so that even small amounts provide enough energy and protein while respecting kidney limits.
19. Psychosocial and financial counseling
Cancer care can cause money worries, job problems, and family stress. Social workers and counselors help with insurance questions, work letters, and community resources. The purpose is to reduce non-medical stress that can harm mental health. The mechanism is to provide practical support and advocacy so that people can stay focused on treatment and recovery.
20. Integrative oncology (carefully supervised)
Some centers offer integrative services like acupuncture, gentle yoga, or music therapy under medical supervision. The purpose is to support comfort, mood, and coping without disrupting standard cancer treatment. The mechanism is to combine safe, evidence-informed complementary therapies with conventional care while checking for interactions or risks.
Drug treatments
(Doses below are general descriptions from drug labels or guidelines, but real doses are always adjusted by oncology teams. Never start, stop, or change cancer drugs on your own.)
1. Sunitinib (Sutent)
Sunitinib is an oral targeted therapy used for advanced or high-risk renal cell carcinoma. It belongs to the class of tyrosine kinase inhibitors (TKIs) that block VEGF and other growth-signal receptors on cancer and blood-vessel cells. A typical regimen in adults is one daily capsule taken in treatment cycles, but exact dose and schedule are chosen by the oncologist. The purpose is to slow tumor growth and cut off blood supply. Common side effects include tiredness, high blood pressure, mouth sores, diarrhea, hand–foot skin changes, and low blood counts.
2. Pazopanib
Pazopanib is another oral TKI for advanced renal cell carcinoma that blocks VEGF and related pathways to reduce blood vessel growth in tumors. It is usually taken once daily on an empty stomach, but dose changes are common if side effects occur. The purpose is to control disease and delay progression. Side effects can include liver-function changes, high blood pressure, diarrhea, hair color change, nausea, and fatigue.
3. Axitinib
Axitinib is a second-generation VEGF-receptor TKI often used when kidney cancer has already been treated with another drug. It is taken by mouth twice daily, with dose adjustments based on blood pressure and tolerability. The purpose is to further block blood vessel growth and slow cancer spread. Side effects commonly include high blood pressure, diarrhea, fatigue, decreased appetite, and hand–foot syndrome.
4. Cabozantinib
Cabozantinib is an oral multi-kinase inhibitor that targets VEGF, MET, and AXL, pathways involved in tumor growth and bone spread. It can be used alone or with nivolumab for advanced renal cell carcinoma. Dosing is usually once daily, with reductions if side effects occur. The purpose is to shrink tumors or keep them stable. Side effects may include diarrhea, mouth sores, tiredness, high blood pressure, and risk of bleeding or blood clots.
5. Sorafenib
Sorafenib is an older oral TKI that blocks several kinases involved in tumor cell growth and angiogenesis. It is given twice a day in tablet form, with adjustments depending on tolerance. The purpose is to slow cancer growth and reduce new blood vessel formation. Frequent side effects include skin rash, hand–foot skin reaction, diarrhea, fatigue, and high blood pressure.
6. Lenvatinib
Lenvatinib is a TKI targeting multiple receptors, including VEGF and FGFR, and is often used in combination with pembrolizumab for first-line treatment of advanced clear cell kidney carcinoma. It is usually taken orally once daily with dose modifications as needed. The purpose is to give strong dual attack with targeted and immune therapy. Side effects can include high blood pressure, diarrhea, decreased appetite, weight loss, and protein in the urine.
7. Everolimus
Everolimus is an mTOR inhibitor taken as an oral tablet, used when kidney cancer has progressed after TKIs. It works by blocking a pathway that controls cell growth and metabolism. The purpose is to slow cell division and starve cancer cells of growth signals. Side effects often include mouth sores, infections, high blood sugar, high cholesterol, and fatigue.
8. Temsirolimus
Temsirolimus is an mTOR inhibitor given as an intravenous infusion, often used for poor-risk advanced kidney cancer. It inhibits the same mTOR pathway, reducing cell growth and angiogenesis. The purpose is to control disease in patients with specific high-risk features. Side effects may include rash, high blood sugar and lipids, mouth sores, infections, and lung inflammation.
9. Nivolumab (Opdivo)
Nivolumab is an immune checkpoint inhibitor (anti-PD-1 antibody) used alone or in combination with ipilimumab or cabozantinib for advanced renal cell carcinoma. It is given by IV infusion at regular intervals or in special long-acting forms. The purpose is to “release the brakes” on T-cells so they can attack cancer cells. Side effects include immune-related inflammation of organs like lungs, liver, intestines, thyroid, and skin, which can sometimes be serious and need steroids.
10. Ipilimumab (Yervoy) with nivolumab
Ipilimumab is an anti-CTLA-4 antibody often combined with nivolumab in certain intermediate- or poor-risk advanced renal cell carcinoma. It is given as IV infusion in cycles. The purpose is to further boost the immune response by blocking another brake on T-cells. The mechanism is stronger activation of immune cells, but this also raises the risk of more intense immune-related side effects, such as colitis, hepatitis, and endocrine problems.
11. Pembrolizumab (Keytruda)
Pembrolizumab is another anti-PD-1 antibody used with axitinib or lenvatinib for first-line treatment of advanced renal cell carcinoma. It is given by IV infusion every few weeks. The purpose is to help the immune system recognize and kill cancer cells. Side effects are similar to nivolumab, including fatigue, rash, and immune-related inflammation in organs that may need prompt medical treatment.
12. Pembrolizumab plus axitinib
This combination uses pembrolizumab to stimulate the immune system and axitinib to block tumor blood vessels. The purpose is to attack the cancer from two directions at the same time, which has shown improved outcomes compared with older treatments in many patients. Side effects include those of both drugs, such as high blood pressure, diarrhea, fatigue, and immune-related organ inflammation, so close monitoring is required.
13. Lenvatinib plus pembrolizumab
This combination therapy is another first-line option for metastatic clear cell kidney cancer. Lenvatinib targets growth and blood vessel receptors, while pembrolizumab boosts immune attack. The purpose is to increase tumor shrinkage and delay progression. Side effects can include diarrhea, fatigue, thyroid problems, high blood pressure, and immune-related reactions; dose changes and supportive care are often needed.
14. Belzutifan
Belzutifan is a HIF-2α inhibitor recently approved for some patients with von Hippel–Lindau disease–related tumors and certain advanced kidney cancers. It is taken orally and works by blocking a key factor involved in tumor response to low oxygen. The purpose is to slow growth of tumors driven by defects in the VHL pathway, which is common in clear cell kidney cancer. Side effects include low oxygen, anemia, fatigue, and dizziness.
15. Bevacizumab
Bevacizumab is a monoclonal antibody against VEGF, given as IV infusion sometimes combined with interferon or other agents in kidney cancer. It binds VEGF directly in the bloodstream to prevent new blood vessel growth in tumors. The purpose is to starve the tumor of blood supply. Side effects can include high blood pressure, nosebleeds, bleeding risk, wound-healing problems, and rare bowel perforation.
16. Interleukin-2 (high-dose IL-2)
High-dose IL-2 is an older immune therapy sometimes used in very fit patients with metastatic kidney cancer at specialized centers. It is given by IV in the hospital and can cause strong immune activation. The purpose is to produce long-lasting complete responses in a small group of patients. Side effects are very serious and can include low blood pressure, fluid in lungs, kidney injury, and heart stress, so it is now used much less often.
17. Interferon-alpha
Interferon-alpha is another older immune therapy that boosts certain immune responses and was once common for metastatic renal cell carcinoma, sometimes combined with bevacizumab. It is given as injections under the skin a few times per week. The purpose is to slow cancer and improve survival modestly, but it has largely been replaced by modern immunotherapy. Side effects include flu-like symptoms, fatigue, and mood changes.
18. Tivozanib
Tivozanib is a newer VEGF-receptor TKI used for relapsed or refractory advanced renal cell carcinoma in some regions. It is an oral medicine taken in cycles, aiming for strong VEGF blockade with a relatively tolerable side-effect profile. The purpose is disease control after other TKIs. Side effects include high blood pressure, fatigue, diarrhea, and voice changes.
19. Clinical-trial combination regimens
Many patients with advanced clear cell kidney carcinoma are treated in clinical trials that combine different TKIs and immunotherapies or test new drugs. The purpose is to find safer and more effective options and sometimes give access to cutting-edge treatment. The mechanism depends on the drugs used, but always involves careful monitoring and strict protocol rules.
20. Palliative systemic therapies (individualized)
For some people, lower-intensity systemic therapy is used mainly to reduce symptoms, not to cure. Doctors may choose gentler doses or simpler regimens based on age, other illnesses, and patient wishes. The purpose is comfort and maintaining function. Side effects and benefits are weighed carefully in shared decision-making.
Dietary molecular supplements
1. Omega-3 fatty acids (fish oil)
Omega-3 fatty acids from fish oil may help reduce inflammation and support heart health in people with cancer. A dietitian may suggest doses around what is found in standard over-the-counter capsules, but exact plans must consider bleeding risk and kidney function. The main function is to modify cell membranes and reduce inflammatory signaling. The mechanism is through effects on eicosanoids and other lipid mediators that influence blood vessels and immune cells.
2. Vitamin D
Vitamin D is important for bone health, muscle strength, and immune function, and deficiency is common in many adults with chronic disease. Usual supplement doses are chosen based on blood levels and kidney function; high doses without testing can be harmful. The function is to regulate calcium balance and immune cell behavior. The mechanism is through vitamin D receptors in many tissues, which influence gene activity related to growth and immunity.
3. High-quality protein powders (whey or plant-based)
When appetite is low, protein powders mixed into drinks can help maintain muscle mass. A dietitian chooses the amount per day to match kidney function and body size. The function is to provide essential amino acids for tissue repair after surgery and during therapy. Mechanistically, these amino acids support muscle protein synthesis and immune cell production, but too much protein can stress damaged kidneys, so careful planning is needed.
4. Probiotic supplements
Probiotics are “good bacteria” in capsules or fermented foods that may support gut health during treatment. Doses are usually measured in billions of CFU, but the exact strain and duration should be discussed with the cancer team, especially in people with low white blood cells. Their function is to help maintain a healthy microbiome. The mechanism includes improving gut barrier function and modulating immune responses, which may influence infection risk and bowel comfort.
5. Curcumin (from turmeric – often food first)
Curcumin is a compound in turmeric with anti-inflammatory and antioxidant properties, usually taken first as part of food. Some people use capsules, but the oncologist must check for interactions with cancer drugs. Its function is to modulate inflammation pathways and oxidative stress. Mechanistically, it affects several cell signaling pathways and free-radical processes, but evidence in kidney cancer is limited, so it should never replace standard treatment.
6. Green tea extract (with caution)
Green tea contains catechins with antioxidant and metabolic effects. Some use moderate amounts in tea form; concentrated extracts must be used carefully because of possible liver toxicity and drug interactions. The function is to provide antioxidant support and mild metabolic benefits. Mechanistically, catechins can influence cell signaling and oxidative stress, but benefit in clear cell kidney cancer is not proven, so medical advice is essential.
7. Selenium (if deficient)
Selenium is a trace mineral involved in antioxidant enzymes such as glutathione peroxidase. Supplementation is only helpful if blood levels are low; too much can be toxic. Its function is to support antioxidant defenses and immune function. The mechanism involves selenoproteins that reduce oxidative damage in cells, but evidence for direct benefit in kidney cancer outcomes is limited and must be weighed against risk.
8. Vitamin B12 and folate (if low)
Cancer and chronic kidney problems can sometimes be associated with low levels of B12 or folate, especially if appetite is poor. Supplements should be based on blood tests. Their function is to support red blood cell production and DNA repair. Mechanistically, they act as co-factors in cell division and methylation reactions; lack of them can worsen anemia and fatigue, but too much folic acid without supervision is not recommended.
9. Iron supplements (only if iron-deficiency anemia)
Iron is needed to make hemoglobin, and some patients develop iron-deficiency anemia from blood loss or poor intake. Oral or IV iron should be used only after blood tests and medical approval because excess iron can be harmful. The function is to correct anemia and improve energy. Mechanistically, iron is part of hemoglobin and many enzymes, but must be carefully balanced, especially in people with kidney disease or receiving certain treatments.
10. Balanced multivitamin (low-dose)
Some people take a low-dose multivitamin to cover small gaps in diet during treatment. The function is general micronutrient support without large pharmacologic doses. The mechanism is simply providing recommended dietary amounts of vitamins and minerals that the body uses for normal metabolism, immunity, and tissue repair. High-dose single vitamins, herbal mixes, or “mega-dose” products should be avoided unless the oncology team agrees.
Immunity-supporting and regenerative / stem-cell-related approaches
1. Granulocyte colony-stimulating factors (G-CSF)
G-CSF drugs (like filgrastim and related products) are injections that stimulate the bone marrow to make more white blood cells when counts are low. The purpose is to reduce infection risk during intensive treatment. The mechanism is binding to G-CSF receptors on bone marrow cells to speed neutrophil production. These drugs support immunity but do not directly kill kidney cancer cells.
2. Erythropoiesis-stimulating agents (ESAs)
ESAs such as epoetin alfa can help some patients with severe anemia from chronic kidney disease or treatment, when used carefully. The purpose is to raise hemoglobin and reduce transfusion needs. Mechanistically, these drugs act like natural erythropoietin, stimulating red blood cell production in the bone marrow. Because of clot and tumor-growth concerns, they are used under strict guidelines and are not suitable for everyone.
3. Vaccinations (e.g., flu, pneumonia, COVID-19)
Keeping up to date with recommended vaccines supports the immune system by preparing it to fight common infections. The purpose is to prevent serious infections that could interrupt cancer treatment or threaten life. The mechanism is to expose the immune system safely to antigens so it can respond faster if the real germ appears. Oncologists decide the best timing with respect to surgery and systemic therapy.
4. Experimental cancer vaccines and cell therapies (in trials)
Some research centers are studying kidney-cancer-specific vaccines and engineered immune cells (such as dendritic cell vaccines or CAR-T-like approaches). The purpose is to train immune cells to recognize tumor-specific antigens more strongly. The mechanism involves collecting immune cells, modifying or pulsing them with tumor markers, and giving them back to the patient. These methods are experimental and should only be done inside regulated clinical trials, never in unapproved “stem cell clinics.”
5. Autologous stem-cell support after high-intensity therapy (rare)
In some cancers, high-dose chemotherapy followed by reinfusion of the patient’s own stem cells is used; this is rarely applied to kidney cancer but is an example of regenerative support. The purpose is to allow very intensive treatment by rescuing the bone marrow afterward. Mechanistically, stored blood stem cells re-seed the marrow so it can start making blood cells again. For clear cell kidney carcinoma, this approach is not standard and is mainly of historical or research interest.
6. Careful avoidance of unregulated “stem cell” products
Many commercial centers advertise “stem cell cures” for cancer, but these are not approved and can be dangerous. The purpose of avoiding them is to protect patients from false claims, infections, and unknown side effects. Mechanistically, these products may introduce untested cells into the body without proof of benefit, sometimes causing tumors or immune reactions. Evidence-based regenerative or immune therapies should always be given only inside proper clinical trials or approved programs.
Surgeries
1. Partial nephrectomy (kidney-sparing surgery)
Partial nephrectomy removes only the tumor and a small margin of normal tissue, leaving the rest of the kidney in place. The purpose is to cure or control cancer while preserving kidney function, especially in small tumors or patients with only one working kidney. Surgeons use open, laparoscopic, or robotic methods, and they carefully control bleeding and protect nearby structures.
2. Radical nephrectomy
Radical nephrectomy removes the whole kidney with the tumor, nearby fat, and sometimes nearby lymph nodes and adrenal gland. The purpose is complete removal of large or locally advanced kidney tumors when partial removal is not safe. The procedure can be open or minimally invasive; after surgery, the remaining kidney must carry all filtration work, so long-term follow-up of kidney function is important.
3. Lymph node dissection (selective)
In some cases, surgeons remove enlarged or suspicious lymph nodes around the kidney or in the abdomen. The purpose is to check if cancer has spread and sometimes to reduce tumor burden. The mechanism is both diagnostic and therapeutic: the pathology report guides staging and treatment choices, while removal of bulky nodal disease may support symptom control or improve outcomes in selected patients.
4. Metastasectomy (removal of metastatic deposits)
Metastasectomy means surgical removal of cancer deposits that have spread to other organs, such as lung or bone, when they are limited and operable. The purpose is to reduce tumor load and sometimes achieve long-term control in selected patients. Surgeons weigh risks and benefits because this is only useful in carefully chosen cases with good overall health and slow-growing disease.
5. Local ablative procedures (cryoablation, radiofrequency ablation)
For small kidney tumors or people who cannot tolerate major surgery, doctors may use special needles to freeze (cryoablation) or heat (radiofrequency ablation) the tumor under imaging guidance. The purpose is to destroy tumor tissue while avoiding big incisions. The mechanism uses extreme cold or heat to kill cancer cells, and these methods can sometimes be repeated if the tumor returns or new small lesions appear.
Preventions
1. Do not smoke or vape tobacco
Avoiding smoking reduces the risk of getting kidney cancer and protects the heart and lungs after treatment. Quitting at any stage still gives benefits, and help from programs and medicines can improve success.
2. Maintain a healthy body weight
Keeping weight in a healthy range with balanced food and regular movement lowers the risk of several cancers and heart disease. It also reduces strain on the remaining kidney after surgery.
3. Control blood pressure
Checking and treating high blood pressure can reduce future kidney damage and heart problems. Lifestyle changes and medicines, chosen by doctors, help protect blood vessels and kidneys.
4. Stay physically active
Regular physical activity, within safe limits, supports weight control, blood sugar, and mood. Even simple daily walking can have strong health benefits over time.
5. Follow a plant-forward eating pattern
Eating mostly vegetables, fruits, whole grains, legumes, nuts, and seeds with modest animal protein supports long-term health. This pattern is linked to lower cancer and heart-disease risk compared with diets high in processed meat and sugar.
6. Limit alcohol
If someone drinks alcohol, keeping it low or avoiding it reduces risk of several cancers and liver disease. For many kidney cancer patients, doctors recommend little or no alcohol, especially while on systemic therapy.
7. Protect from harmful workplace or environmental chemicals
Using correct protection at work and avoiding unnecessary exposure to solvents, heavy metals, and other toxins helps guard the kidneys. Occupational safety rules and personal protective equipment are important.
8. Stay well hydrated (as advised by your doctor)
Adequate fluid intake helps kidney filtration, but in some patients with kidney or heart problems, doctors will give specific limits. Following personalized advice supports safe hydration.
9. Manage diabetes and metabolic health
Good control of blood sugar, cholesterol, and triglycerides lowers damage to small blood vessels, including those in the kidneys. This is achieved with lifestyle and medicines as needed.
10. Attend regular health checkups and follow-up scans
Periodic visits allow doctors to monitor kidney function, blood pressure, and scans after treatment. Early detection of recurrence or complications gives more options and better outcomes.
When to see doctors
People should seek medical help urgently if they notice blood in the urine, new or worsening pain in the side or lower back, a lump in the belly, sudden weight loss, fevers without clear cause, or severe tiredness. These symptoms can have many causes, but they should always be checked.
Anyone already diagnosed with clear cell kidney carcinoma should contact their cancer team quickly if there are new breathing problems, chest pain, strong headaches, yellow eyes, severe diarrhea, dark stools, sudden swelling, confusion, or any side effect that feels severe or worrying. These may be signs of treatment complications that need fast care.
Regular scheduled visits for examination, blood tests, and imaging are also important, even when a person feels well, because early recurrence may only be seen on scans or blood work.
What to eat and what to avoid
1. Eat: Plenty of colorful vegetables and fruits – Avoid: sugary drinks
Colorful plant foods provide vitamins, minerals, and antioxidants that support general health and recovery. Sugary drinks give extra calories without nutrients and can worsen weight gain or blood sugar problems.
2. Eat: Whole grains like brown rice, oats, and whole-wheat bread – Avoid: refined white bread and pastries
Whole grains contain fiber that supports digestion and stable energy. Refined grains raise blood sugar quickly and give less nutrition for the same calories.
3. Eat: Lean proteins (fish, skinless poultry, eggs, tofu, lentils) – Avoid: large portions of processed or red meats
Lean proteins help maintain muscle and repair tissues after surgery and treatment. Processed meats such as sausages and bacon are linked to higher cancer risk and often contain a lot of salt.
4. Eat: Unsalted nuts, seeds, and healthy oils in small amounts – Avoid: deep-fried foods and trans-fat snacks
Healthy fats support brain and hormone function, but they are calorie-dense and must be controlled, especially with kidney concerns. Deep-fried and trans-fat foods increase inflammation and heart-disease risk.
5. Eat: Meals with moderate salt – Avoid: very salty packaged soups, chips, and instant noodles
Too much salt can worsen high blood pressure and harm kidneys. Reading labels and cooking at home with herbs and spices instead of extra salt helps protect cardiovascular and kidney health.
6. Eat: Small, frequent meals if appetite is low – Avoid: forcing very large meals
After surgery or during treatment, appetite may be weak. Small frequent meals, snacks, and oral nutrition drinks can be easier to manage. Forcing large meals can cause nausea and discomfort.
7. Eat: Safe, well-washed foods – Avoid: raw or undercooked meat, fish, and eggs when immunity is low
During periods of low white blood cells, food safety is very important. Well-cooked meals and clean, washed produce lower the risk of infections from food-borne germs.
8. Eat: Adequate fluid (if your doctor agrees) – Avoid: very sugary drinks and energy drinks
Water, weak herbal teas, and other low-sugar fluids help hydration. Very sugary drinks and energy drinks add unnecessary sugar and caffeine, which may stress heart and kidneys. Fluid limits should follow nephrologist guidance.
9. Eat: Foods your team approves that fit your kidney function – Avoid: self-prescribed high-dose protein or herbal powders
Kidney function tests guide how much protein, potassium, and phosphorus you can safely have. Self-prescribing strong supplements can overload the kidney or interact with medicines.
10. Eat: Traditional foods adapted to be lower in salt and fat – Avoid: strict “miracle cancer diets” from the internet
Culturally familiar dishes can be part of a healthy plan if recipes are modified to use less salt, sugar, and unhealthy fat. Extreme “cancer cure” diets found online are usually not evidence-based, can cause malnutrition, and should be avoided.
Frequently asked questions (FAQs)
1. Is clear cell kidney carcinoma always fatal?
No. Many people with small, localized tumors can be cured with surgery, and even those with advanced disease now have better outcomes thanks to targeted therapy and immunotherapy. Survival depends on stage, general health, and response to treatment.
2. What is the main first treatment for localized clear cell kidney cancer?
For tumors confined to the kidney, surgery (partial or radical nephrectomy) is usually the main treatment. In selected high-risk cases, doctors may later add targeted drugs or immunotherapy as adjuvant therapy to reduce recurrence risk.
3. Why are targeted therapies important in this cancer?
Clear cell kidney cancer often has changes in the VHL gene and pathways controlling blood vessel growth, which makes it sensitive to drugs that block VEGF and related signals. Targeted therapies slow growth by cutting off blood supply and interfering with signals that help cancer cells survive.
4. How does immunotherapy help?
Immunotherapies like nivolumab and pembrolizumab block proteins (PD-1 or CTLA-4) that act as “brakes” on immune cells, allowing T-cells to attack cancer cells more strongly. In some patients, this can lead to long-lasting control or even complete responses.
5. Can lifestyle changes cure clear cell kidney cancer?
Lifestyle changes alone cannot cure kidney cancer, but they can support overall health, reduce complications, and improve treatment tolerance. They are best used together with evidence-based medical and surgical treatment.
6. Are all kidney tumors clear cell type?
No. There are several types, including papillary, chromophobe, and rare variants. Clear cell is the most common type, but each subtype has different behavior and may respond differently to treatment, so pathology tests are very important.
7. Will I need dialysis after nephrectomy?
Most people with one healthy remaining kidney do not need dialysis. However, those with pre-existing kidney disease or other risk factors may have reduced kidney function and sometimes need dialysis. Doctors check kidney tests before and after surgery to plan safely.
8. How long do I need follow-up after treatment?
Follow-up usually continues for many years with physical exams, blood tests, and periodic imaging to watch for recurrence and monitor kidney function. The exact schedule depends on tumor stage and the treatments used.
9. Can young people get clear cell kidney cancer?
Most cases occur in older adults, but younger people can be affected, especially if they have genetic syndromes such as von Hippel–Lindau disease. Genetic counseling and testing may be recommended for people with strong family histories or very early onset.
10. Is chemotherapy useful for clear cell kidney carcinoma?
Traditional chemotherapy drugs that work for many other cancers usually do not work well for clear cell kidney carcinoma. That is why current care focuses on surgery, targeted therapies, and immunotherapies instead.
11. Do all patients get the same drug combination?
No. Doctors choose treatment based on stage, risk group, other illnesses, kidney function, and patient preferences. Some receive TKI plus immunotherapy, others get dual immunotherapy, and some start with surgery alone. Personalized plans are standard.
12. Are clinical trials safe?
Clinical trials follow strict rules, ethics review, and close monitoring to protect patients while testing new approaches. They may carry unknown risks, but also give access to promising therapies. Joining requires careful discussion with the oncology team and informed consent.
13. Can I continue working or studying during treatment?
Many people continue some work or study, often with reduced hours or flexible schedules. Fatigue, clinic visits, and side effects may require adjustments. Planning with employers, schools, and the medical team helps create a realistic balance.
14. How can family and friends help?
Family and friends can help with transport, meals, paperwork, and emotional support. Listening without judgment, going to appointments if invited, and helping remember information are all very useful ways to support someone with kidney cancer.
15. What is the most important thing I can do right now?
The most important step is to have open, regular communication with your cancer team, follow their advice, report side effects early, and ask every question you have. Combining evidence-based treatment with healthy lifestyle habits and strong support gives the best chance for good outcomes.
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 28, 2025.
