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Kidney Cancer (Renal Cell Carcinoma)

What Is Renal Cell Carcinoma?

Renal cell carcinoma is the most widespread kidney cancer types. It accounts for approximately 3% of adult cancers, and the incidence has risen steadily by 2-4% each year. It is a collection of different types of tumors, each derived from the various parts of the kidney cell and displaying salient genetic characteristics, histological features, and clinical picture.

Causes

Renal cell carcinoma tends to spread to the lymph nodes, lungs, liver, adrenal glands, brain, or bones when it metastasizes. While the causing factors of renal cell carcinoma are unknown, there are risk factors that increase the chance of developing it:

  • smoking
  • high blood pressure
  • family history of kidney cancer
  • obesity

The chance of developing renal cell carcinoma increases with age. Moreover, males have double the chance of having in comparision to females.

In a lot of patients, this cancer may not produce any symptoms for most of its course. For instance, only about 10% of patients present with the classic triad of pain, blood in the urine, and lump in the abdomen. Other signs and symptoms may include unexplained weight loss, fever, night sweats, weakness, fatigue, nausea, and high blood pressure.

Renal cell carcinoma is associated with a number of paraneoplastic syndromes. These are conditions caused by either the tumor hormones or by the body’s attack on the tumor. In about 20% of these patients, paraneoplastic syndromes are present, such as high blood calcium levels, increased red blood cell count, high platelet count, and amyloid protein deposition in one or more organ systems.

Signs, symptoms, and past medical history play significant roles in diagnostics of renal cell carcinoma. Based on the symptoms and signs, many biochemical tests are considered to provide sufficient diagnostic clues. These tests include kidney imaging (ultrasound) and CT and MRI scanning of the kidneys.

In addition, biopsy of the suspected kidney mass helps confirmation of a diagnosis. Pet scanning is a standard imaging modality to evaluate the extent of cancer spread.

Treatment

The therapeutic approach to renal cell carcinoma depends on the stage or degree of tumor spread, pre-existing medical conditions, and overall health and age. The principal treatment options for renal cell carcinoma consist of surgery, immunotherapy and targeted therapy.

Partial or complete removal of the affected kidney is the standard treatment for localized renal cell carcinoma.

Immunotherapy or biologic therapy works by boosting the body’s immune system to help destroy cancer cells. Cytokines are the artificially engineered versions of natural proteins that activate the immune system. The most common ones to treat kidney cancer are interleukin-2 and interferon-alpha.

The targeted therapy works by blocking the new blood vessels’ growth that nourishes cancer cells or downplaying important proteins in cancer cells that help them grow. Clinical response rates with chemotherapy, either mono agent or combination, are usually less than 15%.

Renal cell carcinoma is not very sensitive to radiation. That is why radiation therapy is more often used to palliate or ease cancer symptoms in case of cancer spread.

Treatment Options

We treat kidney cancer with:

  • active surveillance
  • surgical removal of the tumor
  • surgical removal of the tumor and kidney together

In cases where patients can’t get surgery but need treatment, we can do percutaneous ablation.

The cure is not possible in the late stages of advanced kidney cancer (locally advanced or metastatic disease). We use surgery for debulking or reducing the volume of the disease. Then a patient undergoes a systemic therapy supply.

We offer both targeted therapies and immunotherapies for advanced kidney cancer to control the disease and make the patients live longer.

Our specialits provide clinical research and try to apply treatments early on. We use it even for a surgically curable state, both in the neoadjuvant and adjuvant setting.

A lot of patients do not know that a kidney tumor may not be cancer. In fact, the smaller the kidney tumor is, the more likely that’s the case. By not cancer, we understand a benign tumor, which can continue to grow quite big. These kinds of a tumor cannot spread and become life-threatening. In short, those are the best types of tumors for active surveillance, and we prefer not to treat them.

Patients should not rush into treatment because:

  1. Kidney tumors may not be malignant.
  2. If the kidney tumor is malignant, it may not need treatment. We try to manage it more appropriately with active surveillance.
  3. If the kidney tumor does need treatment and the whole kidney is recommended to come out, surgery could be performed without taking out the entire kidney.
  4. If your doctor recommends a partial nephrectomy, this is a very technically challenging operation.