Daijiworld Media Network- New Delhi

New Delhi, Jun 20: While fever is typically a sign of infection, a persistent, unexplained fever without any identifiable cause could be an early, often overlooked warning sign of kidney cancer, particularly renal cell carcinoma (RCC), experts have cautioned.

According to Dr Iti Parikh, Consultant Medical Oncologist at Bhailal Amin General Hospital, Gujarat, RCC is frequently asymptomatic in its early stages, with most cases detected incidentally through imaging conducted for unrelated reasons. The classic triad of symptoms — flank pain, blood in urine (haematuria), and abdominal mass — occurs in only 9–10% of patients, often indicating advanced disease.

Fever is reported in about 20% of RCC cases, typically intermittent and often accompanied by systemic symptoms like night sweats, fatigue, and weight loss. Dr Parikh points out that when no clear infection is found, fever may reflect extensive or systemic spread of kidney cancer. "Such presentations require clinicians to dig deeper into differential diagnoses, including malignancy," she said.

The most prevalent type of kidney cancer, clear cell RCC, accounts for around 80–85% of cases. While an abdominal ultrasound might reveal abnormal growths, CT scans are more reliable in differentiating between benign cysts and malignant tumours. In selected cases, PET-CT scans are used to assess the extent of disease.

If detected early, the mainstay of treatment is surgery, either through partial nephrectomy (removal of the tumour) or total nephrectomy (removal of the kidney). Post-surgical analysis determines the stage of cancer and the need for additional therapy.

In cases where the cancer is already advanced or metastatic, treatment involves systemic therapy, primarily immunotherapy and oral tyrosine kinase inhibitors. RCC is notably resistant to standard chemotherapy, but immunotherapy has brought remarkable success, establishing itself as a cornerstone of modern RCC management.

Dr Parikh also highlighted several risk factors associated with RCC, including smoking, obesity, hypertension, and chronic kidney disease. Occupational exposure to cadmium, asbestos, petroleum products, and excessive use of NSAIDs also raise concern. Processed food consumption and genetic predisposition may play a role as well.

RCC is more common in men, with most cases diagnosed between the ages of 60 and 80, and the average age of diagnosis around 64. Nearly 65% of patients are diagnosed with cancer confined to the kidney, while 17–20% have lymph node involvement, and 16% present with distant metastases.

Thanks to advancements in early detection and immunotherapy, the five-year survival rate for kidney cancer is now approaching 75%, offering a beacon of hope for patients when diagnosed in time.

As monsoon-related fevers rise and many assume infection, experts urge that persistent, unexplained fever should not be ignored, as it may unmask underlying serious conditions like kidney cancer.