Kidney cancer
What is kidney cancer?
Kidney cancer is a cancer that starts in the kidneys. Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and spread to other areas of the body.
What are the risk factors for kidney cancer?
Kidney cancer risk factors include:
- Smoking
- Obesity
- von Hippel-Lindau disease
- Hereditary papillary renal cell carcinoma
- Hereditary leiomyoma-renal cell carcinoma
- Birt-Hogg-Dube (BHD) syndrome
- Familial renal cancer
- Hereditary renal oncocytoma
- Family history of kidney cancer
- High blood pressure
- Advanced kidney disease
What are the symptoms of kidney cancer?
Early kidney cancers do not usually cause any signs or symptoms, but larger ones might. Some possible signs and symptoms of kidney cancer include:
- Blood in the urine (hematuria)
- Low back pain on one side (not caused by injury)
- A mass (lump) on the side or lower back
- Fatigue (tiredness)
- Loss of appetite
- Weight loss not caused by dieting
- Fever that is not caused by an infection and that doesn’t go away
- Anemia (low red blood cell counts)
These signs and symptoms can be caused by kidney cancer (or another type of cancer), but more often they are caused by other benign diseases. For example, blood in the urine is most often caused by a bladder or urinary tract infection or a kidney stone. Still, if you have any of these symptoms, see a doctor so that the cause can be found and treated, if needed.
How is kidney cancer diagnosed?
Kidney cancer might be found because of signs or symptoms a person is having, or it might be found through lab tests or imaging tests for another reason. If cancer is suspected, tests will be needed to confirm the diagnosis.
How is kidney cancer treated?
For the most part, surgical intervention is needed in order to cure patients of renal-cell carcinoma. However, an in-depth discussion with one’s doctor will establish whether a patient is a candidate for surgical intervention.
Options for surgery include ablative techniques, such as cryotherapy, laparoscopic techniques, which allow the surgeon to perform the surgery through small holes, as well as the traditional open technique. Again, this is based upon the patient’s medical history as well as the size and location of the tumor.
Ablative therapies
Cryotherapy is the preferred modality for ablative therapy. This works by essentially causing “frostbite” in the tumor. Typically, the use of cryotherapy is limited to tumors less than 4 cm in size. Additionally, we also use percutaneous cryotherapy where no incision is made, but a needle is placed through one’s back while under anesthesia where the tumor is frozen.
Robotic/laparoscopic partial nephrectomy
Emerging data indicates the more kidney tissue one has, the better the long-term outcomes. That is, the ability to cut out the tumors from a kidney cancer is shown to prolong a patient’s life in comparison with those who have the entire kidney removed. It is because of this that we perform laparoscopic and robotic partial nephrectomies. This procedure is performed through small keyhole-sized incisions where the tumor is accurately removed from the normal surrounding kidney tissue. Fortunately, hospitalization is dramatically decreased, and patient’s pain levels are also dramatically decreased with this mode of therapy.
Open surgery
Despite the fact that we have seen smaller and smaller tumors with the increased use of imaging, the tumors may be too large to be taken through the keyhole-sized incisions of laparoscopic or robotic surgery and may need open surgery to remove them. Additionally, circumstances may be that the patient has other medical problems, or the location of the tumor necessitates an open approach. Fortunately, research continues to provide newer and newer drugs to target and destroy these cancers.