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UCLA Health - Will I develop Symptoms if a Small Renal Mass is Untreated? | UCLA Health | Brian Shuch, MD

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Author: UCLA Health
Categories: Health
Tags: health
Views: 2 · Last viewed: 2026-10-16 15:01 UTC

Short Summary

Main recommendation: For most small renal masses, active surveillance (monitoring with frequent imaging rather than immediate treatment) is a reasonable approach, because most small tumors grow slowly and rarely cause symptoms. If a tumor shows concerning growth on monitoring, delayed intervention with surgery or ablation can be offered, with a reported 99 percent chance of cure with delayed intervention, which Dr. Shuch says is similar to treating it up front.

Key Points

  • Not every kidney mass is cancer in the same way: some are benign and can grow but not spread, while others are malignant and can invade organs and spread to other sites.
  • Most small tumors do not cause symptoms; the kidney is well protected by surrounding fat and muscle, so a deep tumor is unlikely to cause pain.
  • Growth is usually slow: about 20 percent show no growth in a short period, about 70 percent grow only 0 to 4 millimeters, and faster growers may grow about 5 millimeters a year.
  • Growth rate depends on factors such as the type of kidney cancer, tumor grade (higher grade suggests more aggressive behavior), and location (more central tumors with greater blood supply may grow faster).
  • Symptoms in untreated tumors usually arise only when a tumor becomes large enough to cause local damage, invade the collecting system (causing blood in the urine, or hematuria), or spread to distant sites such as the lungs.

Details Worth Noting

  • Concrete instructions: Monitor the tumor with frequent imaging under active surveillance. If imaging shows the tumor slightly enlarging and the physician becomes worried, the recommended next step is delayed intervention, either surgery or ablation, to remove or treat the tumor before it becomes symptomatic.
  • The speaker notes that patients often attribute back pain to the tumor, but removing a deep, well-protected tumor is unlikely to relieve pain, so the pain is usually unrelated.
  • The speaker frames symptom risk as a long-term concern: a small tumor left untreated over many years could eventually grow large enough to cause local damage or spread, which is why monitoring is needed rather than ignoring it.
  • Benign versus malignant status is not known without a biopsy, which is why surveillance must be closely matched to what is expected.
  • The speaker presents these points as general information from a UCLA kidney cancer specialist, not personalized medical advice.

Bottom Line

Small kidney tumors usually grow slowly and rarely cause symptoms, so close monitoring with timely intervention if growth becomes concerning is the typical approach discussed.