Overview of kidney cancer
In human body the kidneys are situated one on each side of the spine in the lower abdomen. Each kidney is about the size of a fist and have renal glands attached to their top. A mass of fatty tissue (it acts as shock absorber) and an outer layer of fibrous tissue (Gerota's fascia) enclose the kidneys and adrenal glands.
The kidneys are part of the urinary system. Their main job is the removal of wastes and extra water from the blood in the form of urine. The kidneys also make substances that help control blood pressure and the production of red blood cells.
When the cancer starts in the cells of kidney it is termed as renal cancer or cancer of kidneys. Several types of cancer can start in the kidney. The most common type of kidney cancer in adults is the renal cancer. This type is sometimes called renal adenocarcinoma or hypernephroma. Kidney cancer can also spread to other parts of the body, especially the lymph nodes near the kidneys, to the lungs, bones, or liver. Its also possible that it spreads from one kidney to the other.
Stages of kidney cancer
Based on the diagnosis test results a doctor then decides what stage the cancer is in. The staging means the extent to which the tumor has grown and which other body parts besides the part of origin it has spread to. The various stages of renal/kidney cancer are:
Stage I: It is the earliest stage of kidney cancer as the cancer cells are localized only to the kidney. The size of the tumor is not bigger than 2 3/4 inches (7 centimeters) i.e. not bigger than size of tennis ball.
Stage II: In this stage the cancerous tumor is bigger than 7 centimeters but the cells are localized to the kidney only. Its also an early stage.
Stage III: This stage has its variants and can be one of the following:
The tumor is localized to the kidney, but one of the nearby lymph nodes are affected by the cancer cells traveling through the lymphatic system; or
The adrenal gland or the layers of fat and fibrous tissue surrounding the kidney may have been invaded by the tumor, but cancer cells have not spread beyond the fibrous tissue. Cancer cells may be found in one nearby lymph node; or
The cancer cells have spread from the kidney to one of the nearby lymph node and a nearby large blood vessel.
Stage IV: is one of the following:
The tumor extends beyond the fibrous tissue that surrounds the kidney; or
Cancer cells are found in more than one nearby lymph node; or
The cancer has spread to other places in the body such as the lungs.
Recurrent cancer is cancer that has come back (recurred) after treatment. It may come back in the kidney or in another part of the body.
Risk factors/causes of renal cancer
There are various risk factors that may increase the chances of renal cancer. The risk factors for renal cancer are:
Age: Renal cancer can be found most often in people over 40
Smoking: A major risk factor of renal cancer is cigarette smoking. Smoking doubles the chances of cancer in a person. Cigar smoking also may increase the risk of this disease.
Obesity: People who are over weight have an increased risk of kidney cancer.
High blood pressure
Long-term dialysis: people with improper kidney function undergo the treatment of dialysis. It removes wastes from the blood. Being on dialysis for many years is a risk factor for kidney cancer.
Von Hippel-Lindau (VHL) syndrome: VHL is a gene in human body. Changes in this gene cause a rare disease called VHL syndrome. VHL syndrome runs in some families. An abnormal VHL gene increases the risk of kidney cancer.
Occupation: certain occupations involve a lot of chemical handling and certain substances or chemicals may trigger renal cancer. For example coke oven workers in the iron and steel industry are at risk. Workers exposed to asbestos or cadmium also may be at risk.
Gender: Females are less likely than males to be diagnosed with kidney cancer.
Most people who have these risk factors do not get kidney cancer. But these factors do increase the possibility of renal cancer.
Symptoms of kidney cancer
Common symptoms of renal cancer are:
Blood in the urine (making the urine slightly rusty to deep red)
Pain in the side that does not go away
A lump or mass in the side or the abdomen
Weight loss
Fever
Feeling very tired or having a general feeling of poor health
These symptoms may also occur due to infection and don’t mean that cancer exists. But a doctor should be consulted on experiencing such symptoms.
Diagnosis of kidney cancer
A doctor orders a series of tests to diagnose renal cancer if a patient suggests that he/she is experiencing the above mentioned symptoms. A doctor then may advice the following tests to be conducted:
Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
Urine tests: Urine is checked for blood and other signs of disease.
Blood tests: The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
CT scan (CAT scan)
Ultrasound test
Biopsy
Treatment of kidney cancer
Once cancer has been diagnosed there are various factors that a doctor needs to take into account to decide which treatment method or combination of methods suits the patient. These factors include the age and general physical condition of the patient. The stage of the cancer is also taken into account. The various treatment methods available are:
Surgery: Surgical removal of kidney is termed by doctors as nephrectomy. All the diagnosis test results provide enough information to decide whether a part or the entire kidney. But the final decision is that of a pathologist who examines the tissue under a microscope. Surgery is the most common treatment for kidney cancer. It is a type of local therapy. It treats cancer in the kidney and the area close to the tumor. As mentioned the removal of kidney is governed by the stage of cancer and the various ways in which removal of kidney can be done are:
Radical nephrectomy: The removal of entire kidney, adrenal glands, some of the surrounding tissue and some of the lymph nodes is called as radical nephrectomy. Kidney cancer is usually treated with radical nephrectomy.
Simple nephrectomy: The surgeon removes only the kidney. Some people with Stage I kidney cancer may have a simple nephrectomy.
Partial nephrectomy: There are cases when a person has only one kidney or when both the kidneys are affected by cancer. In such a case removal of the lone kidney or removal of both the kidneys is not possible. Surgeon thus removes only the tumor containing part of the kidney. Also, a person with a small kidney tumor (less than 4 centimeters or three-quarters of an inch) may have this type of surgery.
Arterial embolization: Arterial embolization is a type of local therapy that shrinks the tumor. It is done when the surgery is not possible. It relieves the symptoms of cancer. Sometimes it is done before an operation to make surgery easier. In the process the doctor inserts a narrow tube (catheter) into a blood vessel in the leg. The tube is passed up to the main blood vessel (renal artery) that supplies blood to the kidney. The doctor injects a substance into the blood vessel to block the flow of blood into the kidney. The blockage prevents the tumor from getting oxygen and other substances it needs to grow.
Radiation therapy
Biological therapy
Chemotherapy
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