Kidney Cancer | What I Should Know as a Patient

Kidney Cancer

Kidney cancer starts in the kidneys. Kidneys are two bean shaped organs, located behind abdominal organs above waist. It filters our blood in the body, extract waste product from the blood and release the wastage as urine.

When abnormal growth of kidney cells happens. it called tumor. Tumor turns into cancer. One of the most common types of cancer is renal cell carcinoma (RCC).

Day by day the number of patient is increasing alarmingly. As a patient or non-patient everyone should know about kidney cancer if you want to keep your kidneys healthy. Because kidneys do the most important job in your body.

Causes or Risk factors of Kidney Cancer

The exact cause of this disease is unknown to medical science. But the changes in the DNA of kidney cells bind tumor by the time that forms cancer cell. Although there are some primary reasons for kidney cancer mentioned below

Smoking: Smoking is primarily responsible for this disease. People who smoke regularly are at a greater risk of kidney cancer.

Obesity:

People who have gained higher weight and are not aware of their weight, are at a greater risk for kidney cancer.

High Blood pressure:

Though high blood pressure is not linked directly to kidney cancer. It can increase risk of having this disease.

Family History:

Sometimes family history can cause kidney cancer. If your ancestors had kidney cancer before you may have a risk of it.

Radiation Therapy:

Women who have treated before with radiation therapy may an increase the risk of having kidney cancer.

Gene Changes:

Genetic mutation is also responsible for kidney cancer.

Long Term Dialysis:

Dialysis is a process of filtering blood through a machine. When a person’s kidney is not working properly. Long term dialysis history can cause kidney cancer.

Tuberous Sclerosis Complex:

Tuberous Sclerosis Complex is a disease that causes seizures and intellectual disabilities. It also can cause the formation of tumor in many organs of the body.

Von Hippel Lindau Disease:

People with this inherited disorder are at a greater risk of having kidney cancer. This disorder causes non-cancerous tumor in your eyes or in blood vessels or in the brain.

Signs and Symptoms

Symptoms of kidney cancer does not appear in human body at the early stage. Symptoms can be seen when it begins to spread. There are some common symptoms mentioned below.

·       Blood in the urine (Hematuria), which may look pink

·       Lymph or mass in kidney area

·       Flank pain

·       Tiredness

·       Loss of appetite

·       Weight loss

·       Low-grade fever

·       Bone pain

·       High blood pressure

·       Anemia

·       High calcium

·       Back pain that never goes

Diagnosis and Tests for Kidney Cancer

If you have any symptoms, your health care professional will perform a few medical tests. It will help to detect your kidney condition. The tests may include

     Urinalysis:

In urinalysis, your urine sample will be tested to see if it contains any blood is invisible.

        Blood test:

Blood test show the number of each blood cells, It also check for different electrolytes. This test show if there are too few red blood cells (anemia) and your kidney function.

        CT Scan:

CT scan is a special X-ray, where a computer takes series of image from inside your body. It is often done with intravenous contrast (dye). People with kidney cancer cannot take dye.

        Magnetic Resonance Imaging (MRI):

Through MRI a computer takes image of inside of your body using a magnet, and radio waves.

       Ultrasound:

Doctors use high frequency sound waves inside your body to take image of inside of your body. This imaging test helps in detecting kidney cancer.

       Renal Mass Biopsy:

In this procedure doctor insert a micro needle inside the tumor. Then take a sample tissue from tumor. After that health care professional examine it under the microscope to see if there any cancer cells.

When to see a doctor?

If you a see any of symptoms of kidney cancer book an appointment with a kidney cancer specialist.

Stages of Kidney Cancer

Cancers are grouped by stage so that health care professionals can understand the situation of cancer. By following that the take treatment policies. The stage of cancer is based on

•    The location and size of the tumor.
•    At which extent your lymph nodes are affected
•    Spreading area of cancer

Stage I:

The tumor is 7 cm and only located in your kidney. In stage I cancer tumor has not spread to outside of the kidney or to the lymph nodes. (Lymph nodes are small filters that store infection fighting cells)

Stage II:

Tumor is larger than 7 cm but it is still in the kidney. It has not spread to lymph nodes or other parts of the body.

Stage III:

In this stage tumor spread to out of the kidney like in major blood vessel, nearby lymph nodes or in the renal vein and inferior vena cava.

Stage IV:

In stage Iv cancer, tumor spread to outside of your kidney to your adrenal glands. Adrenal glands are the small glands located on top of the kidney.

Types of Kidney Cancer

Renal Cell carcinoma

RCC or renal cell carcinoma is the most common types of kidney cancer. It is also known as renal cell cancer or renal cell adenocarcinoma. 90% of the patients are RCC patients.

Normally, RCC grows as a single tumor in one kidney. But it can grow two or more in one kidney or even in the both kidneys. 

There are several subtypes of RCC, these subtypes depend on examining cancer cells in the lab. Determining the subtype of RCC can be a factor in deciding the treatment for your doctor. It will also help your doctor to determine if your cancer is caused by inherited genetic syndrome.

Clear Cell Renal Cell Carcinoma

This is the most common type of RCC. Out of 10 persons with RCCF, 7 have this RCC form. It looks very clear or pale in the lab.

Non-Clear Cell Renal Cell Carcinoma

Papillary Renal Cell Carcinoma:

This is the second most common subtypes of RCC, 1 of 10 have this subtype, who have RCC. This cancer cells form little finger-like projections (called Papillae). Few doctors notify this cancer as chromophilic. Because the cells take in certain dyes and look pink when they are examined under the microscope.

Chromophobe Renal Cell Carcinoma:

5 out of 100 persons who are having RCC, have this subtype of RCC. It also looks pale and has other certain features that can be seen when it is under the lab.

Rare Types of Renal Cell Carcinoma:

These are very renal cell carcinoma. This 1 % of all renal cell carcinoma.

1.       Medullary carcinoma
2.       Mucinous tubular and spindle cell carcinoma
3.       Neuroblastoma associated RCC
4.       Multilocular cystic RCC
5.       Collecting duct RCC

Unclassified Renal Cell Carcinoma:

There are a few numbers of RCC, that do not fit any of the above’s category. That is why they are called unclassified renal cell carcinoma.

Other Types of Kidney Cancer

Transitional Cell Carcinoma:

Transitional cell carcinoma is also known as urothelial cell carcinoma. Out of 100 patients 5 or 10 have this type of cancer.

It starts in the lining of the renal pelvis (pelvis is the point where kidney meets ureters) instead of starting in kidneys. The pelvis lining cells formed by the cells called transitional cells. It looks like the cells of ureters and bladder.

Cancers that develop from these cells also look like other urothelial carcinomas, like bladder cancer, when examined in the lab. It also linked to cigarette smoking and chemical that cause cancer, which are being used in the workplace.

People who have TCC also can have sign and symptoms of RCC like blood in the urine, and back pain.

Wilms Tumor (nephroblastoma):

This kind of cancer is very rare in adults. It occurs with children.

Renal Sarcoma:

Renal sarcoma starts in the blood vessels itself. It is a very rare kind of kidney cancer.

Management and Treatment

Kidney cancer treatment or renal cell carcinoma treatment depends on grade of the tumors, stage, overall health. It also include age, previous medical history and other factors related to the treatment.

Surgery:

Surgery is the most common type of treatments of kidney cancer. There have two options for surgery

1.   Partial Nephrectomy:

In this surgical option, a portion of the kidney affected by cancer is removed.

2.  Radical Nephrectomy:

In radical nephrectomy whole kidney along with some tissues

Ablation:

People do not want to have surgery or afraid of surgery, are treated with ablation method. In this method cancer is treated by heat and cold therapy. There are two ablation methods

1.     Cryoablation:

In cryoablation method doctor will put a needle into your kidney tumor, then he will freeze the cancer cells with cold gas.

2.     Radiofrequency Ablation:

 Your health care professional will insert a needle in the kidney tumor. After that he will pass electrical current through the cancer cells to destroy them.

Radiation Therapy:

Doctors suggest radiation therapy when patients have only one kidney or if he is not fit for surgery. This method is used to ease the symptoms of kidney cancer in most of the cases.

Chemotherapy:

Chemotherapy is not a proper treatment option for patients. But sometimes it can be beneficial after trying immunotherapy and targeted therapy. Chemotherapy medication have to insert through vein (intravenously), or taken by mouth.

Targeted Therapy:

Targeted therapy is a kinase inhibitor. It works by blocking protein, blood cells that feed cancers and help them to stop the growth of cancer cells.

Targeted therapy is often used after surgery so that cancer cells do not come back. In some case it is used when surgery is not possible. Axitinib is a targeted therapy is being used widely to treat kidney cancer. There are also other medication like Cabozantinib and Lenvaxen that are used to treat renal cell carcinoma.

Immunotherapy:

Immunotherapy is a certain medication that are given to boost immune system to fight cancer. It is a single treatment method or sometimes it is used along with surgery to boost patient’s immune.

Benign or Non-cancerous Kidney Tumor

Some tumors grow in the kidney that are not cancerous. It means they do not metastasize or spread to other parts of the body. Benign kidney tumor can be treated by removing or destroying them if they cause any problem. There are two main benign kidney tumor type mentioned below.

1.   Angiomyolipoma:

It is the most common benign kidney tumor. It occurs mostly in the women. They can be sporadic or people who have tuberous sclerosis (a genetic problem that affect heart, eyes, brain, and lungs).

 Angiomyolipoma is made up of some connective tissue like blood vessels smooth muscles and fat. You should take treatment if you have this tumor when they cause problems like bleeding and pain.

2.   Oncocytoma:

This tumor kind is often seen in the men and can grow large. But it is not sporadic.

Kidney cancer prevention

Kidney cancer is not fully preventable but some precaution can be taken to prevent this.

1. Quit smoking
2. Maintain healthy weight
3. Manage blood pressure
4. Limit toxin exposure
5. Prioritize healthy diet
6. Regular checkup
7. Be mindful of symptoms

If you follow these precautions you can be aware of kidney cancer.

you also can read about Anaplastic Thyroid Cancer

External sources: Mayo clinic