Kidney Cancer
Definition of Kidney cancer (renal cancer)
A tumor arising from the kidney.
Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney and is called an adenocarcinoma. Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50 - 70.
Causes/Risk Factors
The exact cause is unknown. The following may increase the risk of developing kidney cancer:
- Dialysis treatment
- Family history of the disease
- High blood pressure
- Horseshoe kidney
- Polycystic kidney disease
- Smoking
- Von Hippel-Lindau disease (hereditary disease that affects blood vessels in the brain, eyes, and other organs)
Warning Signs/Symptoms
In its early stage, bladder cancer can be asymptomatic or mimic symptoms of benign conditions, such as bladder stones, enlarged prostate or urinary tract infection. If symptoms do appear they should be evaluated as soon as possible. Warning signs include:
- Abdominal pain and swelling
- Back pain
- Blood in the urine
- Swelling of the veins around a testicle (varicocele)
- Flank pain
- Weight loss
Other symptoms that can occur:
- Excessive hair growth in females
- Pale skin
- Vision problems
Diagnosis
This will normally include some or all of the following:
A physical exam may reveal:
- Mass or swelling of the abdomen
- A varicocele in the male scrotum
Tests include:
- Abdominal CT scan
- Blood chemistry
- Complete blood count (CBC)
- Intravenous pyelogram (IVP)
- Liver function tests
- Renal arteriography
- Ultrasound of the abdomen and kidney
- Urine tests
The following tests may be done to see if the cancer has spread:
- Abdominal CT scan
- Abdominal MRI
- Bone scan
- Chest x-ray
- Chest CT scan
- PET scan
Treatment Options
Surgery to remove of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. This can be done robotically, laparoscopically or as an open procedure. The type of approach largely depends on size and position of the kidney tumor. A cure is unlikely unless all of the cancer is removed with surgery.
Hormone treatments may make the tumor smaller in some cases.
Chemotherapy is generally not effective for treating kidney cancer. However, the drug interleukin-2 (IL-2) may help some patients. It is a very powerful drug that can have severe side effects.
Newer medicines to treat kidney cancer include:
- Sorafenib (Nexavar)
- Sunitinib (Sutent)
- Temsirolimus (Torisel)
- Bevacizumab (Avastin)
Radiation therapy usually does not work for kidney cancer.
How well a patient does depends on how much the cancer has spread and how well treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.
Prevention
While there is no known way to prevent bladder cancer, there are ways to reduce risk, including:
- Quit smoking Many options for quitting exist, including support programs, medications and nicotine replacement products.
- Eat more fruits and vegetables
- Maintain a healthy weight
- Control high blood pressure. Lifestyle measures such as exercise, weight loss and diet changes can also help. Some people may need to add medications to lower their blood pressure.
- Reduce or avoid exposure to environmental toxins. If you work with toxic chemicals, take special precautions such as wearing a mask and heavy gloves. In the United States, employers are required to tell employees what chemicals they may be exposed to on the job. Follow employer's safety procedures, and ask if there are other ways to protect yourself from chemical exposure.
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