Kidney cancer can affect more than just the kidneys. One possible effect is swelling, called edema, in the legs, ankles, or other areas.

Swelling can happen at any time — before diagnosis, during treatment, or after treatment ends. This symptom can have many causes, including the cancer itself, treatments, or other factors. Here’s what to know about swelling and how to manage it.

What Is Edema?

Doctors may use the term “edema” to describe swelling that occurs when your body holds on to excess fluid. Fluid buildup can occur anywhere, but it most often affects the extremities (hands, arms, feet, legs, and ankles). Because of gravity, edema is most common in the lower legs.

Edema can cause more than swelling. Symptoms of edema also include shiny skin and pain in the affected area.

Possible Causes of Swelling

Several factors can cause swelling in people living with kidney cancer. Some are related to the cancer itself or to its treatments, while others have different causes. It’s important to talk with your healthcare provider about any swelling you notice.

Edema Due to Kidney Cancer

One job of the kidneys is to remove extra salt and fluid from the body. Tumors can affect this process, making it harder for fluid to drain. When this happens, fluid can build up and cause swelling, which may be an early sign of kidney cancer in some people.

A kidney tumor that blocks lymphatic vessels or blood vessels can also cause swelling, including in the abdomen. In children, sudden swelling in the abdomen may be a sign of Wilms tumor, the most common kidney cancer in children.

Swelling Caused by Kidney Cancer Treatments

Edema is a known side effect of everolimus (Afinitor), a drug used to treat advanced renal cell carcinoma. People taking this medication may develop peripheral edema — swelling in the arms or legs.

Less often, everolimus can cause lymphedema. This happens when lymph fluid builds up and doesn’t drain properly. It usually affects the arms or legs but can also affect the abdomen, especially in people who recently had surgery or radiation therapy in that area.

Other kidney cancer medications that may cause swelling include:

• Cabozantinib (Cabometyx)
• Lenvatinib (Lenvima)
• Pazopanib (Votrient)

Other treatments, such as chemotherapy and immunotherapy, may also cause edema. Call your nephrologist or healthcare team right away if you notice swelling after starting a new treatment.

Side Effects of Surgery

Some people have swelling after kidney cancer surgery. Check your surgical site closely as you recover.

Swelling around the area may be a sign of infection. Contact your doctor right away if you experience:

• Swelling or discoloration near the incision
• Fever
• Chills
• Cough
• Urine that looks cloudy or has a strong odor

In rare cases, swelling may be a sign of a type of blood clot called deep vein thrombosis (DVT). Symptoms include leg swelling along with warmth, pain, or tenderness. DVT can happen if you don’t move much after surgery.

DVT can be serious and even life-threatening. Contact your doctor right away if you think you may have DVT.

Swelling From Other Kidney Diseases

Some people with kidney cancer also have other kidney conditions, either from the disease itself or its treatments. These conditions can also cause edema.

For example, kidney cancer may lead to kidney failure. When this happens, the kidneys stop working properly. Kidney failure can lead to severe edema, especially in the ankles, hands, and face.

Kidney cancer may also lead to chronic kidney disease (CKD) in some people. Edema is common in people with CKD.

Other Possible Causes

Not all swelling is directly related to kidney cancer. Other causes of edema include health issues or lifestyle factors such as:

• Sunburn
• Emphysema or chronic bronchitis
• Long periods of sitting or standing
• Problems with the lymph nodes
• Congestive heart failure
• Pregnancy
• A diet high in salty foods
• Cirrhosis (a liver disease)
• Inflammation from illness or injury
• Low protein levels
• Protein loss in the urine

Managing Edema With Kidney Cancer

Edema can be uncomfortable and frustrating. Your clothes or jewelry may feel tight, or you might have trouble with daily tasks that require fine movement. Treatment depends on the cause of the swelling.

For example, if a kidney cancer treatment is causing edema, your oncologist may suggest changing the medication or adjusting the dose. They may also recommend other treatments or lifestyle changes to help reduce fluid retention.

Medication and Therapy

Medications or therapies that may help reduce edema include:

• Diuretics — These water pills help your body get rid of extra fluid through urine.
• Anti-inflammatory drugs — These may help in some cases if swelling is caused by inflammation, but they may not be safe for everyone with kidney problems.
• Manual lymphatic drainage — This type of massage may help if swelling is due to lymphedema.

Always talk with your care team before starting any treatment, including home remedies.

Lifestyle Changes for Edema

Certain lifestyle changes may help reduce swelling and fluid retention. You might consider:

• Quitting smoking
• Cutting back on alcohol
• Holding ice or cold packs on the affected area
• Following a low-salt diet

Talk with your doctor if you need a referral to a dietitian, a smoking cessation counselor, or other specialists who can help you make these changes.

Speak With Your Oncology Team

Always reach out to your kidney cancer care team about any symptoms or side effects that affect your quality of life. Don’t make changes to your medications, supplements, diet, or exercise plan before consulting your doctor. They can help you choose safe and effective ways to feel better while protecting your kidney health.

Contact your doctor right away if your swelling is severe or happens with trouble breathing or chest pain. It’s also important to report sudden weight gain, changes in urination, or swelling that gets worse.

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On MyKidneyCancerTeam, people share their experience with kidney cancer, get advice, and find support from others who understand.

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