Kidney cancer
What is kidney cancer?
Kidney cancer is a cancerous disease in which malignant degeneration of renal tissue occurs. It has adverse effects on the functions of the urinary system and, over time, becomes the cause of severe disorders in the entire body.
Malignant tumors are characterized by invasive growth with destruction of surrounding tissues. In the case of the kidneys, the development of a neoplasm causes dysfunction, vascular damage, and chronic blood loss. It is fraught with anemia, stuck blood clots in the ureter and bladder, as well as acute urinary retention. The spread of atypical cells in the body leads to the formation of metastases. Secondary tumors can be localized in the respiratory organs, bone tissue, and lungs.
If the disease is detected at early stages of development, timely and proper treatment, the five-year survival rate is 80-90%. That is why it is essential to undergo regular preventive examinations.
Types of kidney cancer
Based on the structure of pathologically altered tissues, the following histologic types of the disease are distinguished:
- renal cell carcinoma;
- nephroblastic;
- mesenchymal;
- neuroendocrine;
- germinogenic.
A classification of kidney cancer by stage is used to determine prognosis:
- At the first (early) stage, malignant transformation is limited to the tissues of the organ, the tumor diameter is less than 7 cm.
- At stage 2, the tumor is concentrated in the kidney but is more than 7 cm in diameter.
- At stage 3 the pathologic process of kidney cancer involves the surrounding structures (paranephral tissue, adrenal gland, vessels and diaphragm).
- At stage 4 tumor has spread beyond the kidney. Target organs may be affected.
In the absence of atypical cells in regional lymph nodes, the prognosis for patients is favorable. Metastases in lymphatic structures and distant organs significantly worsen the patient’s prognosis for recovery.
Symptoms of kidney cancer
In the initial stages, kidney cancer is often asymptomatic. Clinical manifestations occur with secondary involvement of the structures or surrounding tissue compression.
The first sign of kidney cancer is usually hematuria. Blood in the urine often appears suddenly – once or periodically, despite of the seemingly complete well-being of a person. It is a consequence of damage to the organ’s blood vessels by the neoplasm.
Later, women and men note the onset of the following symptoms:
- heaviness, discomfort, painful sensations in the lumbar region;
- If a blood clot blocks the lumen of the ureter, there is renal colic, accompanied by intense pain in the lower back;
- swelling of the face, upper and lower extremities;
- palpable bulky mass in the kidney area;
- subfebrile fever (sometimes a rise in body temperature is almost the only sign of kidney cancer).
At later stages, pathology is accompanied by weakness, fatigue, and a persistent increase in blood pressure. Patients note a decrease in appetite and noticeably lose weight in a short period of time. A frequent symptom of renal cancer in men is varicose veins of the seminal canal or varicocele.
In one out of four persons suffering from this pathology, the tumor metastasizes to other organs – lungs, brain, liver, and bones, which is manifested by the corresponding symptomatology: neurological disorders, icterus, hemoptysis, and abnormal fractures (occur even in the absence of mechanical impact from the outside).
Causes of kidney cancer
The oncological pathology of this localization is considered as polyetiological disease. Although the final causes of its occurrence are still unclear, experts believe that genetic, immune, neuroendocrine, and external factors play a role in its development. The following situations predispose to kidney cancer:
- unfavorable family history;
- tobacco smoking (70% of people suffering from this disease are avid smokers);
- arterial hypertension;
- diabetes;
- obesity;
- kidney trauma;
- radiation exposure to the body;
- working in harmful conditions (with chemicals, dyes);
- prolonged use of certain medications;
- chronic kidney disease (pyelonephritis, nephrolithiasis, chronic renal failure).
Malignant transformation of cells often occurs due to several provoking factors simultaneously.
Diagnosis of kidney cancer
Early stages of kidney cancer are clinically silent. Often, they become an incidental diagnostic finding during ultrasound in connection with other pathology of the kidneys or abdominal cavity organs. For differential diagnosis, laboratory tests, MRI or CT kidney, excretory urography, and radionuclide scanning are used to clarify the diagnosis. A biopsy with subsequent histological examination of tumor fragments is also performed.
A comprehensive examination is performed to detect/exclude metastases, which may include:
- Ultrasound of internal organs;
- MR;
- CT;
- bone scintigraphy.
The patient is referred to subspecialists (cardiologist, phlebologist, endocrinologist) if necessary.
Comprehensive diagnostics allow you to establish the histological type of tumor, determine the degree (stage) of kidney cancer, and assess the condition of other organs.
Kidney cancer treatment
The primary treatment for kidney cancer is to remove the tumor. The earlier the disease is detected, the greater are the chances of organ preservation. Innovative minimally invasive procedures are used to destroy the malignant neoplasm. Surgical treatment is complemented by pharmacological and radiation therapy courses.
Conservative treatment
In the early stages of kidney cancer, it is possible to reduce the size of the tumor and thus perform minimally traumatic surgery. The following methods are used for this purpose:
- cryodestruction;
- radiofrequency ablation;
- Thermotherapy (ultrasound or microwave thermocoagulation);
- chemoembolization.
Targeted, immune, and chemotherapy are actively used in the complex treatment of advanced kidney cancer. These methods aim to stimulate antitumor immunity, target the destruction of atypical cells throughout the body, and suppress their growth and division.
Surgical treatment of kidney cancer
Surgery for this disease involves the removal of the malignant neoplasm and all structures involved in the oncologic process. In case of small size and local development of the tumor, kidney resection (partial removal) is possible. This type of surgery is also performed in case of bilateral lesions, in case of dysfunction of the kidney not involved in the cancer, or case of development of a neoplasm in the patient’s only kidney.
Radical nephrectomy involves the removal of the kidney and nearby structures. This type of surgical treatment is the method of choice because it significantly reduces the risk of disease recurrence.
Extended nephrectomy involves the removal of all involved anatomical structures, including those located remotely.
All these treatment options are available in more than 900 hospitals worldwide (https://doctor.global/results/diseases/kidney-cancer). For example, radical nephrectomy is performed in 19 clinics across Turkey for an approximate price of $9.7 K (https://doctor.global/results/asia/turkey/all-cities/all-specializations/procedures/radical-nephrectomy).
Kidney cancer prevention
The mechanism of kidney cancer development is not fully understood, so prevention involves maximum limitation of factors that can activate the neoplastic process. To reduce the risk of pathology development, it is necessary to:
- treat urologic diseases in a timely and complete manner;
- give up bad habits;
- avoid contact with carcinogens and toxic chemicals;
- to keep your lower back from trauma;
- Have regular preventive check-ups (clinical urine analysis and kidney ultrasound).
Rehabilitation after surgical treatment
Patients who have had surgery for kidney cancer may require chemotherapy. After nephrectomy, a second kidney takes over the function of the lost kidney. If the only kidney has been removed, hemodialysis or donor transplantation is indicated.
