This year it is estimated that 30,000 Americans will be diagnosed with kidney cancer and 12,500 will die of the disease. Both the incidence rate and the mortality rate are increasing; because of the rapid rise, kidney cancer is on the National Cancer Institute’s (NCI’s) watch list. The increases cannot be explained by better detection methods. In fact, despite earlier diagnosis, mortality rates aren’t improving. Fortunately, if we are able to see patients with localized disease, we can often give them a very good 10-year survival. We’ve had less of an impact on patients with locally advanced disease, and despite some treatment innovations and advancements, most patients with metastatic kidney cancer still die of their cancer. There are 4 basic types of renal tumors: clear cell, which comprises 75% to 80% of all kidney cancers; papillary, which comprises 10% to 15%; chromophobe, which comprises 5%; and oncocytoma, which comprises 5%. There are 2 types of papillary tumors: type 1 and type 2.