Can kidney cancer recur after removal

Kidney cancer is one of the conditions that many people fear, and removing the tumor surgically is often a major step in its treatment. However, after the operation, one important question starts running through the patient’s mind: Can kidney cancer come back again after removal? In this Dalily Medical article, we will discuss the possibility of kidney cancer recurrence after nephrectomy, the factors that may increase the risk of cancer coming back, and the best ways to protect yourself through follow-up and prevention.If you want to stay informed and reduce your risk as much as possible, follow this article step by step to learn everything you need to know.

What is Kidney Cancer?
Kidney cancer occurs when kidney cells begin to grow abnormally and form a mass called a tumor. Over time, this tumor may spread to other parts of the body, which is known as metastasis.

Who is Most at Risk of Kidney Cancer?

Most commonly affects people between the ages of 65 and 74.
Men are twice as likely to develop kidney cancer compared to women.
More common in Native American and Black populations.
Rare in children, but around 500–600 children are diagnosed with Wilms tumor (a childhood kidney cancer) each year in the U.S.

Kidney Cancer Survival Rates
Survival depends on the stage of the disease:

Stage	Approximate Survival Rate
Stage 1	Very high
Stage 2	Around 74%
Stage 3	Around 53%
Stage 4	Drops to about 8%

But every case is different, and survival depends on several factors, such as:

Tumor type and aggressiveness
Tumor spread
Tumor size
Patient age
Type of surgery (partial nephrectomy vs. radical nephrectomy with lymph node removal)

Can Blood Tests Detect Kidney Cancer?
Blood tests do not detect cancer directly, but they may show kidney function problems caused by cancer. Important tests include:

Complete Blood Count (CBC): can reveal anemia due to low red blood cells.
Creatinine level: evaluates kidney function.

Most Common Age for Kidney Cancer
Most diagnoses occur between ages 65–74, so it is mainly a disease of older adults.

Is Kidney Cancer Fast-Spreading?

In early stages: usually grows slowly.
In advanced stages: spreads faster and affects other organs.

Can the Kidney Grow Back?
No — the kidney does not regenerate.
If part of the kidney is removed or damaged, it doesn’t grow back.
However, the remaining kidney tissue can adapt and work harder to compensate.

Does Kidney Cancer Cause Death?
According to Oxford Academic, kidney cancer causes around 175,000 deaths every year.
But again, outcomes vary depending on individual factors.

When Is Kidney Cancer Considered Dangerous?

Early stages: easier to treat, less dangerous.
Advanced stages: cancer spreads to other organs, making control more difficult and lowering survival chances.

Can Kidney Cancer Return After Removal?
Studies show that about 20% of patients who had partial or complete nephrectomy may develop recurrence.

Most recurrences happen within the first 2 years.

This is why regular follow-up during those two years is extremely important to detect recurrence early and manage it effectively.

Types of Kidney Cancer

Renal Cell Carcinoma (RCC) – most common type (about 85% of cases)
Subtypes include:
- Clear Cell RCC (most common)
- Papillary RCC
- Chromophobe RCC
Urothelial Carcinoma of the Renal Pelvis
Starts in the part of the kidney where urine collects — similar to bladder cancer.
Renal Sarcoma
Very rare — begins in soft tissues like blood vessels or ligaments inside the kidney.
Wilms Tumor
A childhood cancer — rare in adults but common in kids with kidney cancer.

How Common Is Kidney Cancer?

Accounts for around 3.7% of all cancers in the United States.
More than 62,000 Americans get diagnosed every year.
Risk increases with age.

Causes and Risk Factors for Kidney Cancer
The exact cause is not known, but several risk factors increase the chance of developing it:

Smoking
Obesity
High blood pressure
Family history of kidney cancer
Previous radiation treatment (especially women treated for reproductive cancers)
Genetic mutations
Long-term dialysis
Tuberous Sclerosis Complex
Von Hippel–Lindau disease (VHL)

How Is Kidney Cancer Diagnosed?
If symptoms suggest kidney cancer, the doctor may start with a detailed medical history and physical exam, then order tests, such as:

Urinalysis: to look for blood in urine (even microscopic)
Blood tests: to check blood cell types and kidney function
CT scan with contrast
MRI
Ultrasound
Kidney biopsy (in selected cases)

Most Common Symptoms of Kidney Cancer

Blood in urine (visible or detected by testing)
Persistent flank or back pain
A lump or swelling in the side or lower back
Unexplained weight loss
Fatigue and weakness
Recurrent fever with no clear cause
High blood pressure

Symptoms if Cancer Spreads to Other Organs

Lungs: persistent cough or shortness of breath
Bones: pain or easy fractures
Brain: headache or neurological changes

Stage 3:
The tumor has spread to the tissues surrounding the kidney, or to nearby lymph nodes.

Stage 4:
The tumor has spread outside the kidney to:

the adrenal gland (above the kidney),
distant lymph nodes,
or other organs in the body.

Tumor Grading

Tumors are also graded according to how abnormal the cancer cells look under the microscope:

High-grade tumors: the cells look very different from normal cells, they divide faster, and are more aggressive.
Low-grade tumors: the cells look more similar to normal cells, grow more slowly, and usually spread less.

How Is Kidney Cancer Diagnosed?

Diagnosis involves several steps to confirm the tumor, determine its size, and identify the stage of the disease.

Medical history & physical examination
The doctor asks about symptoms such as blood in urine, flank pain, or weight loss.
They also ask about medications and risk factors such as smoking or high blood pressure.
Then a physical examination of the abdomen and flank is done.

Laboratory tests

Urinalysis: to detect blood or abnormal cells.
Blood tests: to assess kidney function and perform a complete blood count (CBC).

Ultrasound
Often the first imaging test performed.
Helps detect whether a mass in the kidney is solid or cystic.

CT scan
One of the most accurate imaging tools for diagnosing kidney cancer.
Shows tumor size, invasion of surrounding tissues, and involvement of lymph nodes.

MRI
Used in specific situations, especially if the patient is allergic to CT contrast dye.

Biopsy
Sometimes a small sample is taken from the tumor for microscopic examination.
Not always required, because many kidney tumors have a typical appearance on CT scans.

Additional tests if metastasis is suspected

Chest CT scan to check for lung spread.
Bone scan if bone involvement is suspected.

Kidney Cancer Treatment by Stage

Stage 1 & Stage 2

In these stages, the cancer is localized within the kidney.

Main treatment: surgery

Partial nephrectomy: if the tumor is small.
Radical nephrectomy: if the tumor is large.

Traditional chemotherapy is usually not used because kidney tumors typically do not respond well to it.

Survival rates are very high when diagnosed early.

Stage 3

The tumor has reached surrounding tissues or nearby lymph nodes.

Main treatment: surgery

After surgery, the doctor may recommend:

Immunotherapy
Targeted therapy

to reduce the risk of recurrence and treat any microscopic remaining cancer cells.

Stage 4

Cancer has spread to distant organs such as the lungs or bones.

In this stage, surgery is not the main treatment, but may be used in selected cases:

if the kidney causes severe pain or heavy bleeding
to reduce tumor burden before other therapies

Main treatment options:

Immunotherapy
Targeted therapy
Sometimes hormonal therapy (for specific subtypes)
Radiotherapy may be used to control bone pain

Kidney Cancer Surgery

Kidney removal surgery is the primary treatment for most cases, especially in early stages.

Types of surgery

Type	Description
Open surgery	Large incision in the abdomen or flank
Laparoscopy	Small incisions with thin instruments
Robotic-assisted surgery	Similar to laparoscopy but with greater precision and less pain

Basic Steps of the Surgery

General anesthesia
Accessing the kidney through the abdomen or flank
Locating the tumor
Removing the tumor only (partial nephrectomy) or the whole kidney (radical nephrectomy)
Controlling bleeding and cleaning the site
Closing incisions and placing a catheter if necessary

Surgery Duration & Hospital Stay

Surgery duration: about 2–3 hours
Hospital stay:
- Open surgery: 4–7 days
- Laparoscopy or robotic surgery: 2–4 days

Recovery After Surgery

Light activity: after 2–3 weeks
Full activity: after 4–6 weeks
Regular follow-up blood tests and imaging to monitor kidney function

Can You Live with One Kidney?

Yes. Most people live a normal life with one kidney because the remaining kidney adapts and compensates for the lost function.

When Does a Patient Need Additional Treatment After Surgery?

If the cancer is advanced or metastatic, the patient may need:

Immunotherapy
Targeted therapy

The type and duration depend on the stage and the doctor’s assessment.

Treatment by Stage — Summary

Stage	Main Treatment
1 & 2	Surgery only – most patients do not need medication afterwards
3	Surgery + immunotherapy and/or targeted therapy
4	Medications are the main treatment — immunotherapy + targeted therapy