The incidence of kidney cancer in Hawaii has been rising steadily since the 1970s, and today more than 200 people are diagnosed with the disease annually in Hawaii, according to the National Cancer Institute.
Health care professionals say the biggest difficulty with kidney cancer is catching it early: By the time someone begins to feel the symptoms of kidney cancer, the disease is oftentimes already reached a late stage.
And many times, patients are diagnosed when the cancer is found by accident.
That's exactly what happened to U.S. Sen. Mazie Hirono, D-Hawaii, who said doctors found her kidney cancer after spotting a lesion on her rib during a routine physical.
"You never want to have stage four cancer. It sounds like this is a very localized stage four disease, just with one spot, which is better and that's why the senator will be able to get local radiation therapy to that spot," said Dr. Randall Holcombe, director of the University of Hawaii Cancer Center.
In the early stages of kidney cancer, there may be no symptoms.
In later stages, when the cancer has spread to other parts of the body, symptoms include blood in the urine, a lump in the abdomen, pain in the side that won't go away, loss of appetite, weight loss for no reason or anemia.
Prognosis depends on the stage of the disease and the patient's age and overall health.
When the cancer is confined to the kidney, the five-year survival rate is 93 percent. But if it's metastasized, the five-year survival rate drops to 12 percent, the National Cancer Institute reports.
"It is low, the five-year survivability rate for stage 4 disease, but those rates do not take into account some of the new treatments that have become available in just the last several years," Holcombe said.
In 2017, an estimated 14,000 people nationwide are expected to die from kidney cancer. That equates to 2.4 percent of all cancer deaths in the United States.
The National Cancer Institute puts the incidence of kidney cancer in Hawaii at 14 cases per 100,000 residents.
That's far less common than prostate, breast or lung cancer in the islands, and it's slightly below the national average.
But the incidence of kidney cancer is on the rise in the islands. And among those 65 and up, the incidence skyrockets to 51 cases per 100,000 residents, according to the institute's figures.