Dawaa Reference

chronic

Kidney cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class UD25 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Renal Cancer - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK558975/

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

  • It stays silent until late, and more than half of these tumours are found by accident on a scan
  • Only 10 to 15% show the classic triad of flank pain, blood in the urine and fullness in the flank [abdominal pain · blood in the urine · loin pain]
  • Historically more than 60% presented with blood in the urine and nothing else [blood in the urine]
  • Other features are tiredness, weight loss, fever, night sweats, feeling unwell, high blood pressure and anaemia [anaemia · fatigue · fever · hypertension · malaise · night sweats · weight loss]
  • A high calcium means either spread to bone or a paraneoplastic effect
  • Red flag: severe sharp band-like back pain can mean a collapsed vertebra with cord compression from secondary deposits [back pain · collapse]

Signs — what you find (4)

  • A varicocele can appear when tumour grows into the renal vein and vena cava and blocks the testicular vein
  • Deposits in bone eat it away, causing fractures through weakened bone, cord compression and a high calcium
  • Called the great mimic for its paraneoplastic syndromes: high calcium from PTHrP, too many red cells from erythropoietin, Cushing syndrome from ACTH
  • A third already have spread when first seen, so examine for deposits in lung (75%), bone (20%), liver (18%) and brain (8%)

Tests (12)

  • Start with urinalysis and urine cytology, particularly where a urothelial tumour is possible
  • Full blood count and ESR to judge anaemia and platelets
  • Kidney function and electrolytes decide whether contrast can be given for imaging
  • Liver tests separate real liver deposits from Stauffer syndrome, the non-metastatic liver upset; calcium is checked too
  • Ultrasound of the kidney is usually the first study, sometimes with a CT excretory urogram
  • A staging CT of abdomen and pelvis confirms it
  • Chest film or CT looks for lung deposits
  • MRI assesses growth into veins and the spread of disease, and serves where contrast cannot be given
  • Bone scan with alkaline phosphatase for bone deposits and follow-up; CT of the head if brain spread is suspected
  • Suspected cord compression needs an urgent MRI
  • Genetic testing when an inherited syndrome is likely, because of young age or a family history
  • Needle biopsy guided by ultrasound or CT is possible for a suspicious solid or cystic lesion, and no blood or urine marker is yet validated, so imaging carries the diagnosis

If not this — what else fits (12)

  • Any renal mass found on a scan should raise this possibility, since half are found by chance and the disease is usually silent
  • Renal abscess
  • Benign tumours: angiomyolipoma, oncocytoma and renal adenoma
  • Lymphoma of the kidney
  • A simple renal cyst
  • Infarction of the kidney
  • Renal sarcoma
  • A deposit from a cancer elsewhere, such as melanoma
  • Acute or chronic pyelonephritis
  • Bladder cancer
  • Non-Hodgkin lymphoma
  • Adult-type Wilms tumour

SourceStatPearls "Renal Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Renal cell carcinoma requires surgical and oncologic management; the GP's role is recognising suspicious features (blood in urine, flank mass, weight loss) and referring urgently. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Renal cell carcinoma requires surgical and oncologic management; the GP's role is recognising suspicious features (blood in urine, flank mass, weight loss) and referring urgently.

Cautions
  • RED FLAG - Paraneoplastic hypercalcaemia (confusion, severe thirst, polyuria) or polycythaemia: assess urgently and refer.
  • Painless visible blood in the urine, a palpable flank mass, or unexplained weight loss are urgent referral triggers for suspected kidney malignancy.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.