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UCLA Health - Will this Tumor Grow if Left Alone | UCLA Health | Brian Shuch, MD

Thumbnail of the video “UCLA Health - Will this Tumor Grow if Left Alone | UCLA Health | Brian Shuch, MD”
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Author: UCLA Health
Categories: Health
Tags: health
Views: 2 · Last viewed: 2026-10-16 15:02 UTC

Short Summary

Main recommendation: For a small incidentally found kidney tumor, the video suggests that active surveillance (monitoring with serial imaging) is often reasonable, because most tumors grow slowly, and that gathering more information such as biopsy or advanced imaging can help predict the tumor's growth rate and guide the choice between surveillance, ablation, or surgery. Dr. Brian Shuch, director of the UCLA kidney cancer program, frames this as a common question patients ask about whether a tumor will grow if left alone.

Key Points

  • Most small kidney tumors are found incidentally on CT scans done for other reasons, and most behave like a "tortoise," growing slowly rather than rapidly.
  • Dr. Shuch describes growth patterns as "guppies" or "goldfish" (no growth or growth less than 4 mm per year, about 70 percent of tumors) versus "sharks" (growth over 5 mm per year, which he says are more likely to cause harm over time).
  • Subtype matters: about 20 percent of small tumors are probably benign, about 70 percent are lower-risk or indolent, and the rest are more aggressive.
  • Initial size is a predictor: - Dr. Shuch notes initial size is a predictor: a larger tumor carries a higher chance of being malignant and aggressive, and he gives the example that a one-centimeter tumor in a woman might have roughly a 50 percent chance of being benign.
  • Tumor grade (how abnormal cells look under the microscope, graded 1 to 4) and location (peripheral or polar tumors tend to be lower grade; central or hilar tumors tend to be more aggressive) also influence likely behavior.
  • Dr. Shuch explains that the kidney is well protected by surrounding fat and muscle, so he says most tumors will not cause symptoms even if they grow.

Details Worth Noting

  • Concrete instructions: The video gives no step-by-step patient protocol. The practical guidance is that a tumor found on initial imaging is typically re-scanned at about six months to assess growth; a biopsy or advanced imaging (including a PET-CT with the tracer zirconium, and non-invasive histology imaging) can be used to gather more information before choosing management; and the management options discussed are surveillance, needle ablation, or partial or radical nephrectomy (surgery).
  • Biopsy can reveal subtype and grade from a piece of tissue, and a biopsy of most small tumors is said to give a good sample of how aggressive the tumor looks.
  • Patients who feel uncomfortable watching a tumor may benefit from additional information, since that information may predict the future rate of growth.
  • The speaker notes that the WHO has described about 20 to 22 kidney cancer types, compared with only four or five previously.
  • Dr. Shuch notes that a patient's concern that treating only later means being less healthy is a common reason patients ask whether to act now, and that growth is slow for most tumors.

Bottom Line

Most small kidney tumors grow slowly and cause few problems, so careful monitoring, supported by biopsy or advanced imaging when more information is needed, is often a reasonable path, with the decision guided by size, subtype, grade, and location.