What Is Clear Cell Renal Cell Carcinoma? Symptoms, Causes, Diagnosis and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is clear cell renal cell carcinoma?
Clear cell renal cell carcinoma (ccRCC) is the most common form of kidney cancer, starting in the cells lining the kidney's small filtering tubes [5]. It mostly affects men between ages 50 and 70 and rarely causes early symptoms, so it is often found incidentally [5]. Confined tumors are treated with surgery or ablation, and spread disease with immunotherapy and targeted therapy [5].
Key takeaways
ccRCC is the most common kidney cancer. Of the roughly 80,000 U.S. kidney cancer diagnoses each year, ccRCC is the leading type [5] [6].
The cancer cells look like clear bubbles. The name comes from how the cells appear under a microscope [5].
Early stages usually have no symptoms. Later signs include blood in the urine, flank pain, fatigue, fever, a lump, and weight loss [5].
Risk factors are largely lifestyle-related. They include smoking/vaping, high BMI, high blood pressure, dialysis-dependent kidney disease, certain toxins, and long-term pain relievers [1] [5].
Treatment depends on whether it has spread. Surgery and ablation are used for localized cancer; immunotherapy and targeted therapy if it has spread [5].
Survival varies greatly with tumor size and spread. The quoted overall five-year survival is 50–69%, and around 10% for large or spread tumors [5].
What the research says
Several modifiable factors are linked to kidney cancer risk. A systematic review of 125 manuscripts on renal cell cancer found that smoking was harmful in 13 of 14 studies, obesity in 36 of 36, hypertension in 17 of 18, and diabetes in 23 of 27, while total physical activity was beneficial in 10 of 12 studies. The review covered renal cell cancer overall rather than ccRCC specifically (Al-Bayati et al., Urol Oncol, 2019 [1]).
Partial nephrectomy preserved kidney function better than radical nephrectomy in a randomized trial. In EORTC trial 30904 (541 patients with a renal mass of 5 cm or less and a normal opposite kidney), 64.7% of patients who had nephron-sparing surgery and 85.7% of those who had radical nephrectomy developed an eGFR below 60 over a median 6.7 years, while kidney failure (eGFR below 15) was about equally uncommon (1.6% vs 1.5%). Overall survival was lower with nephron-sparing surgery over a median 9.3 years (hazard ratio 1.50; 95% CI 1.03 to 2.16), so the kidney-function benefit did not translate into longer survival in this study population (Scosyrev et al., Eur Urol, 2014 [2]).
After surgery, adjuvant pembrolizumab reduced recurrence in high-risk clear cell kidney cancer. In the KEYNOTE-564 trial, 994 patients with clear-cell renal-cell carcinoma at high risk of recurrence after nephrectomy received pembrolizumab or placebo. Disease-free survival at 24 months was 77.3% with pembrolizumab versus 68.1% with placebo (hazard ratio for recurrence or death 0.68; 95% CI 0.53 to 0.87), and grade 3 or higher adverse events occurred in 32.4% versus 17.7% (Choueiri et al., N Engl J Med, 2021 [3]).
What Is Clear Cell Renal Cell Carcinoma?
Clear cell renal cell carcinoma (ccRCC) is a subtype of renal cell carcinoma (RCC), which is a type of kidney cancer. It starts in the cells that line the small tubes in your kidneys that filter waste from your blood [5]. Clear cell renal cell carcinoma cells rapidly multiply, forming one or more tumors. It usually only affects one kidney, but can affect both [5].
The name comes from what the cancer cells look like under a microscope: clear cell renal cell carcinoma cells look like clear bubbles [5]. This appearance is the key difference between ccRCC and other kidney cancer subtypes.
Name breakdown | Meaning |
Clear cell | The cancer cells look like clear bubbles under a microscope. |
Renal | Relating to the kidneys. |
Cell | Originating in the cells lining the kidney's small filtering tubes. |
Carcinoma | A cancer that starts in the cells lining organs. |
Who Gets Clear Cell Renal Cell Carcinoma?
Anyone can get clear cell renal cell carcinoma, but it affects twice as many men as women [5]. It also most commonly appears in people between 50 and 70 years old [5].
According to the American Cancer Society, an estimated 80,450 people in the U.S. will receive a kidney cancer diagnosis in 2026 (a figure that covers all kidney and renal pelvis cancers) [6], and of these, ccRCC is the most common type [5].
Clear Cell RCC vs. Papillary Renal Cell Carcinoma
Clear cell and papillary renal cell carcinomas are types of kidney cancer that cause similar symptoms, and treatments are also similar [5]. The main difference is how the kidney cancer cells look under a microscope:
Clear Cell Renal Cell Carcinoma Symptoms
Clear cell renal cell carcinoma usually doesn't cause any noticeable symptoms during the early stages [5]. But as the condition progresses, you may experience:
Symptom | What you may notice |
Blood in your pee (hematuria) | Urine may look pink, red, or cola-colored. |
Extreme fatigue | Feeling very tired, even if you get a lot of sleep. |
Fever | Ongoing or unexplained fever. |
Lump on your affected kidney | A palpable lump in the area of the affected kidney. |
Flank pain | Pain on the side of your affected kidney. |
Unexplained weight loss | Losing weight without trying. |
What Causes Clear Cell Renal Cell Carcinoma?
Most kidney cancers, including ccRCC, develop for no known reason [5]. But certain factors may increase your risk:
Is Clear Cell Renal Cell Carcinoma Inherited?
You're at a greater risk of kidney cancer if you have a biological (blood-related) sibling with renal cell carcinoma [5]. Medical professionals aren't sure why.
Some people have genetic conditions that make them more likely to have clear cell renal cell carcinoma, such as Von Hippel-Lindau (VHL) disease. With these conditions, an inherited gene variation causes cysts and tumors to form in different areas of your body. The cysts and tumors usually aren't cancerous, but ccRCC can occur more often in these biological families, and it often develops at an earlier age than average [5].
If you receive a ccRCC diagnosis at a young age or have multiple tumors, your healthcare provider may recommend genetic testing [5].
How Is Clear Cell Renal Cell Carcinoma Diagnosed?
Kidney cancer doesn't usually cause symptoms, so healthcare providers discover most kidney tumors while looking for a cause of other conditions. For example, they may see a kidney tumor on imaging tests like an MRI or CT scan done to check for conditions like kidney stones [5].
Imaging tests can detect a tumor, but it can be difficult to determine whether the mass is noncancerous (benign) or cancerous (malignant) based on imaging alone. To make an accurate diagnosis, a provider may recommend a kidney biopsy or surgery to remove the tumor [5].
If a provider surgically removes the tumor, they'll examine the tumor tissue for cancer. The results can confirm a cancer diagnosis and determine whether it's the clear cell subtype. It's worth noting that as many as 4 in 10 small kidney tumors (less than 4 centimeters) are noncancerous tumors [5], like renal oncocytomas.
After diagnosing ccRCC, a provider will use cancer staging to determine the size of the tumor and whether it has spread to other areas of your body.
Diagnostic step | What it does |
Imaging (MRI or CT scan) | Detects kidney tumors, often incidentally while checking for other conditions like kidney stones. |
Kidney biopsy | Helps confirm whether a detected mass is benign or malignant. |
Surgery and tissue exam | Confirms a cancer diagnosis and whether it's the clear cell subtype. |
Cancer staging | Determines tumor size and spread; there are four stages, and the lower the stage, the less aggressive the cancer [5]. |
Clear Cell Renal Cell Carcinoma Treatment Options
Most treatment options depend on whether the cancer spreads outside of your kidney [5].
If the Cancer Hasn't Spread Outside Your Kidney
Treatment | What it involves |
Surgery (nephrectomy) | A surgeon removes the cancerous part of your kidney (partial nephrectomy) or your entire kidney (radical nephrectomy) [5]. |
Ablative therapies | A percutaneous (needle through the skin) approach to kill cancer cells, using either cryoablation (cold temperatures) or thermal ablation (hot temperatures) to destroy cancer cells [5]. |
If the Cancer Has Spread or Is at High Risk for Spreading
Outlook and Prognosis
Is Clear Cell Renal Cell Carcinoma Aggressive?
Like all carcinomas, clear cell renal cell carcinoma can spread (metastasize) to other parts of your body, and metastatic cancer is more difficult to treat. Compared to other kidney cancers, ccRCC tends to be more aggressive and spreads faster [5].
Renal cell carcinoma most commonly spreads to the lymph nodes, lungs, adrenal glands, liver, brain, and bones [5].
How Fast Does It Grow?
Clear cell renal cell cancer growth rates vary a lot. One study of 46 patients treated for renal carcinoma (about two-thirds of them clear cell) found growth rates ranging from 0.2 to 6.5 centimeters (0.07 to 2.5 inches) per year [4] [5], with an average growth rate of 2.13 centimeters per year (0.83 inches) [4] [5]. The same study found that tumors tended to grow faster in younger patients [4].
What Is the Survival Rate?
The overall five-year ccRCC survival rate is quoted as 50% to 69% [5].
But survival rates depend on the size of your tumor. In general, treatment is less effective on large tumors or if ccRCC spreads to other areas of your body. In those cases, the five-year survival rate if you have a large tumor or if ccRCC has spread is quoted as around 10% [5].
Scenario | Five-year survival rate |
Overall (all stages combined) | 50% to 69% |
Large tumor or cancer that has spread | Around 10% |
Survival statistics vary by source, stage, and treatment era. The American Cancer Society publishes stage-specific survival rates for kidney cancer on its Survival Rates for Kidney Cancer page, and your care team can explain which numbers apply to your situation.
Living With Clear Cell Renal Cell Carcinoma
Learning you have clear cell renal cell carcinoma can inspire a lot of different feelings — fear, anger, depression, anxiety and others. Many people find it helpful to learn as much as they can about ccRCC and ask their loved ones for support. It's also a good idea to connect with ccRCC support groups who understand exactly what you're experiencing. It's important to lean on your care team and ask them any questions that come to mind, including about your treatment options and recovery.
Other ways you can help take care of yourself include:
Self-care step | Why it helps |
Take all medications exactly as prescribed | Keeps treatment on track. |
Eat foods higher in protein and calories | Helps prevent weight loss [5]. |
Sleep as much as you can | Supports recovery and energy. |
Manage stress | Deep breathing, meditation, yoga, art therapy, or relaxing activities like puzzles. |
Stay as active as your energy allows | Physical activity as energy levels permit. |
When Should You See a Healthcare Provider?
Call a healthcare provider if you experience blood in your pee, a lump or pain in your side that doesn't go away, or unexplained fever or weight loss [5]. If you're receiving treatment for ccRCC, call a provider if you experience new or worsening symptoms — they can help you manage the symptoms, change your dosage, or even recommend a new type of treatment. Maintaining your well-being as much as possible is an important part of your treatment.
Questions to Ask Your Provider
What's the best treatment for me?
What are the side effects of your recommended treatment?
Am I at risk of metastatic cancer?
How can I lower my risk of ccRCC spreading?
Are any of my biological family members at risk for ccRCC?
Should I look out for any specific signs of complications?
Conclusion
Clear cell renal cell carcinoma is the most common kidney cancer, named for the clear bubble-like cells that make up the tumor. What makes it challenging is how quietly it begins — early stages rarely produce symptoms, which is why many cases are found by accident on scans done for unrelated reasons. By the time warning signs appear, such as blood in the urine, flank pain, or unexplained weight loss, the cancer may already be more advanced. Known risk factors like smoking, obesity, high blood pressure, dialysis-dependent kidney disease, and certain workplace toxins give most people real ways to lower their chances, while family history and genetic conditions like VHL call for earlier conversation with a provider. Treatment today spans surgery and ablative therapies for localized disease to immunotherapy and targeted drugs when it spreads. With ongoing advances in treatment, there is real ground for hope, especially with early detection.
If you want to turn kidney cancer education into clear, shareable visuals, Rinnit's infographic templates help you make that guidance easy for anyone to understand.
Frequently Asked Questions
What is clear cell renal cell carcinoma?
A subtype of renal cell carcinoma — a type of kidney cancer — and the most common type of kidney cancer.
What does "clear cell" mean?
The cancer cells look like clear bubbles under a microscope.
Is clear cell renal cell carcinoma a type of kidney cancer?
Yes. It's a subtype of renal cell carcinoma, which is a type of kidney cancer.
Where does ccRCC start?
In the cells that line the small tubes in the kidneys that filter waste from your blood.
Does ccRCC affect one kidney or both?
Usually only one kidney, but it can affect both.
Is clear cell renal cell carcinoma the most common kidney cancer?
Yes. Of the roughly 80,000 U.S. kidney cancer diagnoses each year, ccRCC is the most common type.
What does a ccRCC tumor look like?
The cancer cells rapidly multiply, forming one or more tumors made of cells that look like clear bubbles under a microscope.
Does ccRCC cause symptoms early on?
Usually not — it typically doesn't cause any noticeable symptoms during the early stages.
What are the symptoms of clear cell renal cell carcinoma?
Blood in the urine (hematuria), extreme fatigue, fever, a lump on the affected kidney, flank pain, and unexplained weight loss.
Is blood in urine a sign of kidney cancer?
Yes — blood in your pee (hematuria) is one of the symptoms of ccRCC as it progresses.
What is hematuria?
Blood in your pee; one of the possible symptoms of kidney cancer.
Can kidney cancer cause flank pain?
Yes — pain on the side of your affected kidney is a symptom of ccRCC.
Can kidney cancer cause fever?
Yes, fever can occur as the condition progresses.
Can kidney cancer cause a lump?
Yes — you may feel a lump on your affected kidney.
What causes clear cell renal cell carcinoma?
Most kidney cancers, including ccRCC, develop for no known reason.
Does smoking increase kidney cancer risk?
Yes — using tobacco products, including smoking and vaping, increases your risk.
Does obesity increase kidney cancer risk?
Yes — having a BMI greater than 25 (overweight/obesity) is a risk factor.
Does high blood pressure increase kidney cancer risk?
Yes — hypertension is a known risk factor for kidney cancer.
Does dialysis increase kidney cancer risk?
Yes — chronic kidney disease that requires dialysis increases your risk.
Can workplace chemicals cause kidney cancer?
Yes — exposure to workplace toxins like the solvent trichloroethylene can increase risk.
Can pain relievers increase kidney cancer risk?
Long-term use of pain relievers (analgesics) like acetaminophen (Tylenol) is a risk factor.
Who is most likely to get ccRCC?
Anyone can get it, but it affects twice as many men as women and most commonly appears in people aged 50 to 70.
Is clear cell renal cell carcinoma hereditary?
You're at greater risk if a biological sibling has renal cell carcinoma, and some genetic conditions like Von Hippel-Lindau (VHL) disease raise risk further.
What is VHL disease?
A genetic condition where an inherited gene variation causes cysts and tumors to form in different areas of the body; it makes ccRCC more likely and often earlier in life.
When is genetic testing recommended for ccRCC?
If you're diagnosed at a young age or have multiple tumors, your provider may recommend genetic testing.
How is ccRCC diagnosed?
Usually incidentally on imaging (MRI or CT scan) done for other reasons, then confirmed with a kidney biopsy or surgery and tissue examination.
Can imaging tell if a kidney tumor is cancer?
Not always — it can be difficult to tell benign from malignant by imaging alone; biopsy or surgery may be needed.
Are all kidney tumors cancerous?
No — as many as 4 in 10 small kidney tumors (under 4 centimeters) are noncancerous, like renal oncocytomas.
How many stages does ccRCC have?
There are four stages; the lower the stage, the less aggressive the cancer.
How is clear cell renal cell carcinoma treated?
Treatment depends on whether the cancer has spread: surgery or ablative therapies if confined to the kidney, and immunotherapy or targeted therapy if it has spread or is at high risk of spreading.
What is a partial nephrectomy?
Surgery where the surgeon removes only the cancerous part of the kidney.
What is a radical nephrectomy?
Surgery where the surgeon removes the entire kidney.
What is ablation for kidney cancer?
Ablative therapies use a needle-through-the-skin approach to kill cancer cells with cold (cryoablation) or heat (thermal ablation).
What is immunotherapy for kidney cancer?
Treatment that engages your immune system to destroy cancer cells — medications include pembrolizumab (Keytruda) and nivolumab (Opdivo).
What is targeted therapy for kidney cancer?
Treatment that stops cancer cells from growing and multiplying — drugs include axitinib (Inlyta) and cabozantinib (Cabometyx).
When is immunotherapy used for ccRCC?
When the cancer has spread or is at high risk for spreading.
Is clear cell renal cell carcinoma aggressive?
Yes — compared to other kidney cancers, ccRCC tends to be more aggressive and spreads faster.
Where does kidney cancer spread?
Most commonly to the lymph nodes, lungs, adrenal glands, liver, brain, and bones.
How fast does ccRCC grow?
Growth rates vary widely — in one study, from 0.2 to 6.5 centimeters per year, with an average of 2.13 centimeters per year.
What is the survival rate for clear cell renal cell carcinoma?
The overall five-year survival rate is quoted as 50% to 69%, though figures vary by source and stage.
What is the survival rate if ccRCC has spread?
Quoted as around 10% if the tumor is large or has spread to other areas of the body.
What is the difference between clear cell and papillary renal cell carcinoma?
How the cells look under a microscope — papillary cells look like long, thin, fingerlike growths, while ccRCC cells look like clear bubbles. About 1 in 10 people with RCC have the papillary type.
What is renal oncocytoma?
A noncancerous kidney tumor — up to 4 in 10 small kidney tumors are benign like this.
How is a kidney tumor found if there are no symptoms?
Often by accident on an MRI or CT scan done to check for other conditions like kidney stones.
Should I get screened for kidney cancer?
Talk to your provider if you have risk factors — ccRCC is often found incidentally, and early detection improves outcomes.
What should I do if I see blood in my urine?
Call a healthcare provider — blood in your pee is a warning sign that should be evaluated.
How do I take care of myself during treatment?
Take medications as prescribed, eat higher-protein and higher-calorie foods, sleep well, manage stress through breathing, meditation, yoga or art therapy, and stay as active as your energy allows.
What emotional reactions are common after a cancer diagnosis?
Fear, anger, depression, anxiety, and others — connecting with support groups and loved ones can help.
What questions should I ask my provider about ccRCC?
About the best treatment for you, side effects, risk of metastasis, how to lower spreading risk, family risk, and signs of complications.
Can ccRCC be prevented?
Most cases develop for no known reason, but managing risk factors — quitting smoking, maintaining a healthy weight, controlling blood pressure, limiting long-term pain reliever use — may help lower risk.
Do ccRCC and papillary RCC have the same symptoms?
Yes, they cause similar symptoms and have similar treatments — the main difference is the cells' appearance under a microscope.
Can you live with one kidney after a radical nephrectomy?
Yes — a radical nephrectomy removes the entire kidney, and people can live with one remaining kidney; your care team will guide you.
Is ccRCC curable?
Treatment is often effective, especially when caught early and confined to the kidney; your care team can explain what to expect in your situation.
What happens if kidney cancer spreads?
Metastatic cancer is more difficult to treat; immunotherapy and targeted therapy are used.
What is the average growth rate of kidney cancer?
About 2.13 centimeters per year on average in one study, though rates ranged from 0.2 to 6.5 centimeters per year.
Related Reading
Vaping: Understanding the Risks, Dangers, and Health Impacts
Obesity: Symptoms, Causes, Complications and Treatment — A Complete Guide
High Blood Pressure: Silent Symptoms, Serious Risks, and Proven Ways to Lower It
Chronic Kidney Disease: What It Is, Its 5 Stages, Causes, and How It's Treated
Von Hippel-Lindau Disease (VHL): Symptoms, Causes, and Management
Understanding Renal Oncocytoma: A Guide to Benign Kidney Tumors
Ablation for Kidney Cancer: A Less Invasive Treatment Option
References
Al-Bayati O, Hasan A, Pruthi D, et al. Systematic review of modifiable risk factors for kidney cancer. Urol Oncol. 2019;37(6):359-371. PMID: 30685335. https://doi.org/10.1016/j.urolonc.2018.12.008
Scosyrev E, Messing EM, Sylvester R, et al. Renal function after nephron-sparing surgery versus radical nephrectomy: results from EORTC randomized trial 30904. Eur Urol. 2014;65(2):372-377. PMID: 23850254. https://doi.org/10.1016/j.eururo.2013.06.044
Choueiri TK, Tomczak P, Park SH, et al. Adjuvant pembrolizumab after nephrectomy in renal-cell carcinoma. N Engl J Med. 2021;385(8):683-694. PMID: 34407342. https://doi.org/10.1056/NEJMoa2106391
Gofrit ON, Yutkin V, Zorn KC, et al. The growth rate of "clinically significant" renal cancer. Springerplus. 2015;4:580. PMID: 26543715. https://doi.org/10.1186/s40064-015-1385-9
Cleveland Clinic. What Is Clear Cell Renal Cell Carcinoma? Medically reviewed; last updated January 7, 2024; accessed October 15, 2026. https://my.clevelandclinic.org/health/diseases/22273-clear-cell-renal-cell-carcinoma
American Cancer Society. Key Statistics About Kidney Cancer. Last revised January 16, 2025; accessed October 15, 2026. https://www.cancer.org/cancer/types/kidney-cancer/about/key-statistics.html
Medical disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about a medical condition or before making decisions about treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.
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