Kidney cancer, or renal cancer, refers to any cancer that affects the kidney. Older age, obesity, and high blood pressure increase the risk of developing kidney cancer. It is one of the most common cancers in adults. There is no single, definitive treatment for kidney cancer, as it depends on the person’s general health, as well as the stage and type of cancer. However, treatment may include surgery, immunotherapy, or chemotherapy, among others. This article is about kidney cancer, including its causes, diagnosis, treatment, and prognosis.
Kidney cancer begins in the kidneys, a pair of bean-shaped organs located on either side of the spine, behind the stomach. The kidneys filter excess water, salt, and waste from the blood. They then return the filtered blood to the circulatory system and evacuate the waste in the form of urine to the bladder. Cancer begins when cells grow and divide out of control instead of organizing themselves. As a result, cancer cells create masses called tumors. These tumors can invade and damage nearby tissues and organs or spread to other parts of the body. Kidney cancer affects 1 in 46 men and 1 in 80 women during their lifetime. Also, the average age of diagnosis is usually 64 years.
A person with kidney cancer may have tumors in one or both kidneys. Sometimes kidney tumors are benign, meaning they are not cancerous. They may not spread to other parts of the body. However, sometimes they can grow and cause problems. When these tumors start to cause problems, doctors may recommend removing them.
The different types of kidney cancer
There are different types of renal cell cancers, including:
Renal cell carcinoma (RCC): This is the most common type of kidney cancer, accounting for up to 90% of cases. It originates in the renal cortex, or the outer layer of the kidney. Doctors can then divide it into various subtypes.
Transitional cell carcinoma: Between 5% and 10% of kidney cancers are of this type. They originate in the renal pelvis, which is the center of the kidney. Doctors may also refer to them as urothelial carcinomas.
Wilms tumor: This type of tumor usually occurs in children and is rare in adults. Doctors may also refer to it as a nephroblastoma.
Symptoms of kidney cancer
Symptoms do not usually appear in the early stage of kidney cancer, but some people still experience them, especially when the cancer spreads.
Here are some symptoms of kidney cancer:
blood in the urine
pain in the side that does not go away
a lump in the abdomen
loss of appetite
unexplained weight loss
Other diseases can cause similar symptoms. If a person has any of these symptoms, he should contact his doctor.
Doctors don’t know exactly what causes kidney cancer, but genetic and environmental factors may play a role. In the case of kidney cancer, the kidney cells undergo certain changes. Cancer begins when there is a change in the DNA structure of cells, which can trigger their uncontrolled growth. Eventually a tumor forms. The changes can activate oncogenes—genes that help cells grow, divide, and stay alive. They can also turn off tumor suppressor genes, which control cell division and help cells die in time. If a person has changes in more than one gene, it can cause kidney cancer.
The main risk factor for renal cell carcinoma is smoking cigarettes, pipes, and cigars.
Obesity is another important risk factor, especially in women. Experts estimate that quitting smoking and maintaining a moderate weight can cut the incidence of kidney cancer in half.
Other risk factors can be:
high blood pressure
chronic kidney failure
occupational exposure to chemicals such as trichlorethylene
family history of kidney cancer
The stages of kidney cancer are as follows:
Stage 1: The tumor is less than 7 centimeters (cm) in diameter and is only in the kidney.
Stage 2: The tumor is larger than 7 cm but is still in the kidney.
Stage 3: The tumor, regardless of its size, has spread outside the kidney. It may have spread to nearby lymph nodes or blood vessels, structures in the kidney that collect urine, or the layer of fatty tissue that surrounds the kidney.
Stage 4: The tumor grows beyond the layer of fatty tissue in the kidney and may reach the adrenal gland, which sits on top of the kidneys, or nearby lymph nodes. Or, the cancer has spread to other parts of the body.
If a person has symptoms of kidney cancer, the doctor will likely start with:
ask him about his symptoms
inquire about personal and family medical history
perform a physical exam
ask for evidence
If a doctor suspects that a person has kidney cancer, he or she may order one or more of the following tests:
Blood and urine tests: These tests help rule out other possible causes of your symptoms, such as kidney stones or infection.
Imaging scans: An ultrasound, MRI, or CT scan can help the doctor identify the presence of tumors or changes in the shape of the kidney that could be due to cancer.
Biopsy: For this procedure, your doctor will use imaging technology to guide you in removing a tissue sample. He or she will use a needle to take a small sample of kidney tissue and look at it under a microscope. Only a biopsy can confirm the presence of cancer.
Your doctor may also recommend other tests to check for transitional cell cancer.
A person’s treatment options may depend on:
your general health
the type and stage of kidney cancer
previous cancer treatments.
Some options may include:
In most cases, surgery is the main treatment for kidney cancer that can be removed. The surgeon may remove part or all of a kidney, as well as the tissue surrounding the tumor. If necessary, you may need to remove lymph nodes and other tissue. A person can function with only one kidney, so removal of an entire kidney is an option.
Laparoscopic surgery, which requires only small incisions, is often possible.
A sick or frail person may not be able to have surgery. In this case, some non-surgical options may be considered if the cancerous kidney lesion is considered to be small, usually no larger than 4 cm.
Cryotherapy/cryoablation: Extremely cold gases are passed through a probe, creating an “ice ball” at the tip that can destroy the tumor. The procedure can be painful and cause bleeding, infection, and tissue damage near the tumor.
Radiofrequency ablation: An electrical current is passed through the end of a probe to destroy the tumor. It comes with the same risks as cryoablation procedures.
Chemotherapy is the use of powerful drugs to attack and kill cancer cells, which can stop or slow the progression of cancer. Doctors only prescribe chemotherapy when other treatments, such as immunotherapy or targeted therapies, haven’t worked. Kidney cancer cells do not usually respond to chemotherapy, but a small number of people have benefited from it. These medications often affect the entire body and can have widespread side effects. However, the effects usually wear off at the end of treatment.
Immunotherapy increases the ability of the body’s immune system to fight cancer.
Inhibitor drugs can attack certain proteins on the body’s immune cells and change them to attack cancer cells. An exemplary drug targets the PD-1 protein.
Cytokines, which are small proteins that stimulate the body’s immune response, may also be an option.
Common side effects are nausea, vomiting, chills, fatigue, and loss of appetite.
In targeted therapy, drugs target specific functions or genes that play a role in cancer development. They disrupt functions and proteins that are necessary for cancer growth and survival.
An example of such a drug blocks angiogenesis, the process of forming new blood vessels that can feed cancer. Each medication can have its own side effects, but in general, these types of medications can cause fatigue, low red blood cell counts, and mouth sores, among other things.
Radiation therapy usually cannot cure kidney cancer. However, it can help shrink the tumor, limit the spread of cancer cells, and reduce symptoms.
It involves the use of high-energy rays to kill cancer cells. Side effects are usually nausea and fatigue.
Getting an early diagnosis generally improves a person’s future prospects. Medical experts use past statistics to calculate the probability that people with cancer will live at least 5 years after diagnosis, compared to the general population.
For kidney cancer, the following statistics for the 5-year survival rate:
93% for cancers that have not spread beyond the kidneys at diagnosis.
71% for cancer that has spread to nearby tissues
14% for cancers that have affected other parts of the body.
Many different factors influence these estimates, including the type of kidney cancer, the person’s age, and general health.
For all stages, the overall 5-year survival rate after diagnosis is 76%.
Kidney cancer occurs when cells grow out of control in the kidneys and form tumors. There are different types of kidney cancer, with renal cell carcinoma being the most common. Smoking, obesity, and a family history of kidney cancer can increase the risk of developing kidney cancer. However, doctors are not sure of the specific causes.
Kidney cancer treatment may include surgery, systemic treatments, or radiation therapy. These approaches are successful for most people, and kidney cancer has an overall survival rate of 76%.
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