Clinical Condition

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Kidney Cancer

What is a cancer?

Cancer is an abnormal growth of cells in kidney tissue. In time, these cells form a mass called a tumor. Cancer begins when something triggers a change in the cells, and they divide out of control. A cancerous, or malignant, tumor can metastasize, or spread, to other tissues and vital organs.

What are the different types of kidney cancer?

Renal cell carcinoma-most common type and accounts for 85% of all kidney cancers. It usually develops as a single tumour in a kidney but can also involve both kidneys. It arises from urine producing cells of the kidney.

Transitional cell carcinoma-accounts for 6%-7% of all kidney cancers. It arises from urine collecting part of the kidney. Same type of cancer can also affect ureter and urinary bladder.

Sarcoma-It is the least common cancer of all. It arises from the connective tissue and vascular tissue of the kidney.

Wilm’s tumour-It is the most common kidney cancer in children.

What causes kidney cancer?

The exact cause of kidney cancer is not known, but several risk factors have been identified. A risk factor is something — such as a characteristic or behavior — that increases your chance of developing a disease. Risk factors for kidney cancer include:

Smoking — Smokers are at greater risk for kidney cancer. In addition, the longer a person smokes, the higher the risk.

Radiation — Women who have been treated with radiation for cancer of the reproductive organs may have a slightly increased risk for developing kidney cancer.

Gene changes (mutations) — Genes contain instructions for a cell’s function. Changes in certain genes can increase the risk of developing kidney cancer.

Family history — People who have family members with kidney cancer may have an increased risk for developing the cancer themselves.

History of tuberous sclerosis and Von Hippel-Lindau (VHL) disease — Both are genetically inherited syndromes.

Long-term dialysis treatment — Dialysis is the process of cleaning the blood by passing it through a special machine. Dialysis is used when a person’s kidneys are not functioning properly.

What are the symptoms of kidney cancer?

Kidney cancer may not produce any noticeable symptoms in its early stages. However, as the tumor grows, symptoms may begin to appear. For that reason, kidney cancer is often not diagnosed until it has begun to spread.

Symptoms of kidney cancer can include:

Blood in the urine (a condition called hematuria)

A lump or mass in the kidney area

Tiredness

Loss of appetite and/or weight

Low-grade fever

Pain in the side

Bone pain

A general sense of not feeling well

High blood pressure

Anemia (a condition that results from not having enough red blood cells)

Who can be affected by kidney cancer?

Kidney cancer is most commonly seen in 6th and 7th decade of life. But it can be seen in any age group with varying severity.

Whom to consult?

If you have above symptoms best person to consult is urologist.

How kidney cancer is diagnosed?

Urologist diagnose the case after carefully listening to your symptoms and conducting few test that include

Urine examination

Blood tests

Ultrasound examination

Computerised tomography(CT Scan)-This is the test by which definitive diagnosis is made.

Magnetic resonance imaging (MRI)

Chest X-ray

Are all kidney cancers causes severe illness?

Kidney cancers progress in four different stages depending upon the severity of involvement. It includes involvement of only a part of kidney within the capsule in stage I to multi-organ involvement in stage IV.

What is the treatment for kidney cancer?

Surgery is the only treatment modality which cures kidney cancer. Surgical modality depends on the stage of disease

Radical nephrectomy — The surgeon removes the whole kidney, along with the adrenal gland and some of the tissue around the kidney. Some lymph nodes in the area also may be removed.

Partial nephrectomy — The surgeon removes just the part of the kidney that contains the tumor

These surgeries can be performed by open surgical, laparoscopic or robotic approach.

In advanced stages of disease, chemotherapy and biological therapy is used to treat these patients. Chemotherapy, or chemo, uses medicines to kill or stop the growth of cancer cells. Biological therapy uses the body’s own immune system to fight cancer.

What is the outlook of kidney cancer?

If detected sufficiently early kidney cancer is completely curable. The chance of recovery depends on the type and stage of the cancer (whether it is just in the kidney or has spread to other places in the body), as well as the patient’s general state of health.

Like most cancers, the chance of treatment success is highest if kidney cancer is found in its early stages.

Can kidney cancer be prevented?

As the cause of kidney cancer is not known, there is no definite method of prevention. However risk can be reduced by cessation of smoking.

Kidney Cancer or Renal cell carcinoma, attacks the kidneys, an essential part of the body’s urinary system. While cancer in its various forms can strike virtually any organ of the body, only rarely does it seem to attack the kidneys. This is fortunate, because the kidneys perform some of the body’s most vital functions. Cornell Physicians specialize in the diagnosis and treatment of kidney cancer. Renal Cell Carcinoma is the most common type of kidney cancer. RCC begins small and grows larger over time, like many other cancers. Based on limited observations, renal cancers appear to grow approximately 1 cm (1/2 inch) in diameter per year. RCC usually grows as a single mass.

OVERVIEW OF THE KIDNEYS

The kidneys are two bean-shaped organs fixed to the back wall of the abdominal cavity. One kidney is to the left and the other is to the right of the backbone. Both are protected by the lower ribcage. The kidneys’ function is to filter the blood and eliminate the body of excess fluid, salt and waste products. Filtered blood (urine) leaves the kidney through a long tubular structure called a ureter. The ureters connect the kidneys to the bladder. Urine is stored in the bladder until urination.

All of the important functions of kidney can be handled with one kidney and that’s why many people are living normal healthy lives with just one kidney. Kidney cancers may start within the kidney (primary) or have spread from another organ/source. Primary kidney cancers may include renal cell carcinoma, transitional cell carcinoma (renal pelvic tumor), sarcomas and collecting duct tumors.

FIRST & FOREMOST

Kidney cancers tend to grow impressively before they can be diagnosed based on symptoms. Fortunately, the increased use of imaging techniques such as CT scans and ultrasound have allowed incidental detection of kidney tumors at an earlier stage. Additionally, a better evaluation of growths within the kidney are possible with improved CT scanning techniques and MRI scans as well. Taken together, smaller tumors can now more commonly be treated by partial nephrectomy (removal of just the tumor and a small rim of normal kidney tissue) instead of taking out the entire kidney.

CARE OFFERED FOR KIDNEYS

Various urological diseases can affect kidneys. Commonest of them are stone and infections. We provide emergency care in acute pain because of stones and infections. We are equipped with state of art diagnostic and therapeutic modalities at our centre to manage renal stones.

We manage most of the ureteric and kidney stones with endourological procedures. We have rigid as well as flexible endoscopic instruments by which we can access any stones in the urinary tract and can break them with the help of LASER.

We are performing various reconstructive procedures laparoscopically on kidneys, commonest is laparoscopic pyeloplasty. We also correct other abnormalities in the urinary tract like ureteric obstruction laparoscopically.

Kidney cancer is rare compared to prostate cancer. However there is only one curative treatment available for kidney cancer and that is complete surgical excision. We specialise in laparoscopic removal of kidney cancer to giv best survival advantage.

For details about the condition and procedures, refer to our section on clinical condition.