Clear Cell With Renal Cell Cancer is a type of kidney cancer that starts in the tiny tubes of the kidney that filter waste from the blood. Doctors also call it clear cell renal cell carcinoma (ccRCC). It is the most common kind of renal cell carcinoma and makes up about 70–80% of all kidney cancers in adults. Under the microscope, the cancer cells look very pale or “clear” because they are full of fat and sugar (lipid and glycogen) that get washed out during processing.
Clear cell renal cell cancer is the most common type of kidney cancer in adults. It starts from the tiny filtering units of the kidney and often looks “clear” under the microscope because the cells are full of fat and sugar. This cancer can stay in one kidney or spread to lymph nodes, lungs, bones, liver, or brain. Treatment usually includes surgery, targeted drugs, immunotherapy, and supportive care, and doctors follow expert guidelines such as NCCN kidney cancer recommendations to choose the best plan for each person based on stage, risk group, and kidney function.
Clear cell renal cell cancer is strongly linked to some risk factors such as smoking, high blood pressure, obesity, and certain inherited conditions (for example von Hippel–Lindau syndrome). Stopping smoking, keeping a healthy weight, and controlling blood pressure can lower risk and also support treatment results. However, even people without risk factors can get this cancer, so early check-ups and imaging are very important.
Clear cell renal cell cancer usually starts in one kidney, but it can sometimes affect both. It often happens in adults between 50 and 70 years of age and is more common in men than in women. Many tumors are found by chance when someone has an ultrasound or CT scan of the abdomen for another reason, because early clear cell kidney cancer may not cause symptoms.
Other names
Doctors and books may use different names for the same disease. These are some common other names for clear cell renal cell cancer:
Clear cell renal cell carcinoma (ccRCC)
Clear cell renal cancer
Clear cell kidney cancer
Conventional renal cell carcinoma
Conventional renal carcinoma
Clear cell carcinoma of the kidney
All these names point to the same basic problem: a malignant (cancer) tumor made of clear-looking cells in the kidney.
Types of clear cell renal cell cancer
Doctors can group clear cell renal cell cancer in several ways. These “types” help them think about how serious the cancer is and which treatment is best.
By spread (stage) –
Localized clear cell RCC: the tumor is only inside the kidney.
Locally advanced clear cell RCC: the tumor has grown into nearby tissues or veins, but not far away.
Metastatic clear cell RCC: the cancer has spread to other organs such as lungs, bones, liver, or brain.
By grade (how abnormal the cells look) –
Clear cell tumors can be low-grade (cells look more like normal kidney cells and usually grow slower) or high-grade (cells look very abnormal, grow faster, and behave more aggressively). Many systems use grades 1 to 4, with 1 being lowest grade and 4 being highest grade.By cause (hereditary or sporadic) –
Hereditary clear cell RCC: linked to inherited syndromes such as von Hippel–Lindau (VHL) disease, where a mutation in the VHL tumor-suppressor gene increases cancer risk.
Sporadic clear cell RCC: happens without a known inherited syndrome; this is the most common form.
Special pathologic variants –
Pathologists sometimes report variants such as “multilocular cystic clear cell RCC,” “clear cell RCC with sarcomatoid features,” or “clear cell RCC with papillary or spindle components.” These describe how the tumor looks under the microscope and can be linked with different behavior and prognosis.
Even though these types look different, they all belong to the clear cell family and grow from the same basic kidney tubule cells and VHL gene pathway.
Causes and risk factors
For most people, doctors cannot say exactly why clear cell renal cell cancer started. But many risk factors make it more likely. These are often called “causes,” even though they do not always directly create the cancer by themselves.
Cigarette smoking – Smoking is one of the strongest proven risk factors. People who smoke have a higher chance of renal cell carcinoma, and the risk increases with the number of cigarettes and years of smoking. Risk slowly goes down after quitting.
Excess body weight (overweight or obesity) – Extra body fat can change hormone levels and growth signals in the body. This long-term hormonal imbalance increases the chance of kidney cancer, especially clear cell type.
High blood pressure (hypertension) – People with chronic high blood pressure have a higher risk of renal cell carcinoma. It is not clear whether this is due to the blood pressure itself, the medicines, or both, but the association is strong.
Chronic kidney disease and long-term dialysis – Patients with severe kidney damage and those on long-term dialysis have more kidney cysts and a higher chance of developing renal cell cancer in the damaged kidneys.
Older age – The risk of clear cell renal cancer rises with age. It is most often diagnosed in people older than 50–60 years, suggesting that long-term damage and gene changes build up over time.
Male sex – Men are affected about twice as often as women. This may be related to hormones, higher rates of smoking, and some occupational exposures more common in men.
Family history of kidney cancer – Having a close relative (parent, brother, sister) with kidney cancer raises a person’s own risk, even when no specific gene syndrome is found. This suggests shared genes and shared environments.
Von Hippel–Lindau (VHL) syndrome – People born with an inherited mutation in the VHL gene have a very high risk of developing multiple clear cell renal cell cancers at a younger age, along with other tumors in the eye, brain, and spinal cord.
Other hereditary kidney cancer syndromes – Conditions such as hereditary leiomyomatosis and renal cell cancer, Birt–Hogg–Dubé syndrome, and hereditary papillary renal carcinoma can also raise kidney cancer risk. Some affected people may still develop clear cell tumors.
Exposure to certain industrial chemicals – Long-term exposure to chemicals like trichloroethylene (a metal-degreasing solvent) and some other organic solvents has been linked to a higher risk of renal cell carcinoma in workers.
Long-term use of some pain medicines – Heavy, long-term use of certain over-the-counter painkillers, especially older types, has been associated with increased kidney cancer risk, possibly due to chronic kidney damage.
Previous kidney radiation – People who have had radiation to the kidney area as part of treatment for another cancer may have a slightly higher risk of later renal cell carcinoma, because radiation can damage DNA.
Chronic kidney infections or stones – Long-lasting irritation, infection, or repeated stones can damage kidney tissue, which may contribute to cancer development in some cases, especially when combined with other risk factors.
Diabetes and metabolic syndrome – Diabetes and metabolic syndrome often appear together with obesity and high blood pressure. This group of conditions is linked to a higher risk of renal cell carcinoma through complex hormonal and inflammatory pathways.
Diet very high in processed meat and salted foods – Some studies suggest that diets high in processed meats and salt and low in fruits and vegetables may modestly increase RCC risk, likely through chronic inflammation and exposure to carcinogens.
Long-term use of certain diuretics or blood pressure drugs – Some older studies linked certain types of blood pressure medicines and water tablets with higher kidney cancer risk, though it is hard to separate the effect of the drug from the effect of hypertension itself.
Race and ethnicity – In some countries, kidney cancer is a bit more common in certain racial or ethnic groups than others, possibly due to genetic differences, access to care, and lifestyle patterns.
Previous kidney transplant – People who have had a kidney transplant and take long-term immune-suppressing drugs are at increased risk of several cancers, including renal cell carcinoma in the remaining native kidneys.
Occupational exposure to heavy metals – Exposure to metals like cadmium and some petroleum products has been linked in some studies with higher RCC risk, especially when combined with smoking.
Spontaneous gene changes in kidney cells – In many people without clear risk factors, random mutations develop in the VHL gene and other genes inside kidney tubule cells over time. These gene errors can let cells grow out of control and form clear cell RCC even when no external cause is obvious.
Symptoms
Early clear cell renal cell cancer often causes no symptoms and may be found on a scan done for another reason. When symptoms do appear, they are often due to the growing kidney mass, bleeding, or spread to other parts of the body.
Blood in the urine (hematuria) – The urine may look pink, red, or cola-colored, or blood may be seen only under the microscope. This happens when the tumor bleeds into the kidney collecting system or urinary tract.
Pain in the back or side (flank pain) – A dull ache or sharp pain on one side of the lower back or flank can occur when the tumor stretches the kidney capsule or presses on nearby tissues.
Lump or mass in the abdomen or flank – Some people or their doctors can feel a firm lump in the side or belly where the enlarged kidney or tumor is located.
Unexplained weight loss – Losing weight without trying can be a sign that the cancer is using a lot of the body’s energy and changing metabolism.
Loss of appetite – Many patients notice they do not feel hungry, or feel full quickly, because of general illness and chemicals released by the tumor.
Tiredness and weakness (fatigue) – Cancer-related inflammation, anemia, and poor sleep can all lead to feeling very tired even after rest.
Fever not due to infection – Some people have repeated fevers or night sweats without any obvious infection, because the tumor releases inflammatory substances.
Anemia (low red blood cells) – Kidney cancer can interfere with the kidney’s role in making erythropoietin, a hormone that helps the body make red blood cells, leading to anemia with pale skin, dizziness, and shortness of breath.
High blood pressure – Kidney tumors can affect blood flow and hormone production (like renin), which can cause or worsen hypertension.
Swelling in legs or ankles (edema) – If the tumor affects kidney function or blocks major veins, fluid can build up in the legs, ankles, or feet.
Varicocele in men (mainly on the left side) – Enlarged veins in the scrotum that suddenly appear, especially on the left and do not go away when lying down, can sometimes be caused by a kidney tumor compressing the testicular vein.
Bone pain or fractures – If clear cell RCC spreads to the bones, it can cause deep bone pain, tenderness, or even breaks with minor injury.
Cough or shortness of breath – Spread to the lungs or swollen lymph nodes in the chest can cause a persistent cough, chest discomfort, or breathlessness.
Headaches or neurological symptoms – Metastases to the brain can cause headaches, seizures, weakness, or behavior changes in advanced disease.
Paraneoplastic symptoms (body-wide changes not directly from the tumor mass) – Clear cell renal cancer can cause unusual problems like high calcium levels, abnormal liver tests, or changes in blood counts, even when scans do not show metastases. These happen because the tumor makes hormones or immune chemicals.
Diagnostic tests
Doctors use a mix of physical examination, manual bedside checks, laboratory and pathology tests, electrodiagnostic tests (mainly for safety before treatment), and imaging to diagnose clear cell renal cell cancer, check its stage, and plan treatment. The final diagnosis usually comes from looking at a tissue sample (biopsy or removed kidney) under a microscope.
Physical examination tests
Overall physical examination and medical history –
The doctor asks about symptoms such as blood in urine, pain, weight loss, fever, and past diseases like high blood pressure or kidney problems. They also check vital signs, listen to the heart and lungs, and look for general signs of illness. This first step helps the doctor decide which tests to order and whether kidney cancer is likely.Abdominal and flank palpation –
The doctor gently presses (palpates) the abdomen and the side of the body to feel for any enlarged kidney or lump. A large, firm mass in the upper abdomen or flank can suggest a kidney tumor. Sometimes, especially in thinner or younger patients, the tumor can be clearly felt.Costovertebral angle (CVA) tenderness check –
The doctor taps over the area where the kidney lies, between the spine and lower ribs, to see if it is painful. Tenderness here can point to kidney disease, though it is not specific for cancer and can also occur in infections or stones.Blood pressure measurement –
Blood pressure is carefully checked because many people with kidney tumors have high blood pressure. Very high or difficult-to-control blood pressure can be a clue that the kidney is involved and may guide further testing and follow-up.
Manual tests (simple bedside checks and maneuvers)
Bimanual kidney ballottement –
In this test, the doctor places one hand in the flank and the other in front of the abdomen, then gently “rocks” the area to feel the kidney move between the hands. A large or abnormally hard kidney can be felt this way and may suggest a tumor rather than a normal soft kidney.Peripheral edema assessment –
The doctor presses a thumb gently over the lower leg or ankle to check for pitting (a dent that stays after pressing). Swelling can suggest kidney problems, heart problems, or blocked veins and may be seen in advanced kidney cancer.Performance status assessment (simple functional tests) –
The doctor may ask the patient to walk, climb a few steps, or report how daily activities feel. Scales like ECOG or Karnofsky performance status use simple questions and observations to grade how active a patient is. This is important for deciding which treatments (surgery, targeted therapy, immunotherapy) are safe.
Laboratory and pathological tests
Urinalysis (urine test) –
A basic urine test can detect blood, protein, or other abnormal substances. Microscopic blood in the urine is a common early sign of kidney tumors, including clear cell RCC, even when the urine looks normal to the eye.Urine cytology –
A sample of urine is examined under the microscope to look for abnormal or cancerous cells. Urine cytology is more useful for cancers of the renal pelvis and bladder, but it may sometimes show malignant cells from an RCC that has broken into the collecting system.Complete blood count (CBC) –
This blood test measures red cells, white cells, and platelets. People with clear cell RCC may have anemia (low red cells), sometimes high platelet counts, or other changes due to inflammation or bone marrow effects. CBC also helps assess overall health before surgery or systemic therapy.Kidney function tests (serum creatinine and estimated GFR) –
These blood tests show how well the kidneys are working. They are vital before surgery or contrast imaging, because doctors need to know whether the remaining kidney will be strong enough to handle treatment. Abnormal results may also point to chronic kidney disease.Liver function tests (LFTs) –
Liver tests may be done because some patients have abnormal liver results due to metastases or paraneoplastic liver changes, even without obvious liver disease. Abnormal LFTs can affect drug dosing and treatment planning.Serum electrolytes and calcium –
Blood levels of sodium, potassium, and especially calcium are measured. High calcium levels (hypercalcemia) can occur as a paraneoplastic effect of clear cell RCC and may cause confusion, constipation, and weakness.Serum lactate dehydrogenase (LDH) –
LDH is a general marker of cell turnover and damage. High LDH levels are used as one of the risk factors in prognostic scoring systems for advanced RCC and may signal more aggressive disease.Pathology examination of biopsy or nephrectomy specimen –
This is the definitive test. A small tissue sample from the kidney (biopsy) or the whole tumor after surgical removal is processed and studied under the microscope. Pathologists look for clear cells, growth pattern, grade, and special markers to confirm clear cell RCC and to tell it apart from other types of kidney tumors.
Electrodiagnostic tests
Electrocardiogram (ECG) –
An ECG records the heart’s electrical activity. It is not used to diagnose clear cell RCC, but it is important before major surgery or systemic therapy to make sure the heart is strong enough and to detect rhythm problems, especially in older patients or those with high blood pressure.Nerve conduction studies and electromyography (EMG) in special cases –
Very rarely, clear cell RCC can cause paraneoplastic nerve or muscle problems. In such cases, doctors may use nerve conduction tests and EMG to study how nerves and muscles work. These tests do not find the tumor itself, but they help explain unusual weakness or tingling that might be related to the cancer or its treatment.
Imaging tests
Renal ultrasound –
Ultrasound uses sound waves to create pictures of the kidneys. It can quickly show whether a mass is solid or cystic and is often the first imaging test ordered. Many clear cell RCCs are first spotted on ultrasound done for abdominal pain, pregnancy, or other reasons.Contrast-enhanced CT scan of abdomen and pelvis –
A CT scan with contrast dye is the main imaging test for suspected kidney cancer. It provides detailed pictures of the kidney, blood vessels, lymph nodes, and nearby organs. CT helps confirm a solid tumor, measure its size, see whether it invades veins or lymph nodes, and look for spread to liver, lungs, and other areas.MRI of the abdomen (and sometimes chest or spine) –
MRI uses magnetic fields instead of X-rays and is helpful when CT contrast cannot be used or when doctors need a closer look at tumor spread into veins or the spinal canal. MRI is also used to check for metastases in the liver, spine, or brain when symptoms suggest spread.
Non-pharmacological treatments
1. Active surveillance (watchful waiting)
For some people with small tumors or slow-growing clear cell renal cell cancer, doctors may first choose active surveillance instead of immediate drug treatment. This means regular CT or MRI scans, blood tests, and clinic visits to watch the tumor very closely. The purpose is to delay medicine side effects while it is safe. The main mechanism is careful monitoring; treatment is started when scans show faster growth, new symptoms, or higher risk.
2. Smoking cessation programs
Stopping smoking is one of the most powerful non-drug treatments for kidney cancer. Special counseling, nicotine replacement, and group support help people quit and stay smoke-free. The purpose is to reduce further damage to kidney blood vessels and lower the chance of cancer progression and new cancers. The mechanism involves lowering toxic chemicals and inflammation in the blood, which may improve survival after a kidney cancer diagnosis.
3. Healthy weight and nutrition counselling
Dietitians help patients move toward a healthy body weight with balanced meals rich in vegetables, fruits, whole grains, and plant proteins, and low in processed foods and sugary drinks. The purpose is to improve strength, control blood sugar and blood pressure, and lower cancer-related fatigue. The mechanism is simple: a better diet reduces harmful hormones and inflammation and provides the energy and protein needed to recover from surgery and cancer therapy.
4. Structured physical activity and exercise rehabilitation
Gentle walking, cycling, light strength training, and breathing exercises can be tailored to the patient’s energy level and stage of disease. The purpose is to preserve muscle, reduce fatigue, lift mood, and lower risk of blood clots and heart disease. Exercise works by improving circulation, oxygen delivery, and hormone balance, and studies in renal cell carcinoma show better quality of life in active patients.
5. Renal-friendly diet and hydration coaching
A renal-friendly eating plan focuses on enough calories and protein but moderate salt, phosphorus, and sometimes potassium, especially if kidney function is reduced. The purpose is to protect the remaining kidney tissue and reduce swelling, blood pressure, and toxins in the blood. The mechanism is to decrease the load on the kidneys so they can filter waste more easily while the person receives cancer treatment.
6. Lifestyle blood pressure and metabolic control
Lifestyle changes such as less salt, less alcohol, more movement, and better sleep help manage high blood pressure and metabolic problems that are common in kidney cancer patients. The purpose is to lower stroke and heart disease risk and make systemic therapies safer. The mechanism is to reduce strain on blood vessels and kidneys, which may also improve how well targeted drugs and immunotherapy are tolerated.
7. Psychological counselling and psycho-oncology support
Being told you have clear cell renal cell cancer is frightening and stressful. Psychologists and oncology social workers provide talk therapy, coping tools, and family support. The purpose is to treat anxiety, depression, fear of recurrence, and relationship stress. The mechanism is emotional and cognitive: learning new ways to think about illness and manage emotions improves sleep, adherence to treatment, and overall quality of life.
8. Palliative care and symptom-management services
Palliative care is not only for end of life. Specialists join early to help manage pain, breathlessness, nausea, constipation, and complex decisions. The purpose is to improve comfort and daily functioning during all stages of cancer. The mechanism is a whole-person approach that uses education, physical strategies, and coordination with the oncology team to reduce symptom burden without always adding new drugs.
9. Pain coping physiotherapy and movement strategies
Physiotherapists teach gentle stretching, posture changes, heat and cold packs, and sometimes devices like TENS (nerve stimulation) to help manage bone or flank pain. The purpose is to reduce pain and stiffness so people can move more and rely less on strong pain medicines. The mechanism includes improving joint alignment, muscle balance, and blocking some pain signals through nerves and the spinal cord.
10. Prehabilitation before kidney surgery
Before partial or radical nephrectomy, some centers use “prehab” programs that include breathing exercises, light strength training, and nutrition optimization. The purpose is to enter surgery as strong as possible and reduce complications. The mechanism is to build lung capacity, heart fitness, and muscle mass so the body can better tolerate anesthesia, blood loss, and the healing process afterwards.
11. Post-surgical rehabilitation
After surgery, guided walking, breathing exercises, and gradual core strengthening help people recover faster. The purpose is to prevent blood clots, pneumonia, and long-term weakness. Rehabilitation works by slowly loading muscles and lungs again while protecting the surgical area, which speeds up return to normal activities and reduces hospital stay.
12. Genetic counselling and testing for hereditary syndromes
Some patients with clear cell renal cell cancer have inherited conditions such as von Hippel–Lindau disease or other kidney-cancer syndromes. Genetic counsellors explain who should be tested, interpret results, and advise family members. The purpose is early detection and screening in relatives and tailored follow-up for the patient. The mechanism is risk stratification: knowing the genetic mutation changes imaging schedules and sometimes surgical timing.
13. Fertility and family-planning counselling
Younger people with kidney cancer may worry about fertility, pregnancy, and future children. Specialist teams explain how surgery, targeted therapy, or immunotherapy may affect fertility and discuss options such as sperm or egg freezing before treatment. The purpose is to let people make informed choices. The mechanism is practical planning: preserving reproductive cells when possible before cancer therapy may help with future family goals.
14. Occupational therapy and energy-conservation training
Occupational therapists help patients adjust work tasks, home chores, and daily routines to match energy levels. The purpose is to stay independent and safe while managing fatigue, weakness, and pain. The mechanism uses pacing, assistive devices, and ergonomic changes so that muscle and joint strain is reduced, and people can still perform important roles at home or school or work.
15. Peer support groups and patient education classes
Support groups (in person or online) let people share experiences, tips, and emotions with others who have kidney cancer. Education sessions explain scans, staging, drug options, and side effect management in simple language. The purpose is to reduce fear and confusion. The mechanism is social: seeing others coping well makes it easier to stay engaged in care and ask better questions in clinic visits.
16. Stress-reduction techniques (mindfulness, breathing, yoga)
Mindfulness meditation, slow breathing exercises, gentle yoga, and relaxation audio tracks can lower stress and anxiety. The purpose is to calm the nervous system and improve sleep during treatment. The mechanism involves reducing stress hormones like cortisol and improving heart-rate variability, which can lessen pain perception and emotional distress in cancer patients.
17. Telehealth follow-up and remote monitoring
Video visits, phone calls, and electronic symptom reports make it easier to stay in touch with the oncology team, especially for people who live far from cancer centers. The purpose is early detection of side effects and quick adjustment of care plans. The mechanism is frequent, low-burden contact that can catch problems like rising blood pressure or new pain before they become emergencies.
18. Radiation therapy (non-drug locoregional treatment)
Although clear cell renal cell cancer is relatively resistant to radiation, carefully planned radiotherapy can relieve pain or control tumors in bone, brain, or other sites. The purpose is palliation of symptoms and sometimes local control when surgery is not possible. The mechanism is damage to cancer cell DNA using focused beams, which shrinks or slows tumor growth in the treated area.
19. Local ablative procedures (cryoablation, radiofrequency ablation)
For small kidney tumors, especially in people who cannot have full surgery, interventional radiologists can freeze (cryoablation) or heat (radiofrequency ablation) the tumor through needles guided by imaging. The purpose is to destroy the tumor while preserving as much kidney as possible. The mechanism is direct physical injury: extreme cold or heat kills cancer cells and leads to scar tissue in that area.
20. Sleep hygiene and fatigue-management coaching
Specialists teach regular bedtimes, limiting screen use before sleep, short daytime naps, and gentle activity during the day to manage fatigue. The purpose is to improve sleep quality, which often drops during cancer treatment. The mechanism is to reset circadian rhythm and reduce fragmented sleep, which can also improve mood and thinking.
Drug treatments
(All medicines here are prescription anti-cancer drugs. Doses are typical adult schedules from FDA or major guidelines. They must only be used under a cancer specialist’s direct supervision; never self-start or change doses on your own.)
1. Sunitinib (SUTENT – VEGF tyrosine kinase inhibitor)
Sunitinib is an oral targeted drug that blocks VEGF receptors and other kinases that tumors use to grow blood vessels. It is approved for advanced and adjuvant renal cell carcinoma. A common adult dose is 50 mg once daily for 4 weeks, then 2 weeks off, repeated in cycles, adjusted for side effects. The purpose is to starve the tumor of blood supply and slow growth. Side effects can include fatigue, high blood pressure, hand-foot skin reaction, diarrhea, and low blood counts.
2. Pazopanib (VOTRIENT – VEGF tyrosine kinase inhibitor)
Pazopanib is another oral VEGF-targeted medicine approved for adults with advanced renal cell carcinoma. A usual starting dose is 800 mg once daily on an empty stomach, with dose changes if liver tests or other side effects become a problem. The purpose is to block VEGF and related growth pathways so new tumor blood vessels cannot form easily. Common side effects are liver test changes, diarrhea, high blood pressure, hair color changes, nausea, and fatigue, so close monitoring of blood tests and blood pressure is required.
3. Axitinib (INLYTA – VEGF tyrosine kinase inhibitor)
Axitinib is an oral VEGF receptor blocker used after one prior therapy and in combination with immunotherapy for first-line advanced renal cell carcinoma. A frequent schedule is 5 mg twice daily about 12 hours apart, with dose increases or decreases based on tolerance. The purpose is to further suppress tumor blood vessel growth when other drugs have already been tried. Side effects often include diarrhea, high blood pressure, tiredness, hoarse voice, and hand-foot syndrome.
4. Cabozantinib (CABOMETYX – multi-target TKI)
Cabozantinib blocks VEGF receptors and several other kinases involved in tumor growth and spread. It is used alone or with nivolumab for advanced clear cell renal cell carcinoma. Typical adult doses are 40–60 mg once daily, adjusted based on side effects and whether it is combined with immunotherapy. The purpose is to reduce tumor size and delay progression in intermediate and poor-risk disease. Common problems are diarrhea, fatigue, mouth sores, hand-foot syndrome, high blood pressure, and low thyroid function.
5. Lenvatinib (LENVIMA – multi-target TKI, often with pembrolizumab)
Lenvatinib targets VEGF, FGF, and other pathways and is used together with pembrolizumab for some patients with advanced clear cell renal cell carcinoma. A common dose in combination regimens is 20 mg once daily, with reductions if side effects occur. The purpose is to attack tumor blood vessels while the immunotherapy helps the immune system. Side effects can include diarrhea, weight loss, high blood pressure, fatigue, and protein in the urine.
6. Everolimus and temsirolimus (mTOR inhibitors)
Everolimus (oral) and temsirolimus (intravenous) block mTOR, a key pathway controlling cell growth and metabolism. They are used in certain advanced or poor-risk renal cell carcinoma settings, often after VEGF-targeted drugs. Typical adult dosing is everolimus 10 mg once daily or temsirolimus 25 mg intravenously weekly, but doctors individualize based on liver function and other factors. The purpose is to slow cell division and tumor growth. Side effects include mouth sores, high blood sugar, high cholesterol, low blood counts, and lung inflammation.
7. Nivolumab (OPDIVO – PD-1 immune checkpoint inhibitor)
Nivolumab is an intravenous immunotherapy that blocks PD-1, a “brake” on T cells. It is used alone after other treatments or in the first-line setting combined with ipilimumab or cabozantinib. Common doses are weight-based (e.g., 3 mg/kg with ipilimumab) or fixed doses such as 240 mg every 2 weeks or 480 mg every 4 weeks. The purpose is to help the immune system recognize and attack cancer cells more strongly. Side effects are immune-related and may affect skin, gut, liver, lungs, thyroid, or other organs, sometimes seriously.
8. Ipilimumab (YERVOY – CTLA-4 immune checkpoint inhibitor)
Ipilimumab targets CTLA-4, another immune checkpoint, and is usually given together with nivolumab in intermediate- or poor-risk advanced renal cell carcinoma. A common schedule is nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks for 4 doses, followed by nivolumab alone. The purpose is to release two different immune brakes at once so T cells can attack the tumor. Because the immune system becomes very active, serious side effects such as colitis, hepatitis, hormone gland problems, and skin reactions can occur and must be treated quickly with steroids.
9. Pembrolizumab (KEYTRUDA – PD-1 inhibitor, often in combinations)
Pembrolizumab is another PD-1 blocking antibody used with axitinib or lenvatinib for first-line clear cell renal cell carcinoma in many guidelines. Typical adult doses are 200 mg every 3 weeks or 400 mg every 6 weeks by intravenous infusion. Its purpose is similar to nivolumab: boost specific T-cell activity against cancer. Side effects are immune-related and can affect many organs, so close monitoring and early treatment of symptoms like diarrhea, cough, or jaundice are essential.
10. Belzutifan (WELIREG – HIF-2α inhibitor)
Belzutifan is a newer oral drug that blocks HIF-2α, a key protein driving clear cell renal cell carcinoma, especially in tumors linked to VHL gene changes. It is approved for von Hippel–Lindau–related renal cell carcinoma and, more recently, advanced renal cell carcinoma after PD-1/PD-L1 and VEGF-TKI therapy. Typical adult dosing is 120 mg once daily, adjusted for side effects like anemia and low oxygen levels. The purpose is to cut off downstream signals that promote tumor survival in low-oxygen environments.
(There are other important drugs and combinations such as sorafenib, tivozanib, bevacizumab-based regimens, and additional checkpoint-inhibitor/TKI pairs; the oncology team chooses among these based on stage, risk group, prior treatments, and guideline recommendations.)
Dietary molecular supplements
(Supplements can interact with cancer drugs and may strain the kidneys. Always discuss any supplement with your oncologist and kidney doctor before use.)
1. Omega-3 fatty acids (fish oil or algae oil)
Omega-3 fats from fish oil or algae oil have anti-inflammatory effects and may help preserve muscle and improve nutritional status in cancer patients. Typical doses in cancer studies are around 1–3 g of combined EPA and DHA per day, but dosing must be individualized, especially if there is bleeding risk or blood-thinner use. Functionally, omega-3s reduce inflammatory cytokines and may support heart health. The mechanism includes changes in cell membranes and signaling molecules that dampen chronic inflammation.
2. Vitamin D
Many people with kidney cancer have low vitamin D levels. Replacement with vitamin D3 under medical guidance can support bone health, muscle function, and immune balance. Doses often range from 800–2000 IU daily or higher short-term “loading” under supervision, guided by blood tests. Functionally, vitamin D helps calcium balance and may modulate cancer-related pathways. Mechanistically, it binds to vitamin D receptors in many tissues and can influence cell growth and differentiation.
3. Curcumin (from turmeric)
Curcumin is a yellow compound from turmeric with strong antioxidant and anti-inflammatory actions. Laboratory and early research in renal cell carcinoma suggest that curcumin may slow kidney cancer cell growth and even reverse resistance to sunitinib, but this is still experimental and not a stand-alone treatment. Typical supplement doses in studies range from 500–2000 mg per day, often with piperine to improve absorption. Mechanistically, curcumin affects many signaling pathways, including oxidative stress, apoptosis, and ferroptosis.
4. Green tea extract (EGCG-rich)
Green tea and its main polyphenol EGCG have antioxidant and anti-cancer effects in lab models and may lower risk of kidney cancer in population studies. Supplements often contain 200–400 mg EGCG per capsule, but high doses can harm the liver, so medical oversight is essential. Functionally, EGCG reduces oxidative stress and may help protect kidney tissue. Mechanisms include blocking growth signals and improving antioxidant defense inside cells.
5. Selenium
Selenium is a trace mineral involved in antioxidant enzymes. In balanced doses, it may support immune function and antioxidant defense in people with cancer and on certain diets. Typical supplement doses are 50–200 micrograms per day, avoiding higher amounts that can be toxic. Its function is to help enzymes like glutathione peroxidase reduce oxidative damage. Mechanistically, selenium is built into these enzymes and participates directly in detoxifying reactive oxygen species.
6. Vitamin C (controlled doses)
Vitamin C supports immune function and collagen production and can help with wound healing after surgery. Oral doses of 200–500 mg per day are often enough; very high or intravenous doses should only be given in clinical trials or specialized centers. Functionally, vitamin C acts as an antioxidant and may improve iron absorption and fatigue. Mechanistically, it donates electrons to neutralize free radicals and supports enzymes involved in tissue repair.
7. Probiotics
Probiotic bacteria (for example Lactobacillus or Bifidobacterium strains) may improve gut health, diarrhea from some treatments, and overall immune tone. A typical dose is one capsule or serving of a product containing billions of colony-forming units once or twice daily, chosen according to medical advice. Functionally, probiotics help maintain a healthy microbiome. Mechanistically, they compete with harmful bacteria, support the gut barrier, and modulate immune cell activity, which can affect how people respond to immunotherapy.
8. Coenzyme Q10 (CoQ10)
CoQ10 is involved in mitochondrial energy production and acts as an antioxidant. Some cancer patients use it to help with fatigue and heart health, particularly if on drugs that stress the heart. Usual doses range from 100–300 mg per day with food. Its function is to support energy production in heart and muscle cells. Mechanistically, CoQ10 participates in the electron transport chain and helps neutralize free radicals in mitochondria.
9. Resveratrol
Resveratrol is a plant polyphenol found in grapes and berries with antioxidant and anti-inflammatory effects. Experimental work suggests it can influence cancer cell signaling, but human data are limited. Supplement doses often range from 100–250 mg daily. Functionally, it may help reduce oxidative stress and support vascular health. Mechanistically, it affects pathways like sirtuins and NF-κB, which are involved in cell survival and inflammation.
10. Medical nutrition shakes (high-protein, calorie-dense formulas)
Commercial medical shakes are not “pills,” but they act like molecular nutrition supplements, providing protein, calories, and sometimes omega-3s and vitamins in an easy-to-drink form. Typical use is one to three servings daily when appetite is poor. Their function is to prevent weight loss and maintain muscle. Mechanistically, they supply balanced nutrients needed for healing and immune function when regular eating is difficult.
Immune-booster and regenerative / stem-cell–related drugs
(These treatments are highly specialized, often toxic, and never self-administered. They are mentioned to explain options your oncology team may consider or that may appear in research articles.)
1. Aldesleukin (high-dose interleukin-2, PROLEUKIN)
Aldesleukin is an intravenous form of interleukin-2, a strong immune-stimulating cytokine, approved for metastatic renal cell carcinoma in carefully selected patients. It is given in the hospital in very high, repeated doses over several days. The function is to strongly activate T cells and natural killer cells so they attack tumor cells. Mechanistically, IL-2 binds to IL-2 receptors on immune cells and drives their expansion, but this can also cause severe side effects like low blood pressure, fluid leakage, and organ dysfunction.
2. Dendritic cell vaccines
Dendritic cell vaccines use a patient’s own immune cells, loaded with kidney cancer antigens, to train the immune system to recognize the tumor. The vaccine is made in the lab and injected back into the patient at intervals. The purpose is to build long-lasting, tumor-specific immune memory. Mechanistically, dendritic cells present tumor antigens to T cells along with strong activation signals, encouraging a targeted attack on clear cell renal cell cancer cells. This approach is mainly available in clinical trials.
3. Cancer neoantigen and “off-the-shelf” vaccines
Newer vaccines use computer tools to pick neoantigens (mutated proteins) from each person’s tumor or use standardized antigens such as CD70 or CAIX, which are often present in clear cell renal cell cancer. These vaccines are sometimes given alongside checkpoint inhibitors. The purpose is to widen the range of targets the immune system can see. Mechanistically, the vaccines stimulate T cells specific for these unique tumor markers, increasing the depth of immune response.
4. CAR-T cell therapy (experimental in clear cell RCC)
CAR-T cell therapy involves taking a patient’s T cells, genetically engineering them to recognize a kidney cancer target such as CD70 or CAIX, and then infusing them back after chemotherapy. Early trials in metastatic clear cell renal cell carcinoma show promising responses in some patients but are still in research stages. The function is to create “hunter” T cells that can find and kill tumor cells more effectively. Mechanistically, CARs combine an antibody-like binding domain with T-cell activation signals.
5. Natural killer (NK) cell therapies
Some trials collect a patient’s NK cells, activate them in the lab, and infuse them back with supportive cytokines such as low-dose IL-2. The purpose is to strengthen innate immunity, which can kill cancer cells without prior “education.” Mechanistically, NK cells recognize stress markers on tumor cells and release toxic granules to destroy them. These therapies remain experimental and are usually offered only in clinical trials at large centers.
6. Hematopoietic stem-cell transplantation (rare in RCC)
Stem-cell transplantation is not standard care for clear cell renal cell cancer but has been explored in small studies for very advanced or treatment-resistant solid tumors. The aim is to allow high-dose chemotherapy and sometimes a graft-versus-tumor effect from donor immune cells. Mechanistically, high-dose therapy wipes out bone marrow, and infused stem cells repopulate it. Because risks are high and benefits uncertain, this option is reserved for clinical trials or extremely selected cases.
Surgeries
1. Partial nephrectomy (nephron-sparing surgery)
In partial nephrectomy, the surgeon removes only the tumor and a small rim of normal kidney tissue, leaving the rest of the kidney in place. This is often used for small tumors or when preserving kidney function is very important. The procedure is done through open, laparoscopic, or robotic methods. It is done to cure localized cancer while keeping as much kidney as possible working.
2. Radical nephrectomy
Radical nephrectomy removes the entire kidney along with surrounding fat and sometimes the adrenal gland and nearby lymph nodes. It may be performed through open or minimally invasive techniques. The purpose is to remove large or centrally located tumors that cannot be safely removed with a partial operation. Mechanistically, taking out the whole kidney removes the main tumor mass and can be curative in localized disease.
3. Cytoreductive nephrectomy
In some patients with metastatic clear cell renal cell cancer, doctors may remove the main kidney tumor even though cancer has already spread. This is called cytoreductive nephrectomy. The operation is done to reduce tumor burden before or during systemic therapy. The mechanism is partly mechanical (removing tumor) and partly immunologic, as it may improve how well drugs and the immune system work against remaining metastases in selected cases.
4. Metastasectomy (removal of metastases)
Metastasectomy means surgically removing cancer deposits outside the kidney, such as in lung, bone, or liver, when they are limited and operable. It can be done with minimally invasive or open techniques depending on the site. The purpose is to achieve no evidence of disease in carefully chosen patients. Mechanistically, removing all visible disease may prolong survival or delay the need for continuous systemic therapy.
5. Tumor thrombectomy and vena cava surgery
Clear cell renal cell cancer sometimes grows into the renal vein and up into the inferior vena cava. Specialized surgeons can remove the kidney tumor and carefully take out the tumor “thrombus” from the large vein, sometimes with help from heart–lung bypass. This procedure is done to prevent life-threatening clots and to control aggressive local disease.
Prevention tips
Do not smoke and avoid second-hand smoke. Stopping smoking lowers the risk of kidney cancer and many other cancers and improves survival after diagnosis.
Maintain a healthy body weight. Long-term obesity is strongly linked to renal cell carcinoma, so balanced diet and regular activity are key.
Control blood pressure. Managing salt intake, exercise, and prescribed medicines for hypertension reduces kidney damage and cancer risk.
Limit exposure to toxic chemicals. Follow safety rules at work to avoid solvents like trichloroethylene and heavy metals that may increase kidney cancer risk.
Use painkillers wisely. Long-term overuse of some non-steroidal anti-inflammatory drugs (NSAIDs) can injure kidneys; use the lowest effective dose and follow medical advice.
Stay physically active. Regular movement lowers cancer risk in general and supports heart and kidney health.
Follow a plant-forward diet. Eating more vegetables, fruits, beans, whole grains, and fewer processed meats supports weight control and overall cancer prevention.
Stay hydrated sensibly. Adequate fluid intake helps kidney function, but people with reduced kidney function must follow personalized fluid limits from their doctors.
Attend regular check-ups. Routine blood pressure checks, urine tests, and imaging when indicated can catch kidney problems early.
Know your family history. People with inherited kidney cancer syndromes may need earlier or more frequent imaging.
When to see doctors
You should see a doctor promptly if you notice warning signs that may suggest kidney problems or clear cell renal cell cancer. Important symptoms include blood in the urine, persistent pain in the side or lower back not caused by injury, a lump or swelling in the abdomen or flank, unexplained weight loss, ongoing fever, night sweats, or extreme tiredness. These symptoms are often caused by non-cancer problems such as infections or stones, but they always need a proper medical check.
Urgent medical review is especially important if you:
Have visible blood in urine or repeated urinary infections
Have kidney cancer already and develop new or rapidly worsening pain, breathlessness, chest pain, severe headaches, confusion, or sudden weight loss
Feel very short of breath, dizzy, or faint while on cancer therapy
Notice yellowing of the eyes or skin, severe diarrhea, or a new rash while taking targeted drugs or immunotherapy
These features can mean serious complications or treatment side effects that need fast specialist care.
What to eat and what to avoid
Eat plenty of colorful vegetables and fruits. Aim to fill at least half your plate with vegetables and fruits most days to provide vitamins, minerals, fiber, and protective plant compounds.
Choose whole grains over refined grains. Brown rice, oats, whole-wheat bread, and other whole grains support steady energy and healthy weight control.
Include plant proteins and lean animal proteins. Beans, lentils, tofu, nuts, seeds, and moderate portions of fish or skinless poultry help maintain muscle while limiting saturated fat. Kidney patients may need adjusted protein amounts decided with their team.
Use healthy fats and limit unhealthy fats. Prefer olive oil, nuts, seeds, and avocado while avoiding deep-fried foods and trans-fat snacks. This supports heart and kidney health.
Limit red and processed meats. Eating less bacon, sausage, and processed red meat may lower overall cancer risk and help weight control.
Avoid very salty and highly processed foods. Packaged soups, chips, and instant noodles are often high in sodium, which worsens blood pressure and kidney strain.
Be careful with herbal products. Some herbs marketed for “kidney cleansing” or “immune boosting” can be harmful to kidneys or interact with cancer drugs, so never start them without your doctor’s approval.
Limit sugary drinks and alcohol. Sugary beverages add calories without nutrition, and excess alcohol harms liver and overall health. Many kidney cancer patients are advised to drink little or no alcohol.
Discuss fluid and potassium limits if kidney function is reduced. Some people need to limit high-potassium foods like certain fruits or juices; this must be guided by lab results and a renal dietitian.
Use supplements only under supervision. Even “natural” supplements like green tea extract, curcumin, and high-dose vitamins can have side effects or interact with targeted therapies and immunotherapy. Always check with your oncology team before adding them.
Frequently asked questions (FAQs)
1. Is clear cell renal cell cancer always fatal?
No. Outcomes vary widely. Some small tumors can be cured with surgery, and newer targeted therapies and immunotherapies have improved survival for many people with advanced disease. Prognosis depends on stage, risk group, overall health, and how well the cancer responds to treatment.
2. What is the main difference between clear cell and other kidney cancers?
Clear cell renal cell cancer is defined by how the cells look under a microscope and by certain gene changes, especially in the VHL gene, which drive HIF-2α and VEGF signaling. This biology explains why drugs targeting blood vessel growth and HIF-2α are especially important in this subtype.
3. How do doctors decide which drug treatment to start?
Doctors use models such as the IMDC risk score, the cancer’s stage and spread, and the patient’s kidney function, age, and other illnesses. Guidelines like NCCN suggest several first-line choices, including immunotherapy plus TKI combinations or dual checkpoint blockade, and the team and patient decide together.
4. Can lifestyle changes alone treat clear cell renal cell cancer?
No. While exercise, diet, and quitting smoking greatly support health and may improve treatment tolerance, they cannot replace surgery or systemic cancer drugs. Lifestyle care is best seen as a powerful partner to, not a substitute for, standard medical treatment.
5. Are dietary supplements safe during treatment?
Some supplements, like moderate vitamin D or omega-3s, may be helpful for selected patients, but others can be dangerous or interact with drugs. For example, concentrated green tea extract can stress the liver, and herbal mixtures may affect kidney function. Always ask your oncology team before starting any supplement.
6. Why do targeted therapies cause high blood pressure?
Many VEGF-targeted drugs narrow small blood vessels and change how they react, which increases blood pressure. This side effect is common and often managed with blood-pressure medicines and lifestyle changes. Regular monitoring is essential to protect the heart and remaining kidney.
7. What is the difference between immunotherapy and chemotherapy?
Traditional chemotherapy directly attacks fast-dividing cells, including some healthy cells, while immunotherapy drugs like nivolumab and pembrolizumab mainly work by removing “brakes” from the immune system so it can recognize and attack cancer. Immunotherapy side effects come from overactive immune responses rather than direct cell poisoning.
8. Can clear cell renal cell cancer come back after surgery?
Yes, even when the tumor is fully removed, there is a risk of recurrence, especially for higher-stage or high-grade tumors. Doctors may recommend regular scans and sometimes adjuvant targeted therapy to lower this risk. Keeping follow-up appointments is very important for early detection of relapse.
9. Does diet really matter if I already have kidney cancer?
Yes. Good nutrition supports immune function, wound healing, and energy, and helps you tolerate treatments better. Plant-forward, balanced diets guided by a dietitian can also help manage treatment-related weight loss or gain and protect the remaining kidney.
10. Is green tea safe if I have clear cell renal cell cancer?
Moderate green tea drinking is generally safe for most people and may offer antioxidant benefits, but concentrated extracts in pill form can harm the liver, especially when combined with cancer drugs. Always discuss amount and form with your oncology and kidney team before using green tea products for “treatment.”
11. Can exercise worsen my kidney cancer?
For most patients, appropriately chosen exercise is safe and helpful. It does not make tumors grow faster; instead, it can reduce fatigue, support mood, and maintain strength. Your team may suggest avoiding very heavy lifting soon after surgery or when bones are fragile from metastases.
12. Are CAR-T and other cell therapies available for clear cell renal cell cancer right now?
Cell therapies such as CAR-T and NK-cell infusions are being tested in clinical trials for advanced clear cell renal cell cancer, with encouraging early results, but they are not yet standard treatment everywhere. Access is usually through research centers, and risks and benefits must be carefully discussed.
13. How long do people usually stay on targeted therapy or immunotherapy?
Many people continue these drugs as long as the tumor is controlled and side effects remain manageable. Some protocols stop immunotherapy after about two years of good response, while TKIs may be continued or adjusted for longer. Decisions are individualized based on scans, symptoms, and preferences.
14. What if I cannot tolerate the first treatment I receive?
If side effects are severe or the cancer continues to grow, doctors can switch to another targeted drug, another immunotherapy, or a clinical trial option. Having more than one line of therapy is common in advanced clear cell renal cell cancer, and new drugs continue to appear.
15. What should I, or my family, remember most?
The most important points are: do not ignore warning symptoms, keep all follow-up visits and scans, never change or add medicines or supplements without your cancer team’s advice, and focus on both medical treatment and daily lifestyle (food, movement, sleep, emotional support). Working closely with a multidisciplinary team gives the best chance of long, good-quality life with clear cell renal cell cancer.
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.
