Renal/ Kidney Cancer

The most common type of kidney cancer is renal cell cancer. It starts in the cells lining the tubules (the smallest tubes) inside the nephrons.

The main types of renal cell cancer are:

• clear cell – around 75 out of 100 renal cell cancers (75%)
• papillary – around 15 in 100 renal cell cancers (15%)
• chromophobe – around 5 in 100 renal cell cancers (5%)

Some risk factors are:

• Smoking.
• High blood pressure. High blood pressure can damage your kidneys and is associated with kidney cancer.
• Gender.  The disease is seen about twice as often in men than in women.
• Having advanced chronic kidney disease (CKD) that requires dialysis treatment.
• Family history. Brothers and sisters of people with kidney cancer have a much higher chance of getting the disease. This may be due to shared genes, or something you were exposed to in the environment, or both.
• Long-term use of a pain-relieving drug called phenacetin. (This drug was banned in the United States during the early 1980s).
• Certain rare genetic diseases, such as von Hippel-Lindau disease, Birt Hogge Dube syndrome, and others. People with these conditions have a much higher risk of getting kidney cancer.

Symptoms

Most Kidney cancer now diagnosed after having scan of abdomen for some other reason. 

Kidney cancer rarely causes signs or symptoms in its early stages. And currently there are no routine tests used to screen for kidney cancer in the absence of symptoms. 

In the later stages, kidney cancer signs and symptoms may include:

• Blood in your urine, which may appear pink, red or cola colored
• Pain in your back or side that doesn’t go away
• Loss of appetite
• Unexplained weight loss
• Tiredness
• Fever, which usually comes and goes (intermittent)

Treatment

The most common treatment for kidney cancer is with surgery to remove all or part of the kidney.  However, your treatment will depend on the stage of your disease, your general health, your age, and other factors.  Some forms of treatment include:

Surgery  

Removing all or part of the kidney with surgery is called a nephrectomy.  It is the most common treatment for kidney cancer.  Most people with early kidney cancer (stages I, II, and II) can be cured with surgery. There are two basic types of nephrectomies for kidney cancer:

• Partial Nephrectomy: In this procedure, the surgeon removes just the tumor or part of the kidney that has the tumor.  The kidney is preserved.

• Radical Nephrectomy:  In this procedure, the surgeon removes the complete kidney.  If needed, the surrounding tissues and lymph nodes may also be removed.  Most people can live a healthy, normal life with one kidney.

Thermal ablation.   This is a treatment that kills the tumor by burning or freezing it.  The most common types of thermal ablation are radiofrequency ablation (burning) or cryoablation (freezing). It is used mostly in people with small tumors who are not good candidates for surgery.

Active surveillance.  In some cases, a small tumor (less than 4 centimeters) can be closely watched to see if it grows.  This is called “active surveillance.”  Many small tumors grow slowly and not all kidney tumors require surgery.  Some actually behave like non-cancerous tumors.  This may be a good option if you are elderly, frail, or have multiple health problems like diabetes, heart disease, and cancer.  It is rarely recommended for people who are healthy and young.  You will need careful monitoring with regular imaging and laboratory work