CANCER KIDNEY

WHAT IS KIDNEY CANCER?

Sometimes, tumor-like masses develop inside the kidneys, including cases of kidney cancer. It is crucial to have an evaluation done to determine whether the mass is malignant or not.

In the specific context of kidney cancer, there are several treatment options available. An early diagnosis can offer even more therapeutic alternatives. It is essential to have the support of the medical team to better understand the advantages and disadvantages of each treatment.

WHAT ARE THE TYPES OF KIDNEY CANCER?

There are several variants of kidney cancer, each with its own distinct characteristics. Let's explore some of them:

• 1. Renal Cell Carcinoma (RCC): RCC is the most common form of renal cancer in adults, accounting for approximately 85% of all diagnosed cases.
• 2. Transitional Cell Cancer: Transitional cell carcinoma comprises 6% to 7% of kidney cancers. This type of cancer usually starts in the area where the ureter connects to the main part of the kidney, called the renal pelvis. In addition, it can occur in the ureters or bladder.
• 3. Renal Sarcoma: Renal sarcoma is a rare form of kidney cancer, accounting for only about 1% of cases. It arises in the connective tissues of the kidneys and, if left untreated, can spread to nearby organs and bones.
• 4. Wilms Tumor: This is the most common type of kidney cancer in children, accounting for approximately 5% of kidney cancer cases.

Each type of kidney cancer requires a specific treatment approach. It is essential to seek medical advice to determine the type of kidney cancer and develop an appropriate and personalized treatment plan.

WHAT ARE THE SIGNS OF KIDNEY CANCER?

Kidney cancer, in its early stages, may not have noticeable symptoms. However, as the tumor develops, symptoms may arise, leading to the diagnosis. Each person may experience different signs, and here are some of the symptoms associated with kidney cancer:

• 1. Hematuria (presence of blood in the urine).
• 2. Presence of a nodule or mass in the kidney region.
• 3. Flank pain (side area of abdomen or back).
• 4. Feeling tired or fatigued.
• 5. General malaise.
• 6. Loss of appetite.
• 7. Unintentional weight loss.
• 8. Low fever.
• 9. Bone pain.
• 10. High blood pressure.
• 11. Anemia (low blood cell count).
• 12. Elevation of calcium levels.

WHAT IS THE MAIN CAUSE OF KIDNEY CANCER?

There is no exact cause for kidney cancer, but the following causes are mentioned. Below are some of those factors:

• 1. Smoking: Smoking is associated with a higher risk of kidney cancer. Also, the longer a person smokes, the greater the risk.
• 2. Obesity: Obesity is considered a risk factor for kidney cancer. Generally, the higher a person's body mass index (BMI), the greater the risk.
• 3. High blood pressure: High blood pressure has been linked to an increased risk of kidney cancer.
• 4. Family history: Having family members with kidney cancer can increase your risk of developing the disease.
• 5. Radiation Therapy: Women who have received radiation treatment for cancer of the reproductive organs may have a slightly increased risk of developing kidney cancer.
• 6. Genetic changes (mutations): Certain genetic mutations can increase your risk of developing kidney cancer. These mutations affect the instructions that genes provide for cell function.
• 7. Long-term dialysis: People undergoing long-term dialysis treatment, used when the kidneys are not working properly, have an increased risk of kidney cancer.
• 8. Tuberous sclerosis complex: Tuberous sclerosis is a disease that can cause seizures, intellectual disability and tumor formation in various organs, including the kidneys.
• 9. Von Hippel-Lindau Disease (VHL): Individuals with this inherited genetic condition have a higher risk of developing kidney cancer. Von Hippel-Lindau disease causes benign tumors to form in blood vessels, usually in the eyes and brain.

HOW IS KIDNEY CANCER DIAGNOSED?

When symptoms of kidney cancer are present, the doctor will perform a thorough medical history and physical examination. In addition, various tests may be ordered to aid in the diagnosis and evaluation of cancer. These tests include:

• 1. Urinalysis: A urine sample is analyzed for the presence of blood. Even small amounts of blood, imperceptible to the naked eye, can be identified in urine tests.
• 2. Blood tests: These tests measure the count of different types of blood cells and analyze the levels of electrolytes in the body. A blood test may reveal anemia (low red blood cell count) or kidney dysfunction (via creatinine analysis).
• 3. Computed tomography: This is a special X-ray exam that uses a computer to create detailed images of the inside of the body. It is usually performed using an intravenous contrast agent. However, in cases of renal failure, contrast may not be administered.
• 4. Magnetic Resonance Imaging (MRI): Magnetic resonance imaging is a test that uses a powerful magnet, radio waves and a computer to generate highly detailed images of the inside of the body in high resolution.
• 5. Ultrasound: This test uses high-frequency sound waves that are transmitted through the body's tissues, generating images displayed on a monitor. It is a useful method for detecting tumors, which have different density from healthy tissues.
• 6. Kidney biopsy: During this procedure, a thin needle is inserted into the tumor to collect a small tissue sample (biopsy). A pathologist will examine this sample under a microscope, looking for cancer cells. Performing a biopsy for kidney cancer may or may not be recommended by the doctor, as its accuracy is not always guaranteed.

WHAT ARE THE STAGES OF KIDNEY CANCER?

Cancers are usually classified into stages, which describe the extent of the disease and help with treatment planning. The stage of a kidney cancer is determined by the following factors:

• 1. Tumor location and size: The stage takes into account the location of the tumor in the kidney and its size.
• 2. Lymph node involvement: It is assessed whether the lymph nodes close to the kidney are affected by the cancer.
• 3. Presence of metastases: It checks whether the cancer has spread to other tissues and organs.

Based on these characteristics, kidney cancer is classified into the following stages:

1. Stage I: The tumor is 7 centimeters or less in diameter and is restricted to the kidney only. There is no involvement of lymph nodes or other tissues.
2. Stage II: The tumor is more than 7 centimeters in diameter but still limited to the kidney. There is no presence of metastases in lymph nodes or other tissues.
3. Stage III: Cancer has spread to major blood vessels, such as the renal vein and inferior vena cava, or to tissue surrounding the kidney, or to nearby lymph nodes.
4. Stage IV: The tumor has spread outside the kidney, reaching the adrenal gland (located above the kidney), distant lymph nodes, or other organs.

These stages help doctors determine the appropriate treatment for kidney cancer, taking into account the extent of the disease and its potential for spread.

HOW IS KIDNEY CANCER TREATED?

Kidney cancer treatment is personalized based on the stage and grade of the tumor, as well as the patient's age and general health. There are several treatment options available, which include surgery, ablation, radiotherapy, targeted therapy, immunotherapy and, in specific cases, chemotherapy.

• Surgery:

Surgery is usually the preferred option for most stages of kidney cancer. There are different surgical procedures to consider, such as:

- Partial nephrectomy: During this surgical procedure, the surgeon selectively removes the portion of the kidney that contains the tumor, sparing the healthy surrounding tissue.

- Radical nephrectomy: The surgeon removes the entire affected kidney along with some of the surrounding tissue.

• Ablation:

In certain situations, the use of heat or cold can be used to destroy cancer cells. Cryoablation and radiofrequency ablation are techniques used when surgery is not feasible.

- Cryoablation: In this procedure, a needle is inserted into the skin and directed towards the kidney tumour.

- Radiofrequency ablation: A needle is inserted into the skin and directed into the kidney tumor, where an electrical current is applied to destroy the cancer cells.

• Radiotherapy:

Radiation therapy may be recommended when the patient has only one kidney or when surgery is not a suitable option. It is usually used to relieve symptoms related to kidney cancer, such as pain.

• Targeted therapy:

Targeted therapy uses specific drugs to block features that promote cancer cell growth. These drugs can interrupt the blood supply needed by the tumor or inhibit proteins essential for its development. Targeted therapy is often used when surgery is not an option. In some cases, these drugs may be given after surgery to reduce the risk of the cancer coming back.

• Immunotherapy:

Immunotherapy uses drugs to stimulate the patient's immune system, helping it to recognize and destroy cancer cells more efficiently.

• Chemotherapy:

Chemotherapy is not the standard treatment for kidney cancer, but in some cases it can be helpful, usually after trying immunotherapy and targeted therapy. Chemotherapy drugs can be given orally or intravenously and are generally well tolerated by the patient.