What is Kidney Cancer?
Kidney cancer occurs when cells in the body begin to grow abnormally. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common non-cancerous kidney tumor is a fluid-filled area called a cyst.
Simple cysts are benign and do not progress to cancer. But solid kidney tumors are cancerous more than 80% of the time. The most common kidney cancer is called renal cell carcinoma (RCC), which approximately 9 out of 10 kidney cancer patients have. Kidney cancer centers around the world have identified several subtypes of RCC, all based on how the cancer cells look under a microscope. Knowing the subtype of RCC can be a factor in deciding kidney cancer treatment.
In the U.S., approximately 2% of all cancers arise from the kidney. Each year, kidney cancer centers and doctors diagnose approximately 52,000 Americans. A staggering number. Kidney cancer is about twice as common in males than females and is usually diagnosed between the ages of 50 and 70 years. With early diagnosis, kidney cancer treatment can be highly effective – survival rates for patients with kidney cancer range from 79-100%. So if you’re getting around that age, make sure you find a kidney cancer doctor to schedule a consultation immediately!
Most people have two functional kidneys. They produce urine that drains through narrow tubes (ureters) into the bladder. The kidneys are located in each flank protected by muscles of the back and ribcage. The kidney is the main filter of the body and performs many bodily functions, such as controlling fluid balance, regulating electrolytes, preventing acid buildup, eliminating waste products, producing urine, and regulating blood pressure. The kidney also manufactures hormones which aids in the production of red blood cells.
When the kidneys are damaged or a significant portion of kidney tissue is removed due to kidney cancer surgery, the normal functions of the kidneys may be impaired. In most cases, mild to moderate impairment causes very minor problems. In cases when kidney function is severely impaired, dialysis may be required.
What Causes Kidney Cancer?
Here are some known links that may increase the risk of developing kidney cancer:
– Smoking: The amount that one smokes seems to be related to the increase in risk. This increased risk drops once one stops smoking.
– Hypertension: Studies have suggested that certain medicines used to treat high blood pressure may raise the risk of kidney cancer. However, it has not been determined if it hypertension itself or the medication (or both) that may be the cause of the increased risk.
– Obesity: Obesity may cause changes in hormones that can lead to RCC.
– Family history of kidney cancer: Those with a strong family history of RCC have a higher risk of developing RCC. It is highest for those who have a brother or sister with RCC.
– Workplace Exposure: Many studies have suggested that workplace exposure to certain substances like cadmium, herbicides, organic solvents and trichloroethylene increases the risk for RCC.
– Race: African Americans, American Indians, Alaska Natives have slightly higher rates of RCC.
– Chronic kidney failure and/or dialysis: Those with advanced kidney disease, especially those needing dialysis, have a higher risk of RCC.
– Diet with high caloric intake or fried/sautéed meat: A diet heavy in these foods often leads to obesity which is a risk factor for RCC.
– Other hereditary or genetic risk factors: hereditary papillary RCC, hereditary renal oncocytoma, hereditary leiomyoma RCC, von Hippel Lindau disease, Brit Hogg Dube Syndrome (BHD), tuberous sclerosis and Cowden Syndrome are all linked to higher rates of RCC.
Oftentimes many cancerous kidney tumors do not produce symptoms. Instead, they are found incidentally on imaging when evaluating for an unrelated problem or during a routine screening for those at high risk.
However, more advanced cancerous tumors may compress, stretch and invade the structures near the kidney, causing pain in the flank, abdomen or back. A mass may be felt. Blood in the urine either visible or seen microscopically are possible kidney cancer symptoms as well. If the cancer has spread, shortness of breath, coughing up blood, bone pain or bone fracture may occur as well. Neurologic functions may change if it has reached the brain.
Kidney Cancer Diagnosis
Currently there are no blood or urine tests that directly detect the presence of kidney tumors.
When a kidney tumor is suspected, an imaging study is obtained. The initial imaging study is usually a renal ultrasound or CT scan of the abdomen and pelvis. In some cases, a combination of imaging studies may be required to completely evaluate the tumor. If cancer is suspected, the patient is then further evaluated to determine if the cancer has spread beyond the kidney using additional imaging and blood tests.
Kidney Cancer Treatment
Treatment of kidney cancer is largely based on the size and location of the tumor– if it has spread or metastasized. When the tumor has spread to other organs, there are four primary treatment options your kidney cancer doctor will discuss with you: nephrectomy followed by immunotherapy, initial treatment with immunotherapy, clinical research trials and surveillance.
When the tumor appears confined to the kidney there are three kidney cancer treatment options: tumor removal (surgery), tumor ablation and surveillance. A nephrectomy (whole or partial) is the surgical removal of the whole kidney or a portion of the kidney where the tumor is confined in order to rid the body of the tumor. It is considered the gold standard of treatment for kidney cancer. A nephrectomy can be performed through a traditional incision with open surgery or through several small incisions laparoscopically.
– Open nephrectomy (radical and partial): Traditional open nephrectomy (partial or radical) is performed through a flank or abdominal incision. This incision is typically 3-8 inches in length and may include removal of a rib.
– Laparoscopic, da Vinci Robotic radical nephrectomy: Laparoscopic nephrectomy is performed using telescopes that are inserted into the abdominal cavity through small “keyhole” incisions; however, a somewhat larger incision is often made to permit removal of an intact kidney.
Open and laparoscopic radical nephrectomies have similar complication rates and provide equally effective kidney cancer treatment for patients with tumors that appear confined to the kidney. When compared to open radical nephrectomy– a laparoscopic radical nephrectomy has less postoperative pain, shorter hospital stay and shorter recovery time. However, not all patients are candidates for laparoscopic nephrectomy as it is best suited for small, localized tumors that have not invaded the lymph nodes or renal vein.
Finding a Kidney Cancer Doctor
Oftentimes, many people don’t know who or where to go for kidney cancer diagnosis and treatment. The medical professional who is most capable, will always be a urologist. So if you don’t have a fancy kidney cancer center in your area, ask your doctor to refer you to a urologist. And if you’re in the Austin area or nearby, Dr. Shaw and the Austin Urology Institute will be ready to take care of you.
So if you’re getting close to 50, don’t wait to schedule a consultation. Kidney cancer will not discriminate, and the sooner you find out the safer you’ll be.