Kidney cancer

Kidney cancer is mostly common among people who are above 40 years of age. Renal cell cancer, also known as adenocarcinoma or hypernephroma, is the most common type of kidney cancer that occurs in adults. When kidney cancer spreads beyond the kidney, the lymph nodes get affected by the cancer cells. Kidney cancer can also spread to various other organs such as lungs, bones, or liver.

Kidney-cancerWhile transitional cell carcinoma affects the renal pelvis, Wilms tumor is a type of kidney cancer that commonly occurs in children.

Causes:

  • Cigarette smoking
  • Obesity
  • High blood pressure
  • Being on long-term dialysis is a prominent risk factor for kidney cancer.
  • Von Hippel-Lindau (VHL) syndrome: VHL is a very rare genetic disease. It is mainly caused by alterations or abnormalities in the VHL gene. Besides increasing the risk of kidney cancer, it can also result in cysts or tumors in the eyes, brain, and other regions in the body.
  • Occupation: People involved in certain occupations which constantly expose them to hazardous chemicals or substances such as asbestos or cadmium are at a greater risk of getting affected by kidney cancer.
  • Gender: When compared to females, males are more likely to be diagnosed with kidney cancer.

Symptoms:

Some of the common symptoms of kidney cancer include:

  • Blood in the urine
  • Severe pain on the sides
  • The presence of a lump or mass on the side or the abdomen
  • Weight loss
  • Fever
  • Feeling extremely tired or poor health

Diagnosis:

Your doctor may perform one or more of these procedures for diagnosis:

  • Physical examination: The doctor conducts physical examination and various tests to check and confirm if you have fever, high blood pressure or tumor.
  • Urine tests: Urine test is conducted to confirm if there is blood in urine or symptoms of other diseases.
  • Blood tests: Your blood is checked to see if your kidneys are functioning properly and to verify the level of substances, such as creatinine. If you have an extremely high level of creatinine, it may mean that the kidneys are not functioning well.
  • Intravenous Pyelogram (IVP): In this procedure, the doctor injects a special dye into a vein in your arm. The dye, which passes through the body, gets collected in the kidneys. This will be revealed in the series of x-rays which tracks the dye as it travels through the kidneys to the ureters and bladder. This test helps to confirm if you have a kidney tumor or other problems.
  • CT scan: A CT scan is often recommended as it helps to confirm if the person is affected by kidney tumor.
  • Ultrasound test: An ultrasound test helps to diagnose if there is a solid tumor or cyst.
  • Biopsy: A biopsy refers to the removal of a small amount of tissue in the kidney to confirm the presence of cancer cells. In some cases, the doctor might recommend a biopsy to the patient.
  • Surgery: On the basis of the results of the CT scan, ultrasound, and X-rays, the doctor may or may not recommend surgery to remove either a part or the entire kidney. The final diagnosis is made by a pathologist who examines the tissue under a microscope.

Various stages in Cancer

In order to plan the treatment that is appropriate for the patient, the doctor must know the extent or severity of the disease. The various stages of cancer are essentially based on two factors; the size of the tumor and whether the cancer has spread to other regions of the body. This will involve various imaging tests such as an ultrasound, a CT scan or an MRI.
The various stages of cancer include:

Stage I: This is an early stage of kidney cancer. In this stage, the tumor usually measures up to 7 cms. The cancer cells are present only in the kidney.

Stage II: This is also an early stage of kidney cancer. However, in this stage, the tumor generally measures more than 7 cms. The cancer cells are present only in the kidney.

Stage III: may be one of the following conditions:

The tumor has not extended beyond the kidney, but cancer cells have invaded the lymphatic system or to one of the nearby lymph nodes; or

  • The tumor has spread to the adrenal gland but the cancer cells have not spread beyond it. The cancer cells may be present in one of the nearby lymph nodes; or
  • The cancer cells have spread beyond the kidney to one of the nearby large blood vessels. Cancer cells may be present in one of the nearby lymph nodes.

Stage IV: may be one of the following:

  • The tumor has extended beyond the adrenal gland, the fibrous tissue that surrounds the kidney; or
  • Cancer cells are present in more than one nearby lymph node; or
  • The cancer has invaded other regions in the body such as the lungs.
  • Possibility of recurrent cancer or cancer that has recurred after treatment. It may recur in the kidney or any other part of the body.

Kidney cancer treatment: The methods

People affected by kidney cancer may undergo one or more of the following treatments including surgery, arterial embolization, radiation therapy, biological therapy, or chemotherapy. Moreover, they may have to usually undergo treatment for controlling pain and other symptoms as well as to alleviate the side effects of therapy, and to ease emotional issues. This kind of treatment is known as supportive care or palliative care.

Surgery

Surgery is the most commonly recommended treatment for kidney cancer. The surgery or operation performed for removing the kidney is called a Nephrectomy. There are different types of nephrectomies, which essentially depends on the stage of the tumor.

Radical nephrectomy: Kidney cancer is generally treated with Radical nephrectomy. In this process, the surgeon removes the whole kidney along with the adrenal gland and some portions of the tissue surrounding the kidney. Some of the lymph nodes in the region also may be removed.

Simple nephrectomy: In this process, the surgeon removes only the kidney.

Partial nephrectomy: In this process, the surgeon removes only the part of the kidney that is affected by the tumor. This type of surgery is recommended when the person has only one kidney, or when the cancer has invaded both kidneys. A person affected by a small kidney tumor (which is less than 4 centimeters) is also a possible candidate for Partial nephrectomy.

Arterial embolization

Arterial embolization is a type of local therapy that is used to shrink or reduce the tumor. Embolization is usually used to alleviate the symptoms of kidney cancer.

In this procedure, the doctor inserts a catheter into one of the blood vessels in the leg. The catheter is then passed up to the renal artery that transports blood to the kidney. The doctor injects a special substance into the blood vessel to interrupt the flow of blood into the kidney. This blockage inhibits the flow of oxygen to the tumour and prevents it from growing and developing further.

Radiation therapy

Radiation therapy or radiotherapy uses high-energy rays to kill cancer cells. The patient has to undergo treatment at the hospital, 5 days a week, for several weeks. Patients have radiation therapy prior to surgery to shrink or reduce the tumor. Some even have it post -surgery to eliminate the cancer cells that may remain in the area. Radiation therapy may also help to relieve pain and other problems caused as a result of cancer.

Biological therapy

Biological therapy is a type of systemic therapy which uses the natural ability or immune system of the body to fight cancer. The body generally produces interferon alpha or interleukin-2 in small amounts in response to certain infections or diseases. For the treatment of cancer, they are created in the laboratory in large amounts.

Chemotherapy

Chemotherapy, a type of systemic therapy where anti-cancer drugs travel through the bloodstream in to different part of the body to prevent or control the spread of the disease. This is not very effective in common variety of kidney cancer

Side effects of kidney cancer treatment

The side-effects of mainly depend on two factors; the type and extent of the treatment. It may vary for each person, and it may change based on the treatment sessions.

However, some of the general side-effects of the treatments are:

  • Poor appetite, nausea and vomiting
  • Fever, chills and muscle aches
  • Diarrhea
  • Mouth and lip sores
  • Hair loss
  • Fatigue and weakness
  • Easy vulnerability to infections and tendency to bruise or bleed easily

Follow-up care

Follow-up care following the treatment for kidney cancer is extremely important. The doctor regularly monitors the recovery of the person who has undergone the treatment for kidney cancer and to check if there is any probability for the recurrence of cancer. The patient may also have to undergo lab tests, chest x-rays, CT scans, or other tests.