Explore our resources about sickle cell trait and RMC. Expand each topic to read more.
Renal medullary carcinoma (RMC) is a very rare and aggressive cancer that starts in the inner part of a kidney. Aggressive means it can grow and spread quickly. RMC is seen most often in teens and young adults. RMC is strongly linked to sickle cell trait, but having the trait does not mean a person will develop this cancer.
Sickle cell trait is an inherited blood condition. RMC is a very rare and aggressive kidney cancer. They are different conditions, but people with sickle cell trait have a higher risk of RMC. RMC is still extremely rare, and most people with the trait will never develop it. If you do not know your trait status, ask a healthcare provider about hemoglobin electrophoresis, a blood test that checks which types of hemoglobin you have.
Blood in the urine is the most common sign of RMC. Other possible signs include a lump in the abdomen, fever or night sweats, pain near a kidney or in the side or back, fatigue, and unexplained weight loss. These symptoms can have many causes, but they should be checked.
Contact a healthcare provider promptly, especially if you see blood in your urine, even once. Tell them if you have sickle cell trait or do not know your status. Ask what evaluation is appropriate for you.
This information is for education and does not replace medical care. Sources: National Cancer Institute’s RMC guide ↗ and CDC sickle cell trait guide ↗, and MD Anderson’s explanation of the connection ↗.
Sickle cell trait and renal medullary carcinoma (RMC) are different conditions. Sickle cell trait means a person inherited one usual hemoglobin gene and one sickle hemoglobin gene. RMC is a very rare and aggressive kidney cancer. Most reported RMC cases involve sickle cell trait, but RMC can also occur in people with sickle cell disease. Having either condition does not mean someone will develop RMC.
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Sickle cell trait means inheriting one usual hemoglobin gene (A) and one sickle hemoglobin gene (S). Sickle cell disease involves two genes that make abnormal hemoglobin, such as HbSS or HbSC, and can cause serious health problems.
To learn your status, ask a healthcare professional about hemoglobin electrophoresis, a blood test that identifies hemoglobin types. You can also ask whether your newborn screening result is available.
RMC is a rare, aggressive cancer of the kidney’s inner region, called the medulla. Most reported cases involve sickle cell trait (HbAS). It can also occur with sickle cell disease, including HbSS and HbSC. Most people with these conditions will never develop RMC.
The medulla has low oxygen and other conditions that can make red blood cells sickle. Researchers are studying whether repeated tissue injury there contributes to RMC and changes involving a gene called SMARCB1 and its INI1 protein. This is a developing explanation, not a proven sequence for every patient.
Knowing your trait status matters, but having sickle cell trait does not mean you need routine RMC screening. Discuss your own questions and symptoms with a healthcare professional.
Troy Anthony Haynes Jr. was an athlete and received care at MD Anderson Cancer Center. His treatment team included Dr. Pavlos Msaouel, an RMC physician-scientist who designed Troy’s clinical trial. We share this information to honor Troy and help athletes, families, coaches, and healthcare professionals recognize concerns early. It does not suggest that sports caused Troy’s cancer.
The inner kidney naturally has low oxygen and other conditions that can encourage red blood cells to sickle in someone with sickle cell trait. Very intense exertion and dehydration may add stress. Researchers are studying whether repeated injury there contributes to RMC and changes involving SMARCB1/INI1. This is a developing explanation, not a proven sequence for every case.
A carefully scoped observation: MD Anderson reports that about 60%–70% of the young Black men with sickle cell trait who developed RMC described in its explanation also had a history of high-intensity exercise. That figure is not a percentage of all people with RMC. It does not prove that exercise caused anyone’s cancer or establish an individual athlete’s risk. Dr. Msaouel and colleagues have studied the possible association in patients and experimental models.
Do not assume blood in the urine is “just training” or diagnose RMC yourself. A clinician can investigate the cause.
Having sickle cell trait does not mean an athlete must stop playing sports. To reduce exercise-related illness:
These precautions are for exercise-related illness. They have not been proven to prevent RMC. In the United States, RMC is seen more often in young Black people in part because sickle hemoglobin conditions are more common in that population; people of other backgrounds can also be affected.
Sources: MD Anderson and Dr. Pavlos Msaouel on RMC and exercise ↗ · Published RMC and exercise research ↗ · CDC guidance for athletes with sickle cell trait ↗
This information is for education, not a diagnosis or a personal training or treatment plan.
When cancer has spread: Symptoms depend on where it has spread and can include a persistent cough, chest pain, or bone pain. These symptoms do not automatically mean RMC.
Blood in the urine or side pain can also have other causes, including infection or kidney stones. Seek prompt medical evaluation, especially for visible blood in the urine, rather than trying to diagnose the cause yourself.
RMC is often advanced when found. Treatments used for more common kidney cancers may not work well for it. For most patients, an RMC-experienced team begins with chemotherapy and considers surgery later when appropriate. The plan depends on the person and the extent of the cancer.
Questions to ask the care team:
This toolkit is for education. It is not a diagnosis or a personal treatment plan.
Learn more from the National Cancer Institute’s RMC guide, CDC sickle cell trait information, and MD Anderson’s RMC information.