Kidney Cancer in Young Adults: Rising Risks and the Truth About Symptoms

March is Kidney Cancer Awareness Month, a time dedicated to education, early detection and supporting those affected by this disease. This year, the conversation carries a heavy weight following the recent passing of Brad Arnold, the 47-year-old lead singer of 3 Doors Down, who shared his stage 4 clear cell renal cell carcinoma (ccRCC) in May 2025. His story highlights that kidney cancer is not just a disease of the elderly, but one that increasingly impacts younger adults.

To help navigate these concerns, Dr. Eric Singer sat down for an interview with CURE to delve deeper into what the rising incidence of cancers in younger adults means.

He is a urologic surgeon, medical oncologist, and professor of urology and bioethics at The Ohio State University. At the OSUCCC – James, Singer serves as chief of the Division of Urologic Oncology, director of the Urologic Oncology Fellowship, and co-director of the Genitourinary Disease-Specific Research Group.

You can hear more from him in our recent video here!

CURE: In light of the recent passing of singer Brad Arnold, many are surprised to learn that kidney cancer can affect younger populations. What should patients under 50 know about their risk?

Singer: Not only with kidney cancer, but with many malignancies, we're thinking and learning more about what we call adolescent and young adult (AYA) or early-onset cancer. This essentially refers to patients being diagnosed decades earlier than we would often expect. This is an area of ongoing research, including work here at the James. We have a new initiative called the Bridge Program where we're looking to bring all of our resources to better understand early-onset AYA cancers.

Where I come in, focusing on kidney cancer, there are several things we consider. When we see patients diagnosed at a young age, some of that is due to hereditary syndromes, people who have a genetic alteration passed down from parent to child. A very well-known example is VHL, or von Hippel-Lindau syndrome. People with that condition often develop bilateral and multifocal tumors (tumors in both kidneys in multiple locations) at an earlier age than we would see in what we call sporadic kidney cancer.

There is also familial kidney cancer, where we see multiple people in a family having cancer that doesn't have a specific hereditary or genetic cause; we worry about those patients being at risk at a younger age as well. In terms of things to watch out for, a lot of kidney health has to do with basic health: avoiding obesity, avoiding smoking, and managing diabetes. If you have any of those conditions, try to control them. If you notice anything like blood in the urine, seek medical attention and see a urologist to evaluate it.

Most kidney tumors today are still found incidentally; someone gets an imaging study for another reason like food poisoning, falling off a ladder, or a car accident, and we see a small kidney mass. Then we have to figure out if that mass is kidney cancer or not.

Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer. Can you explain in patient-friendly terms what it is and how it differs from other kidney cancers?

If you think of kidney cancer like ice cream, it comes in different flavors. ccRCC is the "vanilla." About 75% of the time, it's going to be clear cell. We do have other histologies, like papillary or chromophobe, and we are even able to classify these tumors by their molecular signatures.

You'll sometimes see labels like FH-deficient, HLRCC-associated, or BAP1. These are abbreviations we use as our understanding grows regarding what makes these tumor histologies different. More importantly, this helps us determine how to target them with therapy and how to best combine surgery, systemic therapies, and radiation based on each patient's disease and histology.

Having a better understanding of the tumor helps us understand the best way to treat and follow patients.

Early kidney cancer often has few symptoms. What warning signs should younger adults pay attention to, and when should they speak with a doctor?

Kidney cancer is challenging because we don't have screening for it. For men and prostate cancer, there's a PSA test; for women, there are mammograms; for everyone, there are colonoscopies. We don't have a standard screening for kidney cancer yet, though many people are working on it.

The "classic triad" of symptoms we used to see was flank pain, a large abdominal mass, and blood in the urine. Fortunately, that's less common now because our imaging is better and people get scans for many reasons. Again, we often find kidney tumors when they're small and found incidentally. However, if you're having a lot of flank pain, blood in your urine, or unintentional weight loss, you should see your primary care doctor.

Certainly, if you have blood in the urine, a urologist should be involved. Fortunately, many people who have blood in the urine do not have kidney cancer; it may be a benign cause, but it is certainly something we check for.

What lifestyle, environmental, or genetic factors may be contributing to the rise in kidney cancer rates for younger populations?

We are continuing to see an increase in the incidence of kidney cancer in younger patients over time. Maintaining kidney health involves basic lifestyle choices: avoiding obesity, not smoking, and being mindful of environmental risk factors like certain chemicals. Knowing your family history is also vital.

Many of us haven't really asked our parents or grandparents about their medical history, but that information can be incredibly helpful in understanding familial risk.

What treatment advances in kidney cancer are helping people live longer and maintain that quality of life?

I remember in December 2005 and January 2006 when the first targeted therapies, Nexavar (sorafenib) and Sutent (sunitinib), were approved for advanced kidney cancer. That really ushered us from the era of cytokine therapy, where we would use high-dose interleukin-2 or interferon, into the TKI era. We have since moved through those therapies and are now in the immunotherapy era, where we are combining drugs for patients who have advanced kidney cancer.

We are either using two immunotherapy drugs or one immunotherapy drug and one targeted therapy, and those have been a huge advance. I think one of the things we are really excited about right now is how we can combine therapies to treat both distant disease (cancer outside the kidney that may have spread to other places) and the primary tumor in the kidney itself.

We just completed a study called CYTOKICK, where we used immunotherapy plus targeted therapy for three months followed by cytoreductive surgery. We then removed the primary tumor in patients who had cancer that had spread elsewhere and treated them with more medicine after surgery, utilizing a perioperative approach instead of just giving medicine either before or after surgery.

As we increase our understanding of how kidney cancer and its different types work, we are able to combine treatments in new orders and combinations. There is a lot of exciting data on new drugs like HIF inhibitors…

We want to ensure we are providing good cancer care. We want to maximize quality of life and be aggressive in our management of side effects from both the treatments we provide and the disease itself. Finally, we want to ensure we are referring patients to high-volume centers with high-volume providers, as that has been shown to provide the best benefit and outcomes.

What message would you share about awareness and hope for patients who are feeling anxious?

The kidney cancer community is an amazing group. I'm privileged to be involved with organizations like the Kidney Cancer Association and the International Kidney Cancer Coalition. These groups partner with physicians to move the field forward.

Talk to your primary care doctor, get a referral to a kidney cancer expert if you have concerns, and seek a genetic evaluation if there’s a family history. Finally, ask about clinical trials. That is how we advance the field.

We try to have a clinical trial available for every patient at every stage; it isn't just for someone with advanced disease. It may be right for you at your initial diagnosis or even for prevention. Look for a National Cancer Institute-designated Comprehensive Cancer Center to ensure you are getting the best care.

References

1. “How New Treatments Are Changing the Future of Kidney Cancer,” by Dr. Eric A. Singer. CURE Today; March 5, 2026. https://www.curetoday.com/view/how-new-treatments-are-changing-the-future-of-kidney-cancer

Transcript has been edited for clarity and conciseness.

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