RCC is a group of diseases that occurs in the renal epithelium. The most common subtype is clear cell RCC (ccRCC), which represents ~70% of adult RCCs. ccRCC has the highest risk of metastasis, and so it is considered advanced RCC. Approximately 30% of RCC patients present with advanced RCC at the time of diagnosis.^1-4

While there are rarely signs or symptoms in the earlier stages of RCC, possible signs of advanced disease may include blood in the urine, lower back pain on one side, a mass on the side or lower back, fatigue, loss of appetite, weight loss, persistent fever that is not caused by an infection, and anemia.⁵

References

1. American Cancer Society. What is kidney cancer? Revised May 5, 2020. Accessed November 9, 2021. https://www.cancer.org/cancer/kidney-cancer/about/What-is-kidney-cancer.html 

2. Nabi S, Kessler ER, Bernard B, Flaig TW, Lam ET. Renal cell carcinoma: a review of biology and pathophysiology. F1000Res. 2018;7:307. 

3. Brufau BP, Cerqueda CS, Villalba LB, Izquierdo RS, González BM, Molina CN. Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics. 2013;33(6):1691-1716. 

4. Jonasch E, Walker CL, Rathmell WK. Clear cell renal cell carcinoma ontogeny and mechanisms of lethality. Nat Rev Nephrol. 2021;17(4):245-261. 

5. American Cancer Society. Signs and Symptoms. Revised February 1, 2020. Accessed November 9, 2021. ​​​​​​​​​​​​​https://www.cancer.org/cancer/kidney-cancer/detection-diagnosis-staging/signs-and-symptoms