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Kidney cancers, also called renal cancer is a disease in which kidney cells become malignant (cancerous) and grows out of control, forming a tumor. Almost all kidney cancers first appear in the lining of tiny tubes (tubules) in the kidney. This type of kidney cancer is called renal cell carcinoma. The good news is that most of these cancers are found before they spread (metastasize) to distant organs. And cancers caught early are easier to treat successfully. However, these tumors can grow to be quite large before they are detected.

The kidneys are two bean-shaped organs, each about the size of a fist. They lie in your lower abdomen on each side of your spine. Their main job is to clean your blood, removing waste products and making urine.

Causes and Risk Factors of Kidney Cancer

Doctors don’t know the causes of kidney cancer. But certain factors appear to increase the risk of getting kidney cancer. For example, kidney cancer occurs most often in people older than age 40. These are some other risk factors for kidney cancer:

• Smoking: If you smoke cigarettes, your risk for kidney cancer is twice that of nonsmokers. Smoking cigars may also increase your risk.
• Being male: Men are about twice as likely as women to get kidney cancer.
• Being obese: Extra weight may cause changes to hormones that increase your risk.
• Using certain pain medications for a long time: This includes over-the-counter drugs in addition to prescription drugs.
• Having advanced kidney disease or being on long-term dialysis, a treatment for people with kidneys that have stopped working.
• Having certain genetic conditions, such as von Hippel-Lindau (VHL) disease or inherited papillary renal cell carcinoma.
• Having a family history of kidney cancer. The risk is especially high in siblings.
• Being exposed to certain chemicals, such as asbestos, cadmium, benzene, organic solvents, or certain herbicides
• Having high blood pressure: Doctors don’t know whether high blood pressure or medication used to treat it is the source of the increased risk.
• Having lymphoma: There is an increased risk of kidney cancer in patients with lymphoma.

What Are the Symptoms of Kidney Cancer?

• Blood in your urine
• A lump in your side or abdomen
• A loss of appetite
• A pain in your side that doesn’t go away
• Weight loss that occurs for no known reason
• Fever that lasts for weeks and isn’t caused by a cold or other infection
• Extreme fatigue
• Anemia
• Swelling in your ankles or legs

Kidney cancer that spreads to other parts of your body may cause other symptoms, such as:

• Shortness of breath
• Coughing up blood
• Bone pain

What Are the Stages of Kidney Cancer?

Your prognosis depends on your age and general health as well as the grade and stage of your kidney cancer. These are the stages of kidney cancer. The higher the stage, the more advanced the cancer.

Stage I: A tumor 7 centimeters or smaller that is only in the kidney

Stage II: A tumor larger than 7 centimeters that is only in the kidney

Stage III: A tumor that is in the kidney and in one nearby lymph node, or
A tumor that is in an adrenal gland — the gland sits right above the kidney — or in a layer of fatty tissue around the kidney and may also be in one nearby lymph node, or
A tumor that is in the kidney’s main blood vessel and may also be in one nearby lymph node.

Stage IV: Cancer has spread beyond the fatty layer of tissue around the kidney, and it may also be in one nearby lymph node, or
Cancer may have spread to two or more nearby lymph nodes, or
Cancer may have spread to other organs. These may include the bowel, pancreas, or lungs. It may also be found in nearby lymph nodes.

What Are the Treatments for Kidney Cancer?

Once you have a diagnosis and know your stage of kidney cancer, you and your doctor can plan treatment. Your doctor may refer you to a specialist for treatment. This could include an urologist, a medical or radiation oncologist, or a surgeon. Kidney cancer is one of the more common cancers to undergo spontaneous remission. However, the incidence is quite low (approximately 0.5%). There are several standard types of treatment for kidney cancer. In most cases, surgery is the first step. Even if surgery removes the entire tumor, though, your doctor may suggest an extra treatment to kill any remaining cancer cells that can’t be seen.

Surgery for kidney cancer

These are the main types of surgery for kidney cancer. Which type you have depends on how advanced your cancer is.

• Open Nephrectomy: Open partial nephrectomy is defined as a removal of a portion of the kidney to achieve total removal of the entire tumor. Open partial nephrectomy is performed through a single 6- to 7 Inch abdominal or flank incision. As the incision is large enough to work through, the procedure is done without the use of a laparoscopic cameras’ or gas to expand the body spaces. Open partial nephrectomy is the kidney sparing surgery with the longest tract record and is often considered the gold standard for nephron sparing surgery.
• Radical Nephrectomy: Kidney cancer may be treated with radical nephrectomy, in which the entire kidney, along with the adrenal gland and some tissue around the kidney, is surgically removed. Some lymph nodes in the area also may be removed.
• Simple Nephrectomy: Some patients with early kidney cancer may have a simple nephrectomy which involves removing only the kidney.
• Partial Nephrectomy: A surgeon removes the section of the kidney with the tumor. This procedure may be used when the patient has only one kidney or the cancer affects both kidneys, and only in patients with small kidney tumors.

Percutaneous Radiofrequency Ablation of Renal Tumor:

For inoperable kidney tumors, radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy kidney tissue. This treatment is much easier on the patient and is more effective than systemic therapy. Radiofrequency energy can be given without affecting the patient’s overall health and most people can resume their usual activities in a few days. In this procedure, the interventional radiologist guides a small needle through the skin into the tumor. From the tip of the needle, radiofrequency energy is transmitted into the tumor, where it produces heat and kills the tumor cells. The dead tumor tissue shrinks and slowly turns into a scar.

Authored By : Dr. Mahendra Jain