NBA Hall of Famer Dwyane Wade Reveals Kidney Cancer Diagnosis

Basketball Hall of Famer Dwyane Wade talked for the first time yesterday about his surgery for kidney cancer in December 2023.

During an episode of “The WY Network” podcast, Wade revealed that he underwent a partial nephrectomy, during which 40% of one kidney was removed. Recorded shortly before the 1-year anniversary of the surgery, Wade provided few details about the nature of the cancer or his treatment, but he acknowledged an emotionally, as well as physically, taxing personal journey.

“I think it was the first time my family, my dad, my kids — they saw me as weak,” he said. “That moment was probably the weakest point I’ve ever felt in my life. That moment I was by myself, I was struggling. One thing you never want as a man, you never want your family to see you weak, don’t want to be perceived as weak. You don’t want to be seen in your weak moments.”

“Fortunately for me, my family got in, they jumped in. What I saw in the midst of that, and me going through illness, I saw my family — who may not always talk, may not always agree, don’t always see each other — I saw everybody show up for me and be there for me. In that process of my weakness, I found strength in my family.”

After retiring from a 17-year career in the NBA, Wade no longer had regular health checkups that come with being a professional athlete. At age 41, he decided to see a doctor because of abdominal discomfort and lower urinary tract symptoms. Imaging studies requested as part of his workup revealed a mass in his kidney, which turned out to be malignant.

Incidental Discovery

Although most kidney cancer diagnoses involve older individuals, the circumstances surrounding Wade’s diagnosis are not uncommon, said Bradley Leibovich, MD, a consultant urologist at the Mayo Clinic in Rochester, Minnesota.

“The symptoms he described aren’t symptoms of kidney cancer,” Leibovich, who also chairs the board of directors for the Kidney Cancer Association, told MedPage Today. “Things that happen in the kidneys don’t affect how frequently you urinate. The fact of the matter is, the majority of the time when people get diagnosed with kidney cancer, it’s because we get scans for some other reason and we find it by accident, or incidentally.”

Incidental diagnoses also have led to more diagnoses in younger people, said Wesley Yip, MD, of City of Hope in Duarte, California.

“A lot of the statistics of kidney cancer came from times before we started finding them so early,” Yip told MedPage Today. “Usually, patients had larger tumors that took time to grow and become symptomatic with things like blood in the urine or a palpable mass or unintentional weight loss. But more and more, we’re finding masses in younger people, oftentimes [when looking] for other things. Maybe they got in a car accident or underwent imaging for some other reason.”

In most cases, diagnosis at a younger age does not reflect a more aggressive type of disease. Certain genetic alterations are associated with diagnosis at a younger age, but they represent a minority of cases and often are associated with a family history of the cancer, said Yip.

African-American heritage is associated with a rare type of kidney cancer related to sickle cell trait or sickle cell disease. Incidental diagnoses may occur more often as a consequence of workups for conditions that occur more often in Black patients, such as hypertension and diabetes. Overall, however, African Americans are not at greater risk of developing the cancer.

Patients with early-stage kidney cancer, such as Wade’s case, usually are cured by partial nephrectomy, said Leibovich. The surgery has evolved considerably in recent years and often is performed by minimally invasive and/or robotic techniques, which allow early hospital discharge and quick recovery and return to normal activities. Systemic therapy usually is not required.

Minimal Surgery, Rapid Recovery

“That’s one of the reasons I chose this specialty,” said Leibovich. “When a tumor is appropriate for partial nephrectomy — and even some that aren’t and we have to take the whole kidney — the majority of these tumors we expect to cure by just removal of the tumor. We just watch people closely and make sure we don’t see recurrences with scans.”

“When we do a robotic-assisted laparoscopic approach, patients are often in the hospital just 1 night and they have very minimal pain,” he added. “They typically don’t need anything more than Tylenol [acetaminophen] to get over the pain. They can return to normal activities 6 weeks later.”

Some small tumors can be treated with ablative techniques that only require insertion of a needle through the skin and into the tumor.

When performed as an open procedure, partial nephrectomy can cause considerable pain, particularly with side entry, said Leibovich.

“We need to let people know that when we find these [tumors] by accident, the expectation is that the majority of the time, people are going to live a normal lifespan,” he added. “Sometimes that’s with surgery, sometimes with something less than surgery.”

As with all medical conditions, exceptions exist, and kidney cancer is no different. If pathologic assessment reveals higher grade or stage of disease, systemic immunotherapy might warrant consideration.

“We talk to patients about the risks and benefits of the therapy as well as the risk of recurrence,” he said. “We talk about what the medication entails, the side effects, and whether they want to reduce this risk of recurrence with a particular medication.”

Post-Treatment Evaluation

Follow-up after surgery depends a lot on tumor characteristics that affect the likelihood of recurrence.

“Usually, we get some type of imaging of the abdomen 3 to 6 months after surgery,” said Yip. “After that, it depends on the risk of recurrence. Sometimes we do CT scans at 6-month intervals or sometimes we switch to ultrasound to reduce the risk of radiation exposure, especially if they are going to have a lot of imaging over time.”

“The highest risk of recurrence is during the first 5 years. Some patients may end follow-up at that time. I tend to follow patients pretty much indefinitely, just to maintain the relationship, but we start to do imaging less often, with ultrasound or something that doesn’t require radiation.”

The advent of targeted agents and immunotherapy has led to unprecedented advances in treatment of kidney cancer, which have driven improved survival, including advanced-stage disease.

“We had literally no drugs for advanced kidney cancer approved by the FDA before 1992 and just one drug from 1992 to 2005, which was fairly ineffective,” said Leibovich. “We’ve gone from that to over 20 different treatments now for advanced kidney cancer, and some people are being cured when we couldn’t cure them in the past. Even those who are not cured are living much longer with better quality of life.”

Kidney cancer was one of the earliest targets for PD-(L)1 inhibitors, after laboratory studies showed that the PD-1/L1 checkpoint system did not function well, if at all, in kidney cancers.

“We have a lot of great options for patients, where they can enjoy the normal length of their life and quality of life as well, even in advanced disease,” said Yip. “It used to be really bad. Now, with this diagnosis, there is a lot of hope and a lot of ways we can treat it.”

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