Clear cell renal cell adenocarcinoma is another name for clear cell renal cell carcinoma (ccRCC), the most common type of kidney cancer in adults. It starts in the tiny filters of the kidney called proximal tubules, which normally clean the blood and make urine. In this cancer, the kidney cells grow in an uncontrolled way and form a solid lump (tumor) inside the kidney.
Clear cell renal cell adenocarcinoma is a common type of kidney cancer that starts in the tiny filtering tubes (proximal tubules) inside the kidney. Doctors also call it clear cell renal cell carcinoma (ccRCC). Under the microscope, the cancer cells look “clear” because they are full of fat and sugar that wash out during tissue processing. This type makes up about 70–80% of all renal cell cancers and usually grows from the cells that clean the blood and make urine.
Clear cell renal cell adenocarcinoma is the most common type of kidney cancer in adults. It starts from the tiny tubules in the kidney that filter blood and make urine. Under the microscope, the cancer cells look “clear” because they are full of fat and sugar that are washed out during processing.[¹] This tumor usually grows as a single mass in one kidney, but it can spread to lymph nodes, lungs, bones, liver or brain if not found early.[²] Many cases are linked to changes in a gene called VHL, which makes the cells produce too many growth signals and new blood vessels, helping the cancer grow and spread.[³] Treatment depends on tumor size, spread, kidney function and overall health, and often needs a mix of surgery, targeted drugs and immunotherapy planned by a cancer team.[⁴]
In many patients, clear cell kidney cancer is linked to damage in a gene called VHL (von Hippel–Lindau). VHL normally helps control blood vessel growth. When it is not working, the cancer cells make too many growth signals (like VEGF and HIF-2α). This allows new blood vessels to grow, feeds the tumor, and helps it spread. Understanding this pathway led to targeted drugs that block these signals and slow tumor growth.
Under the microscope, these tumor cells look “clear” because they are full of fat and sugar (lipid and glycogen) that get washed out during preparation, leaving the cells pale or empty-looking. Doctors use this clear appearance plus special staining tests to confirm that the tumor is a clear cell type.
Clear cell renal cell carcinoma makes up about 70–80% of all renal cell carcinoma cases, so when people say “kidney cancer” in adults, they often mean this type. It can stay only in the kidney for a long time, or it can spread (metastasize) to other organs such as lungs, bones, liver, or brain if not found early.
Other names
Doctors and scientists may use several names for the same disease. All of the names below usually mean clear cell renal cell adenocarcinoma:
Clear cell renal cell carcinoma (ccRCC)
Clear cell kidney cancer
Conventional renal cell carcinoma (older term used in many pathology papers)
Renal clear cell carcinoma
Clear cell carcinoma of the kidney
These different names can be confusing, but they all describe a kidney tumor made of clear-looking cells that starts in the kidney tubules.
Types
Doctors can group clear cell renal cell carcinoma into different “types” or categories based on how it behaves, where it came from, and how far it has spread.
Sporadic clear cell RCC – This is the most common form. It happens in people with no known inherited syndrome or clear family pattern. A random (acquired) change in genes inside kidney cells causes the tumor.
Hereditary / familial clear cell RCC – Some people inherit a faulty gene, most often a VHL (von Hippel–Lindau) mutation, that strongly increases their risk of clear cell kidney tumors, sometimes on both kidneys and at younger age.
Localized clear cell RCC – The tumor is only inside the kidney and has not grown into nearby organs or blood vessels and has not spread to distant sites. This stage generally has better outcomes with surgery.
Locally advanced clear cell RCC – The tumor has grown into nearby tissues such as the adrenal gland, fat around the kidney, or large veins, but there is still no distant spread on imaging. It is more serious and harder to remove completely.
Metastatic clear cell RCC – Cancer cells have spread to far-away organs such as lungs, bones, liver, or brain. Treatment usually needs medicines that affect the whole body (systemic therapy), often combined with surgery in selected cases.
Causes (risk factors)
In most patients, doctors cannot point to one single cause, but many risk factors increase the chance of getting clear cell renal cell adenocarcinoma.
Cigarette smoking – Smoking is one of the strongest proven risk factors. Harmful chemicals from tobacco are filtered by the kidneys and can damage kidney cell DNA, making cancer more likely. The risk goes down slowly after quitting, but it stays higher than in never-smokers for many years.
Obesity (excess body weight) – Extra body fat changes hormone levels and increases inflammation, which can push kidney cells to grow and divide too much. Obesity is estimated to account for a large fraction of renal cell carcinoma cases worldwide.
High blood pressure (hypertension) – Long-term, poorly controlled high blood pressure can injure kidney blood vessels and kidney tissue, and is an independent risk factor for renal cell carcinoma, even when body weight and smoking are considered.
Older age – Clear cell RCC is much more common in people over 55. As we age, our cells collect more genetic errors over time, making cancer more likely.
Male sex – Men are affected about twice as often as women. Hormonal differences, patterns of smoking, and certain job exposures may partly explain this higher risk.
Family history of kidney cancer – Having a close relative (parent, brother, sister) with renal cell carcinoma raises the chance that shared genes or shared environmental factors increase risk.
Von Hippel–Lindau (VHL) syndrome – In this inherited condition, people have a germline mutation in the VHL tumor suppressor gene, which strongly predisposes them to multiple clear cell kidney tumors and cysts as well as eye and brain lesions.
Birt–Hogg–Dubé syndrome – This inherited disorder, caused by mutation in the FLCN gene, leads to skin bumps, lung cysts, and a higher risk of various kidney tumors including clear cell RCC.
Hereditary leiomyomatosis and RCC (HLRCC) – This syndrome results from mutations in the FH gene and usually causes aggressive kidney cancers; although often papillary, it still increases general RCC risk and shows how inherited gene changes can drive kidney tumors.
Other inherited RCC syndromes – Conditions like hereditary papillary RCC and tuberous sclerosis complex increase the risk of kidney tumors overall, including clear cell variants in some patients, by altering normal growth-control pathways.
Chronic kidney disease (CKD) – Long-standing kidney damage from any cause makes the kidney tissue more unstable and prone to forming both benign cysts and malignant tumors.
Long-term dialysis and acquired cystic kidney disease – People who have been on dialysis for many years often develop many kidney cysts and have a much higher risk of RCC, including clear cell type, especially in shrunken, scarred kidneys.
Occupational exposure to trichloroethylene and similar solvents – Certain industrial chemicals (for example, some metal-degreasing agents and chlorinated solvents) are linked to increased kidney cancer risk in workers who are exposed over many years.
Exposure to heavy metals such as cadmium – Some studies suggest that long-term exposure to metals like cadmium, often in battery or metal industries, may raise the risk of renal cell carcinoma by damaging kidney tubules.
Long-term use of certain painkillers (analgesics) – Extended high-dose use of some older pain medicines such as phenacetin (no longer widely used) has been associated with chronic kidney damage and increased RCC risk.
Diabetes and metabolic syndrome – People with type 2 diabetes and related metabolic problems often also have obesity, high blood pressure, and abnormal lipids, a cluster that together seems to raise RCC risk.
Unhealthy diet (high in processed and red meat, low in fruits and vegetables) – Diets that promote obesity and chronic inflammation are indirectly linked to kidney cancer, while diets rich in plants and whole foods may be protective.
Prior radiation to the kidney area – Radiation therapy to the abdomen or flank area, especially in childhood, can very rarely damage kidney DNA and contribute to later tumor formation.
Immunosuppression after organ transplant – Patients who receive long-term immune-suppressing drugs to protect a transplanted organ have higher rates of several cancers, including kidney cancer, because their immune system is less able to remove abnormal cells.
Ethnic and genetic background – Some populations show higher or lower RCC rates, suggesting that inherited genetic factors and interactions with lifestyle can modify risk of clear cell kidney cancer.
Symptoms
Clear cell renal cell adenocarcinoma can be silent for a long time, and many tumors are found by accident on scans done for other reasons. When symptoms appear, they may be due to the mass in the kidney or due to spread to other organs or hormone-like substances made by the tumor (paraneoplastic effects).
Blood in the urine (hematuria) – This is one of the most common warning signs. The urine may look pink, red, or cola-colored, or blood may be found only under the microscope. It happens when the tumor bleeds into the urine collecting system.
Flank pain – People may feel a dull ache or sharp pain on one side of the back or side (between ribs and hip). This pain can come from the tumor stretching the kidney capsule or pressing on nearby nerves.
Abdominal or flank mass – Sometimes a lump can be felt in the side or abdomen on exam, especially in thinner people or when the tumor is large. This is part of the classic triad of RCC (mass, pain, hematuria).
Unintentional weight loss – Many patients lose weight without trying because cancer cells use a lot of energy and trigger body-wide inflammation, which reduces appetite and increases calorie burning.
Tiredness and weakness (fatigue) – Chronic fatigue can result from anemia, inflammation, poor sleep, and the general strain of having an active cancer in the body.
Fever without clear infection – Some patients have repeated fevers or low-grade temperature rises because the tumor releases inflammatory substances called cytokines.
Night sweats – Waking up soaked in sweat can be another sign of systemic inflammation or hormone-like substances coming from the tumor.
Loss of appetite (anorexia) – People may feel full quickly or simply not want to eat, which together with weight loss is a common sign of advanced kidney cancer.
Anemia symptoms (pallor, shortness of breath, dizziness) – The tumor or damaged kidney may make less erythropoietin, a hormone that stimulates red blood cell production, leading to low hemoglobin and typical anemia complaints.
High blood pressure (new or worsening) – Clear cell RCC can increase blood pressure by affecting kidney salt-water balance or by making extra renin, a hormone that raises blood pressure.
Swelling of legs and ankles (edema) – When kidney function is reduced or veins are compressed by the tumor, fluid can build up in the lower limbs, causing puffiness and tight shoes or socks.
Varicocele in men (especially on the left side) – A new or worsening cluster of enlarged veins above the testicle can occur if a left-sided kidney tumor presses on or blocks the testicular vein, causing blood to back up.
Bone pain or broken bones – If cancer spreads to bones, it can cause deep, persistent pain or fractures with minor injury, and sometimes high calcium levels that worsen symptoms.
Cough or shortness of breath – Spread to the lungs can cause chronic cough, chest discomfort, or breathlessness, often picked up on imaging before causing strong symptoms.
Confusion, headaches, or other brain-related problems – In rare advanced cases, spread to the brain or high blood calcium from tumor activity can lead to confusion, headaches, or changes in behavior.
Diagnostic tests
Doctors use a combination of history, physical exam, lab tests, and imaging scans to diagnose clear cell renal cell adenocarcinoma and to see how advanced it is. A definite diagnosis usually needs pathology (looking at cells under a microscope) from a biopsy or removed kidney.
Physical exam tests
General physical examination and medical history – The doctor asks about symptoms such as blood in urine, weight loss, fever, and pain, and examines the whole body for lumps, tenderness, swelling, and signs of anemia or other illnesses. This first step guides which tests are needed next.
Blood pressure measurement – Because kidney cancer can both cause and worsen high blood pressure, checking blood pressure helps detect a possible paraneoplastic effect and also assesses whether the patient is fit for surgery or medicines.
Weight and body mass index (BMI) check – Measuring weight and height shows if the patient is underweight from cancer-related weight loss or overweight, which is itself a risk factor and can influence surgical and anesthesia planning.
Manual tests (bedside maneuvers)
Abdominal palpation for mass – The doctor gently feels (palpates) the abdomen and flanks with the hands to detect any firm or irregular mass in the kidney area, especially in larger tumors. This can support suspicion of a solid kidney lesion.
Kidney ballottement test – With one hand on the back and the other on the front of the abdomen, the doctor may try to “ballotte” or push the kidney between the hands. A large, mobile kidney mass may be felt in renal cell carcinoma.
Costovertebral angle (CVA) tenderness test – The doctor taps or presses over the costovertebral angle (where the ribs meet the spine). While this is more often used to check for kidney infection, it can also show tenderness when a tumor stretches the kidney capsule.
Leg edema assessment – Pressing a thumb on the shin or ankle for several seconds can show “pitting edema.” This may indicate kidney dysfunction, low protein levels, heart strain, or venous blockage associated with a large renal tumor or its effects.
Lab and pathological tests
Urinalysis – A simple urine test looks for blood, protein, and abnormal cells. Microscopic or visible blood in urine with no infection is a key signal that triggers imaging to search for kidney and urinary tract tumors.
Urine cytology – A specialist looks at urine under the microscope to search for cancer cells that have shed into the urine. While more useful for bladder cancers, it can sometimes show atypical cells when a kidney tumor involves the collecting system.
Complete blood count (CBC) – This blood test checks red cells, white cells, and platelets. Many RCC patients have anemia (low red cell count) or sometimes very high red cells or platelets due to hormone-like substances released by the tumor.
Kidney function tests (serum creatinine and blood urea nitrogen) – These tests measure how well the kidneys are cleaning the blood. Results are important for planning contrast imaging and surgery, and for tracking changes after tumor treatment or nephrectomy.
Liver function tests (LFTs) – These tests check for liver injury and can suggest involvement of the liver by metastases or detect paraneoplastic effects, and they help decide which medicines are safe to use.
Serum electrolytes and calcium levels – Kidney cancer can cause high calcium (hypercalcemia) or shifts in other electrolytes. These blood tests detect problems that may explain confusion, weakness, or abnormal heart rhythms.
Lactate dehydrogenase (LDH) and other general markers – LDH is a non-specific marker of cell turnover. High LDH, together with anemia and other lab changes, is used in some scoring systems to estimate how aggressive metastatic RCC may be.
Renal mass biopsy with histopathology – A needle biopsy takes a small core of tissue from the kidney mass. A pathologist examines the cells under the microscope and uses special stains to confirm clear cell type and grade. This helps guide treatment choices, especially when surgery is risky.
Electrodiagnostic and monitoring tests
Electrocardiogram (ECG / EKG) – This heart tracing test checks for rhythm problems or prior heart damage before anesthesia or systemic therapies. While it does not diagnose the kidney tumor, it is important for safe surgical and drug treatment planning.
Ambulatory blood pressure monitoring – A portable device measures blood pressure repeatedly over 24 hours. This can confirm true hypertension due to the tumor and help manage blood pressure before and after kidney surgery or targeted therapy.
Imaging tests
Renal ultrasound – This painless scan uses sound waves to look at the kidneys. It can show a solid mass versus a simple cyst and is often the first imaging test when blood in urine or kidney problems are found.
Contrast-enhanced CT scan of abdomen and pelvis – CT with contrast dye is the main imaging tool for diagnosing renal cell carcinoma. It shows the size and shape of the mass, its blood supply, any spread into veins, and nearby lymph nodes, and helps plan surgery.
MRI scan of kidneys and abdomen – MRI is used when CT contrast dye is unsafe (for example, poor kidney function) or when more detail is needed about tumor extension into big veins or the spine. It can better define soft tissues and help in surgical decision-making.
Chest CT scan – Because clear cell RCC often spreads to the lungs, a CT scan of the chest is usually done to look for nodules or other signs of metastasis. Finding or excluding lung spread is essential for accurate cancer staging.
Non-pharmacological treatments
These treatments do not replace cancer drugs or surgery. They support your body, reduce complications and improve quality of life. Always discuss any change with your oncology team.[⁵]
Smoking cessation
Stopping smoking lowers the chance of new kidney damage, heart disease and second cancers. The purpose is to remove a major toxin that harms blood vessels and kidney tissue and may worsen cancer outcomes. The main mechanism is simple: with no tobacco, harmful chemicals like nicotine and tar stop entering your blood, so inflammation falls, oxygen delivery improves, and your body can better handle surgery, drugs and radiation. Counseling, nicotine replacement and smartphone programs can make quitting more successful.[⁵]Weight management and healthy BMI
Many people with clear cell kidney cancer are overweight or obese, which increases kidney strain and changes hormones such as insulin and inflammatory signals. The purpose of weight management is to reduce stress on the remaining kidney and lower heart and diabetes risks. The mechanism is gradual fat loss through balanced eating and regular activity, which improves blood pressure, blood sugar and inflammation, helping your body tolerate treatment and recover better.[⁵]Supervised physical activity program
Gentle but regular exercise (like walking, cycling or light resistance work) can improve strength, mood and fatigue in people with cancer. The purpose is to keep muscles working, maintain heart fitness and reduce treatment-related tiredness. The mechanism involves better blood flow, more efficient oxygen use and hormone changes that reduce inflammation and improve mood chemicals like endorphins. A physiotherapist or exercise specialist can tailor a safe plan, especially after surgery.[⁵][⁶]Kidney-friendly diet with dietitian support
A kidney-friendly diet focuses on enough calories and protein for healing but avoids excess salt and very high protein that could stress the remaining kidney. The purpose is to protect kidney function during and after treatment. The mechanism is balancing nutrients so that blood pressure, fluid balance and waste products (like urea) stay in a safer range. A renal dietitian can individualize limits on salt, phosphorus or potassium, depending on blood tests.[⁵]Tight blood pressure control (non-drug strategies)
High blood pressure is common in people with kidney cancer and can be worsened by some targeted drugs. The purpose of lifestyle blood pressure control is to support medicines and protect heart and kidney health. The mechanism includes lowering salt intake, losing weight, limiting alcohol, avoiding excess caffeine and practicing relaxation, which together reduce vessel stiffness and pressure on the kidney’s tiny filters.[⁵]Diabetes and blood sugar management (lifestyle part)
If you have diabetes, good control reduces kidney and nerve damage and improves wound healing after surgery. The purpose is to prevent further injury to the kidney that has already been stressed by cancer or surgery. The mechanism is a mix of planned meals, physical activity and careful monitoring, so glucose levels stay closer to target. This reduces chronic inflammation and vascular damage that could limit cancer treatment options later.[⁵]Alcohol moderation or avoidance
Heavy drinking can damage the liver, interfere with drug metabolism and worsen blood pressure. The purpose is to reduce organ stress and interactions with cancer drugs. The mechanism is simple reduction or complete avoidance of alcohol, which lowers toxic breakdown products like acetaldehyde, improves sleep quality and makes it easier for the body to process anti-cancer medicines safely.[⁵]Stress-reduction and psychological counseling
A cancer diagnosis often brings fear, sadness and anxiety. The purpose of counseling, mindfulness, breathing exercises or CBT is to help you cope, sleep better and stick to complex treatment plans. The mechanism lies in calming the stress response, reducing stress hormones like cortisol and improving thought patterns so that people feel more in control and less overwhelmed, which can even reduce perception of pain and fatigue.[⁵]Pain management with non-drug methods
Alongside pain medicines, methods like relaxation, heat or cold packs, gentle stretching, massage from trained therapists and cognitive behavioral techniques can ease discomfort. The purpose is to reduce total pain burden and possibly limit the need for high doses of pain pills. The mechanism is explained by reduced muscle tension, distraction of the nervous system and better emotional control, which may all lower pain signals reaching the brain.[⁵]Physiotherapy and rehabilitation after surgery
After partial or radical nephrectomy, people often feel weak and stiff. The purpose of physiotherapy is to regain movement, prevent clots and get back to daily activities safely. The mechanism is graded exercises that slowly rebuild core strength, breathing capacity and balance. This helps the lungs clear secretions, reduces risk of chest infections and helps people tolerate later systemic treatments.[⁵]Sleep hygiene and fatigue management
Cancer and drugs often disturb sleep. The purpose of sleep hygiene is to improve rest quality, which aids healing and mood. Mechanisms include regular sleep times, limiting screens before bed, keeping the bedroom dark and quiet, and using short daytime naps carefully. Better sleep supports immune function, hormone balance and attention, helping you manage complex medical information.[⁵]Infection prevention and vaccination (non-drug habits)
Good hand washing, oral care, skin care and avoiding close contact with sick people can lower infection risk, especially if treatment weakens immunity. The purpose is to prevent hospitalizations and treatment delays. The mechanism is reducing exposure to germs and keeping natural barriers like skin and mouth healthy, so that bacteria and viruses have fewer entry points. Vaccines are drug products, but the behaviors around them (planning, timing, exposure avoidance) are partly non-pharmacologic.[⁵]Avoiding unnecessary nephrotoxic substances
Some painkillers, contrast dyes and herbal remedies can harm the kidney. The purpose of this strategy is to protect the remaining kidney from extra injury. The mechanism is simply not adding further toxins: people use alternative pain methods, ask for kidney-safe imaging options where possible and avoid self-medication with unknown products. This helps preserve filtration and may allow more cancer treatment choices later.[⁵]Dietary sodium and fluid balance guidance
Too much salt and, in some cases, too much or too little fluid can raise blood pressure and swelling. The purpose is to keep circulation stable and support kidney function. Mechanism: limiting processed foods and salty snacks and following individualized fluid advice reduces water retention and pressure in blood vessels, easing the load on the kidney and heart.[⁵]Social work and practical support services
Cancer often disrupts work, finances and family roles. The purpose of involving a social worker is to connect patients with transport help, financial advice, workplace adjustments and home care services. Mechanism: by reducing practical stress, people can focus energy on treatment and self-care, adding stability and improving adherence to follow-up visits and medicines.[⁵]Palliative care for symptom control (at any stage)
Palliative care is not only for end of life. Its purpose is to manage pain, breathlessness, nausea, anxiety and other symptoms throughout the cancer journey. Mechanism: a team approach (doctors, nurses, psychologists, spiritual care) sets goals, adjusts treatments and supports both patient and family. This can actually extend life in some cancers by reducing crises and unplanned hospital stays.[⁵]Support groups and peer connection
Talking with others who have kidney cancer can reduce isolation. The purpose is emotional support and sharing coping strategies. Mechanism: hearing others’ stories normalizes fears and provides practical tips about living with one kidney, managing fatigue or returning to work. This often boosts hope and motivation to continue treatment.[⁵]Nutritional counseling for treatment side-effects
Many drugs cause nausea, taste changes or diarrhea. The purpose of targeted nutrition advice is to maintain weight and muscle despite these problems. Mechanism: small frequent meals, texture changes, high-calorie drinks and specific food choices (like bland foods for nausea) reduce discomfort and make it easier to take in enough energy and protein for healing.[⁵]Occupational therapy and daily-living adaptations
Occupational therapists can suggest tools and layout changes at home to save energy and protect the body. The purpose is to keep independence in washing, dressing, cooking and working. Mechanism: using grab rails, shower chairs or reorganized workspaces reduces strain on the trunk and incision area after nephrectomy, and helps people pace their energy across the day.[⁵]Structured follow-up and survivorship plan
After active treatment, scheduled visits and tests help find recurrences or new problems early. The purpose is long-term safety and reassurance. Mechanism: a written survivorship plan outlines visit timing, lab and imaging tests, late side-effect checks and lifestyle targets. Knowing the plan reduces anxiety and encourages people to continue healthy habits and monitoring.[⁴][⁵]
Drug treatments
Drug treatment for clear cell kidney cancer depends on stage and risk group. For many people with advanced or metastatic disease, the main options are immunotherapy (drugs that help your immune system attack the tumor) and targeted therapy (drugs that block growth signals and blood vessels in the cancer). These uses and schedules come from FDA prescribing information and international guidelines.[¹][²]
For safety, exact milligram doses must always be decided by your oncology team based on weight, kidney function and other illnesses. The brief “dosage” and “time” notes below are general patterns only, not personal prescriptions.
Pembrolizumab (KEYTRUDA, PD-1 inhibitor)
Pembrolizumab is an immune checkpoint inhibitor that “releases the brakes” on T-cells so they can recognize and attack cancer cells. It is approved with axitinib as a first treatment for advanced renal cell carcinoma.[²] It is given by IV infusion on a repeating schedule (often every 3 or 6 weeks). The main purpose is to prolong survival and shrink tumors. Side effects come from immune over-activation and can include fatigue, rash, diarrhea, thyroid problems, lung or liver inflammation, which need quick medical attention.Axitinib (INLYTA, VEGFR tyrosine kinase inhibitor)
Axitinib blocks VEGF receptors on blood vessels, reducing the tumor’s blood supply. It is used with pembrolizumab or avelumab as first-line therapy in advanced RCC and can also be used after other treatments.[¹][²] It is an oral pill taken one or two times per day. The purpose is to slow or stop tumor growth. Common side effects are high blood pressure, diarrhea, hand-foot skin reactions, tiredness and mouth sores.Nivolumab (OPDIVO, PD-1 inhibitor)
Nivolumab is another immune checkpoint inhibitor. It is used alone or with ipilimumab or with cabozantinib for advanced RCC, including after prior anti-angiogenic therapy.[¹] It is given by IV infusion every few weeks. The purpose is to help the immune system control or shrink the cancer. Mechanism and immune-related side effects are similar to pembrolizumab and can involve many organs (skin, bowels, lungs, liver, hormones).Ipilimumab (YERVOY, CTLA-4 inhibitor, in combination)
Ipilimumab targets CTLA-4, another “brake” on T-cells. In kidney cancer it is typically used only in combination with nivolumab for selected patients with intermediate or poor-risk advanced disease.[¹][²] It is given by IV in several initial doses, then nivolumab is continued alone. The purpose is a stronger, more durable immune attack on the cancer. Side effects are immune-related and can be more intense than single-agent treatment, so close monitoring is essential.Cabozantinib (CABOMETYX, multi-target TKI)
Cabozantinib blocks several growth and blood-vessel signals (including MET, AXL and VEGFR). It is approved alone and with nivolumab for advanced RCC.[¹] It is taken by mouth once daily. The purpose is to slow tumor growth and delay progression. Mechanism involves reducing new blood vessel formation and interfering with tumor cell signaling. Side effects commonly include diarrhea, fatigue, high blood pressure, mouth sores, loss of appetite and hand-foot syndrome.Sunitinib (SUTENT, multi-target TKI)
Sunitinib was one of the first targeted drugs for advanced RCC and is still used in some settings. It is an oral medicine taken once daily in repeating treatment cycles (periods on drug followed by rest).[¹] It blocks VEGF receptors and other kinases, cutting off the tumor’s blood supply. Side effects can include fatigue, high blood pressure, altered taste, diarrhea, low blood counts and changes in skin or hair color.Pazopanib (VOTRIENT, VEGFR TKI)
Pazopanib is another oral VEGF-targeting drug used for advanced RCC. It is taken once daily on a continuous schedule. The purpose and mechanism are similar to sunitinib: starving the tumor of new blood vessels and growth signals. Common side effects include high blood pressure, liver enzyme elevation, diarrhea, nausea, hair color changes, fatigue and, rarely, heart rhythm problems, so liver and heart monitoring is needed.Sorafenib (NEXAVAR, multikinase inhibitor)
Sorafenib blocks several kinases involved in cell growth and blood vessel formation. It is less commonly used now but may still be considered after other options. It is taken by mouth, usually twice daily. The purpose is disease control when newer regimens are not suitable. The mechanism is inhibition of RAF kinase and VEGF receptors. Side effects include hand-foot skin reactions, rash, diarrhea, hypertension and fatigue.Tivozanib (FOTIVDA, VEGFR TKI)
Tivozanib is a highly selective VEGF receptor inhibitor approved in some regions and used in later-line RCC. It is taken orally in repeating cycles. The purpose is to offer another targeted option after prior therapies. It works by blocking VEGF-driven blood vessel growth around the tumor. Side effects are similar to other VEGF inhibitors, such as high blood pressure, diarrhea, voice change and fatigue.Lenvatinib (LENVIMA, multi-target TKI)
Lenvatinib targets VEGF, FGF and other receptors and is used in combination with pembrolizumab or everolimus in advanced RCC.[²] It is an oral drug taken once daily. The purpose is to intensify tumor growth blockade and improve response rates. Mechanism includes powerful anti-angiogenic effects. Side effects include hypertension, diarrhea, weight loss, fatigue and protein loss in urine, so blood pressure and kidney function must be watched.Everolimus (AFINITOR, mTOR inhibitor)
Everolimus blocks the mTOR pathway, which controls cell growth and metabolism. In RCC it is used alone or with lenvatinib after prior VEGF-targeted treatment. It is taken orally once daily. The purpose is to slow tumor cell growth when other options are limited. Side effects can include mouth ulcers, infections, high blood sugar and cholesterol, lung inflammation and low blood counts.Temsirolimus (TORISEL, mTOR inhibitor)
Temsirolimus is an IV mTOR inhibitor used mainly for poor-prognosis advanced RCC. It is infused weekly. The purpose is disease control in patients who cannot tolerate or have progressed on other agents. The mechanism is similar to everolimus, blocking growth and survival signals inside tumor cells. Side effects include rash, high blood sugar, high fats in blood, low blood counts and infusion reactions.Avelumab (BAVENCIO, PD-L1 inhibitor, in combination)
Avelumab blocks PD-L1, another immune checkpoint. It is used with axitinib as a first-line option for advanced RCC.[²] It is given by IV infusion every few weeks. The purpose is to strengthen immune attack while axitinib blocks tumor blood vessels. Side effects are immune-related (like other ICIs) plus those from axitinib, so patients need careful monitoring and quick treatment of any serious symptoms.Bevacizumab (AVASTIN, anti-VEGF antibody, with interferon)
Bevacizumab is a monoclonal antibody against VEGF. Historically, it has been combined with interferon-alpha for metastatic RCC to slow disease by blocking blood vessel growth. It is given IV every few weeks. The purpose is improved progression-free survival. Common side effects include high blood pressure, bleeding, clotting and wound-healing problems, so it is used cautiously around surgery.High-dose Interleukin-2 (IL-2, immunotherapy)
High-dose IL-2 is an older immune-stimulating treatment that can occasionally produce long-lasting complete remissions in selected, very fit patients with metastatic RCC. It is given IV in the hospital under close monitoring. The mechanism is strong activation of T-cells and natural killer cells. Side effects are severe and can include low blood pressure, fluid leakage into tissues, heart stress and organ dysfunction, so it is reserved for specialized centers.Interferon-alpha (immunotherapy, now rarely used alone)
Interferon-alpha boosts some immune functions and was widely used before modern targeted and checkpoint therapies. It may still be part of certain combination regimens. It is given by injection several times per week. The purpose is modest tumor control. Mechanism includes stimulation of immune cells and direct anti-proliferative effects. Side effects often include flu-like symptoms, fatigue and mood changes.Belzutifan (HIF-2α inhibitor)
Belzutifan is a newer oral drug that inhibits HIF-2α, a key factor activated when VHL is lost in clear cell RCC. By blocking this pathway, it reduces expression of genes that drive blood vessel growth and survival. It is used in certain advanced RCC settings and in some hereditary syndromes. Side effects can include low oxygen levels, anemia and fatigue, so blood counts and oxygen saturation are monitored.Pembrolizumab + Axitinib combination regimen
This regimen combines immune checkpoint blockade with VEGF-targeted therapy and is a standard first-line option for many patients with advanced clear cell RCC.[²][³] The purpose is to improve overall survival and response rates compared with older drugs like sunitinib. Mechanism: pembrolizumab activates T-cells while axitinib cuts off tumor blood supply; together they attack the cancer from two sides.Nivolumab + Ipilimumab combination regimen
For intermediate- or poor-risk advanced RCC, this immune-only regimen is often recommended.[²][³] The purpose is to achieve deep, long-lasting responses in a subset of patients. Mechanism: ipilimumab activates T-cells early, while nivolumab sustains their attack on tumor cells. Side effects can be significant immune-related toxicities involving gut, liver, skin or hormone glands and require rapid management.Nivolumab + Cabozantinib combination regimen
This combination is another first-line option for advanced clear cell RCC.[²][³] Cabozantinib blocks growth and angiogenesis, and nivolumab reactivates T-cells. The goal is to improve survival and delay progression more than either agent alone. Side effects combine those of both drugs, so the team carefully adjusts doses and may pause one or both medicines if serious toxicity occurs.
Dietary molecular supplements
There is no supplement that can cure clear cell renal cancer. Some nutrients might support general health, immunity or recovery, but they can also interact with cancer drugs. Always ask your oncologist before starting any supplement. Dosages should stay within products’ standard ranges or what your doctor advises; do not exceed them.
Vitamin D – important for bone and immune health; low levels are common in people with chronic illness. It may support bone strength and mood. Mechanism: helps regulate calcium, immune cell function and inflammation. Excess doses can cause high calcium and kidney damage, so blood levels should be checked.
Omega-3 fatty acids (fish oil or algae oil) – may modestly reduce inflammation, support heart health and help maintain weight. Mechanism: omega-3s compete with omega-6 fats in cell membranes and can produce less inflammatory signaling molecules. High doses can increase bleeding risk, especially with anti-angiogenic drugs, so medical supervision is needed.
Probiotics – beneficial bacteria in capsules or fermented foods may help with diarrhea or bowel changes from some therapies. Mechanism: they help balance the gut microbiome, support the gut barrier and may reduce harmful bacteria. People who are very immunosuppressed should only use products approved by their doctors because rare bloodstream infections can occur.
Protein supplements (whey, plant-based shakes) – useful if appetite is poor but protein needs are high after surgery or during treatment. Mechanism: provide ready-to-absorb amino acids to maintain muscle and healing. People with reduced kidney function may need protein limits, so a renal dietitian should guide how much and which type to use.
Multivitamin at standard dose – a simple once-daily multivitamin can fill small diet gaps. Mechanism: provides required vitamins and trace minerals for hundreds of enzyme reactions. Very high-dose single vitamins are not recommended because they may feed tumor growth or increase side effects.
Curcumin (turmeric extract) – has anti-inflammatory and antioxidant properties in lab studies. Mechanism: may modulate NF-κB and other signaling pathways. Evidence in kidney cancer patients is limited, and high doses may affect blood clotting or drug metabolism, so it should not be used without oncology approval.
Green tea extract (EGCG) – contains polyphenols with antioxidant and mild anti-proliferative effects in cell experiments. Mechanism: may affect signaling pathways and oxidative stress. Concentrated extracts have been linked to rare liver injury, so if used at all, it should be at modest doses with liver test monitoring.
Selenium (within dietary range) – an essential trace element for antioxidant enzymes. Mechanism: supports glutathione peroxidase, which protects cells from oxidative damage. Excess selenium can cause hair loss, nail changes and nerve problems, so supplementation should only correct proven deficiency.
Vitamin B-complex – supports nerve function, red blood cell production and energy metabolism. Mechanism: B vitamins serve as co-factors in many metabolic reactions. In people with kidney disease, some B vitamins may be used more rapidly, but mega-doses are unnecessary and sometimes risky; standard doses are usually enough.
Coenzyme Q10 (CoQ10) – involved in mitochondrial energy production and acts as an antioxidant. Some people use it for fatigue. Mechanism: supports the electron transport chain in cells. It may interact with blood thinners and other drugs, so any use should be discussed with the oncology and cardiology teams.
Immunity-boosting, regenerative and stem-cell-related drugs
For clear cell kidney cancer, “immunity booster” drugs are powerful anticancer medicines, not simple tonics. True stem-cell or regenerative drugs are still experimental in this disease.
Immune checkpoint inhibitors (nivolumab, pembrolizumab, avelumab, ipilimumab)
These drugs strengthen T-cell attacks on cancer by blocking PD-1, PD-L1 or CTLA-4 checkpoints. The purpose is to help the immune system recognize and kill tumor cells more effectively. Mechanism: they remove inhibitory signals on T-cells, increasing their activity and persistence. They are given by IV and can cause serious immune-related inflammation in normal organs, so benefits and risks must be carefully balanced.[¹][²][³]High-dose IL-2
IL-2 is a cytokine that strongly stimulates immune cells. In a small, carefully chosen group of very fit patients, it can produce long-term remissions. The purpose is to create a massive immune response against cancer. Mechanism: expands and activates T-cells and natural killer cells throughout the body. Because it can dangerously lower blood pressure and affect organs, it is only used in specialized centers.Experimental CAR-T or TIL (tumor-infiltrating lymphocyte) therapies
In research trials, doctors take a patient’s immune cells, re-engineer them to better recognize the tumor, grow them in the lab and then infuse them back. The purpose is to give the patient “super-charged” cancer-fighting cells. Mechanism: genetically modified or expanded lymphocytes actively seek and destroy tumor cells. These treatments remain experimental in RCC and can cause serious side effects like cytokine-release syndrome, so they are not standard care yet.[³]Hematopoietic growth factors (like G-CSF) for low white cells
These drugs are not anticancer agents but support immunity when counts are low. The purpose is to reduce risk of infections during intensive treatment. Mechanism: they stimulate the bone marrow to produce more white blood cells. They are given by injection and may cause bone pain and, rarely, other complications, so they are used only when clearly needed.Erythropoiesis-stimulating agents (ESAs) for anemia
ESAs help the body make more red blood cells in some anemia settings. In cancer, they are used with caution because they may increase clot risk or affect survival if misused. The purpose is to reduce transfusion needs and improve fatigue in selected patients. Mechanism: they act like erythropoietin, stimulating red cell production in the bone marrow. Decisions about their use in RCC are complex and guideline-driven.Regenerative medicine and stem-cell approaches for kidney damage (research)
Some experimental approaches aim to repair damaged kidney tissue using stem-cell-derived products or regenerative scaffolds. The purpose would be to restore kidney function after major injury. Mechanism: stem cells may differentiate into kidney-like cells or release repair signals. At present, these methods are not standard for patients with clear cell renal cancer and should only be considered in controlled clinical trials.
Surgeries (Main procedures and why they are done)
Partial nephrectomy (nephron-sparing surgery)
The surgeon removes the tumor and a small margin of normal tissue but leaves the rest of the kidney. The purpose is to cure or control localized cancer while preserving as much kidney function as possible, especially for small tumors or patients with one working kidney.Radical nephrectomy
This operation removes the entire kidney with the tumor, nearby fat and sometimes lymph nodes and adrenal gland. The purpose is complete removal of larger or more complex tumors when partial nephrectomy is not safe. It can be done via open or minimally invasive approaches, depending on size and location.[⁴]Laparoscopic or robotic nephrectomy
Here, the same partial or radical nephrectomy is performed through small keyhole incisions using a camera and special instruments. The purpose is to reduce pain, hospital stay and recovery time while achieving similar cancer control in selected cases. The mechanism is minimal disruption of muscles and tissues compared with large open cuts.Ablative procedures (cryoablation, radiofrequency ablation)
For some small kidney tumors in patients who are high-risk for surgery, needles are placed into the tumor under imaging guidance to freeze (cryoablation) or heat (radiofrequency/microwave) the cancer. The purpose is local tumor destruction with less invasive treatment. These methods can be effective but may have a slightly higher chance of needing repeat treatment.Metastasectomy (surgery for limited metastases)
If someone has only a few small spots of cancer in the lungs, liver or bone, surgeons may remove or treat those areas with surgery, ablation or focused radiation. The purpose is to reduce tumor burden and sometimes prolong survival when systemic therapy is already controlling other disease sites.
Prevention strategies
Do not smoke or vape; quitting lowers kidney cancer risk and protects the remaining kidney.
Maintain a healthy body weight with balanced eating and regular activity.
Keep blood pressure under good control with lifestyle and, if needed, medicines.
Manage diabetes and cholesterol to protect blood vessels and kidneys.
Avoid long-term, heavy use of over-the-counter painkillers (especially some NSAIDs) without medical advice.
Limit exposure to workplace chemicals such as certain solvents or heavy metals by following safety rules.
Drink adequate (but not excessive) fluids as advised, especially if you have only one kidney.
Attend all follow-up visits and imaging after treatment so recurrences can be found early.
Encourage at-risk family members (for example with strong family history or known genetic syndromes) to speak with a genetic counselor.
Keep vaccinations and general health checks up to date to reduce infection and overall health stress.
When to see doctors
You should contact your doctor or oncology team urgently or seek emergency care if you notice blood in your urine, sudden severe side or back pain, trouble passing urine, sudden shortness of breath, chest pain, confusion, high fever or rapid swelling of legs or face. These can signal bleeding, blood clots, infection, kidney failure or drug side effects. You should also make an appointment soon if you have slowly worsening tiredness, weight loss, poor appetite, new bone pain, chronic cough, night sweats or any new lump. During treatment, you should inform your team quickly about new diarrhea, skin rash, yellow eyes, severe headache or vision changes, because immune-related side effects can worsen fast but are often reversible if treated early. Never stop or start cancer medicines or supplements on your own; always talk to your oncology team first.
What to eat and what to avoid
Eat plenty of colorful vegetables and fruits in cooked or soft forms if needed; they give vitamins, fiber and protective plant compounds.
Choose whole grains like oats, brown rice or whole-wheat bread instead of refined white bread and sugary cereals.
Use lean protein (fish, skinless poultry, beans, tofu, eggs) in amounts your dietitian recommends, especially if kidney function is reduced.
Include healthy fats such as nuts, seeds and small amounts of olive or canola oil, and limit deep-fried foods.
Limit salt by avoiding highly processed foods (instant noodles, salty snacks, canned soups) and not adding much salt at the table.
Drink fluids as advised by your doctor; this may mean steady, moderate intake rather than very high or very low amounts.
Avoid or minimize processed and smoked meats like bacon, sausages and deli meats, which can increase sodium and possibly cancer risk.
Avoid heavy alcohol use, and many people with cancer choose to avoid alcohol completely.
Be careful with “natural” herbal products or concentrated juices, as some can harm the kidney or interact with cancer drugs.
If appetite is low, use small frequent meals, soft high-calorie foods and nutrition drinks suggested by your dietitian instead of forcing large meals.
Frequently asked questions
Is clear cell renal cell adenocarcinoma curable?
If the tumor is found early and removed completely with surgery, many people are cured and live a normal life span. Once the cancer has spread beyond the kidney, cure is harder, but modern immunotherapy and targeted drugs can control the disease for years in some patients. Your outlook depends on stage, general health and how the tumor responds to treatment.Can I live with only one kidney after surgery?
Yes. Most people do very well with one kidney as long as they protect it. The remaining kidney can grow and do extra work. You will need regular blood and urine tests, blood pressure checks and lifestyle care (no smoking, careful use of medicines) to keep that kidney healthy.Why did I get this cancer?
For many people there is no single clear cause. Risk factors include smoking, obesity, high blood pressure, some workplace exposures and certain inherited conditions. Having these factors does not mean it is your fault; they only change risk, and many people with kidney cancer have no obvious risk factors at all.Do I always need chemotherapy?
Traditional chemotherapy (the type used in many other cancers) does not work well in clear cell RCC, so it is rarely used. Instead, most people receive targeted therapy and/or immunotherapy, which are more effective for this tumor type. Your doctor will explain which combinations are recommended for your stage.Will treatment make me very sick?
Side effects are possible, but they vary widely. Some people have mild tiredness or stomach upset; others develop stronger problems like high blood pressure, diarrhea or immune-related inflammation. The key is to report new symptoms early so your team can adjust doses, give supportive medicines or pause treatment before side effects become severe.How long will I need to take cancer drugs?
Many targeted and immunotherapy regimens are given until the cancer grows again or side effects become too strong. In some cases, after a long period of disease control or complete response, doctors may discuss stopping treatment. Decisions are very individual and are based on scan results, lab tests and how you feel.Can diet alone treat my cancer?
No. Diet and supplements cannot cure clear cell renal cell cancer. A healthy eating pattern is important to support your strength and help your body handle surgery and medicines, but it must be combined with the treatments recommended by your oncology team. Be cautious of anyone who offers “miracle” cures through food or supplements alone.Is it safe to fast or follow extreme diets during treatment?
Extreme fasting or very restrictive diets can cause weight and muscle loss, worsen weakness and sometimes interfere with treatment. In most cases, they are not recommended. If you want to try any special eating pattern, discuss it with your oncologist and dietitian so they can adjust your plan safely.Can I continue working during treatment?
Many people can work part-time or full-time, especially in less physically demanding jobs, but they may need flexible schedules. Fatigue and clinic visits can make full-time work difficult. Occupational and social workers can help you talk with employers, adjust duties and explore financial support if needed.Is exercise safe for me now?
Light to moderate exercise is usually safe and helpful, especially when guided by your doctors and a physiotherapist. Right after surgery you will start with short walks and breathing exercises, then build up slowly. During drug treatment, you may have to adjust activity on days when you feel more tired or unwell.Should my family be tested for kidney cancer genes?
Most cases are not inherited, but some families carry gene changes (like VHL and others) that increase risk. Your doctor may suggest genetic counseling if you are young at diagnosis, have several family members with kidney cancer or have other related tumors. The counselor can advise whether genetic testing is appropriate for relatives.How often will I need scans after treatment?
Follow-up schedules vary, but many people have CT or MRI scans every few months at first, then gradually less often if everything stays stable. The goal is to detect recurrences or new lesions early, when they may be easier to treat. Your exact schedule will be written in a survivorship plan by your team.Can clear cell kidney cancer come back after years?
Yes, recurrences can sometimes occur many years after surgery, which is why long-term follow-up is important. The risk depends on the original tumor size, grade and stage. Even if you feel well, keeping your follow-up appointments and reporting new symptoms early is essential.Is it safe to become pregnant after kidney cancer?
This is a complex question. For some people with small, early tumors that were fully removed and who have stable kidney function, pregnancy may be possible later with careful monitoring. However, many cancer drugs can harm a developing baby and must be stopped long before conception. Anyone thinking about pregnancy should discuss timing and safety in detail with their oncology and obstetric teams.Where can I find trustworthy information and support?
High-quality sources include national cancer guidelines, patient groups focused on kidney cancer, and information from major cancer centers. Your doctors, nurses and hospital social workers can point you to websites, printed materials and local or online support groups that are evidence-based and regularly updated. Avoid sources that promise quick cures, ask for large payments or discourage standard medical care.
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.
