Cancer (tumor) of the kidney: symptoms and treatment

Cancer is when cells in the body grow out of control. These cells can form a tumor or damaged tissue. If cancer cells grow in the kidney, it is called kidney cancer.

• The most common kidney cancer in adults is renal cell carcinoma. It forms in the lining of very small tubes in the kidney.
• Cancers found in the center of the kidney are known as transitional cell carcinoma.
• Wilms tumor is a kidney cancer that very young children can get.

On average, people are diagnosed with kidney cancer at around age 64. It’s rarely found in people younger than age 45. Generally, our lifetime risk for developing cancer in the kidney is about 1 in 63 (1.6%)1. This risk is higher in men than in women. With timely diagnosis and treatment, kidney cancer can be cured.

Getting an early diagnosis for kidney cancer improves the outlook for patients. patient who receives a diagnosis at Stage I has an 81 percent chance of living for at least another 5 years.
At Stage II, there is a 74 percent chance of surviving for another 5 years, at Stage III, there is a 53 percent chance, and if the disease is diagnosed at Stage IV, the likelihood of surviving 5 years or longer is around 8 percent.
If your tests show you have kidney cancer, you will want to talk with a cancer specialist. The doctors who can help include:

• A urologist: a surgeon who specializes in treating diseases of the urinary system and reproductive systems
• A radiation oncologist: a doctor who treats cancer with radiation therapy
• A medical oncologist: a doctor who treats cancer with medicines such as immunotherapy

Symptoms

Kidney tumors may not hurt or show any signs. Sometimes a growth in the kidney can cause:

• Blood in the urine
• Pain in the side, abdomen or back that doesn’t go away
• A lump in your abdomen
• Loss of appetite and weight loss for no known reason
• Anemia and fatigue
If cancer spreads (metastasizes) beyond the kidney, symptoms depend upon where it spreads. Short breath or coughing-up blood may occur when cancer is in the lung. Bone pain or fracture may occur when cancer is in the bone.

Causes

Cancer in the kidney is linked to the following risks:
• Smoking
• Obesity
• Chronic high blood pressure
• Misusing certain pain medicine for a long time
• Von Hippel-Lindau syndrome
• Tuberous sclerosis
• Family history of kidney cancer

Stages and Grading of Kidney Cancer

If cancer cells are found, your doctor will need to know the tumor stage and grade. A carefully diagnosed grade and stage will help your health care team find the best treatment.

These descriptions define the main kidney cancer stages:
• Stage I: The tumor is confined to the kidney and less than 7.0 cm in size. There is no spread to lymph nodes or distant organs.

• Stage II: The tumor is confined to the kidney and greater than 7.0 cm in size. There is no spread to lymph nodes or distant organs.

• Stage III: These include tumors of any size, with spread into the lymph nodes adjacent to the kidney or into the large veins leading from the kidney to the heart (venous tumor thrombus). This stage does not include tumors that invade into other adjacent organs or those with distant metastasis.

• Stage IV: This stage includes any cancers that have invaded into adjacent organs such as the colon (large bowel) or the abdominal wall, and those with distant metastases.

Diagnosis

Unfortunately, there are no blood or urine tests that directly detect kidney cancer. Most often a tumor is diagnosed during routine screening for people with genetic risks (e.g. Von Hippel-Lindau disease, tuberous sclerosis). Or it is found when a person sees a doctor about an unrelated problem.
These are tests most often used to diagnose kidney cancer:

• Physical exam and history: A health care professional will check for lumps or anything else that seems unusual. They will ask about your health habits, past illnesses and treatments.
• Ultrasound exam
• Blood chemistry studies
• Urinalysis: Unusual levels of sugar, protein, red blood cells, and white blood cells can indicate a problem.
• Liver function test: to measure the enzymes released by the liver.
• Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder are taken to see if cancer is found there.
• CT scan (CAT scan or computed tomography)
• MRI (magnetic resonance imaging)
• Biopsy: The sample(removed by a fine needle from the tumor) is viewed under a microscope by a pathologist

Treatment Options

The treatment plan that you choose with your doctor depends on many things:

• Tumor grade and stage
• Your age
• Your overall health and health history
• Your anatomy (the anatomy of your kidney collection system)

Removing the kidney

Most kidney cancers are treated first by surgery. A person can function with just one kidney, so removing a kidney is an option.Nephrectomy involves removing the kidney, the nearby adrenal gland, a border of healthy tissue, and the adjacent lymph nodes. The surgery can be done laparoscopically, through small incisions.

Removing a part of kidney

If the tumor is less than 1.5 inches, or 4 centimeters across, the surgeon may remove only part of the kidney in a partial nephrectomy.If the cancer has spread outside the kidney, surgery may not cure it, but it can ease pain and make other non-surgical treatments more effective.

Removing the tumor

In nephron-sparing surgery, the tumor, but not the kidney, is surgically removed. This may be an option during the early stage of kidney cancer, or if the patient has only one kidney.A patient who is unwell or frail may not be able to undergo surgery. In this case, a number of nonsurgical treatment options are possible.

Embolization

It aims to block the flow of blood to the tumor. The surgeon inserts a small tube known as a catheter into the groin. X-ray images guide the catheter into the blood supply for the kidney. A special material passes through the catheter into the blood vessel, blocking the blood supply to the kidney and starving the tumor of oxygen and nutrients. This causes the tumor to shrink.

Cryoablation

It involves inserting one or more special needles, known as cryoprobes, through small incisions into the tumor. An imaging scan guides the process. A gas in the needles freezes the cells around the tip of each needle. Another gas warms thaws the tissue, and then the cells are refrozen. This freeze-thaw cycle kills the cancer cells.

Biological therapy

In biological therapy, or immunotherapy, drugs use the body's own immune system to fight cancer. Examples are interferon and interleukin-2. Side effects include nausea, vomiting, chills, elevated body temperature, and loss of appetite.

Radiation therapy

Radiation therapy cannot usually cure kidney cancer, but it may help reduce the spread and the severity of symptoms. Patients typically undergo a few minutes of treatment daily for a number of days.

Prevention and life expectancy

Measures to reduce the risk of developing kidney and other cancers include:

 Not smoking
 Eating plenty of fruit and vegetables
 Exercising regularly
 Keeping the body weight within normal limits for your height, sex, and age
 Getting at least 7 hours good quality continuous sleep every 24 hours
 Maintaining a healthy blood pressure
 Avoiding toxic chemicals

Treating problems like high blood pressure, diabetes, high cholesterol, and obesity, can help prevent future kidney damage.