Kidney cancer research continues to flourish in the Cambridge Renal Cancer Group (CanRenCam) within the Department of Surgery. A collaboration between Mr Tom Mitchell (Clinical Lecturer, Department of Surgery), the Wellcome Sanger Institute and the TRACERx Renal consortium has revealed how and when renal cell carcinomas initiate to clearly depict the evolutionary trajectories of these tumours. In the first of a trio of papers published in Cell (12th of April 2018), the authors showed that the hallmark genomic event in kidney cancer, loss of the short arm of chromosome 3p occurs in adolescence, often 50 years prior to the eventual diagnosis. Perhaps even more remarkably; by using an inversion of Knudson’s two-hit hypothesis, it appears that we all harbour several hundred cells in our kidneys with this first genomic event. The odds of any one of us developing kidney cancer remains low, but the early presence of these “seed” cells may provide an opportunity for early intervention to reduce the burden of disease for those at high risk of developing kidney cancer.