Kidney cancer

Kidney Cancer

Kidneys and Their Function

Humans typically have two kidneys, which are responsible for filtering blood and removing waste products, excess minerals, salts, and water to produce urine. Each day, about 190 liters of blood pass through the kidneys, producing roughly 2 liters of urine. In addition to filtration, kidneys produce hormones that help regulate blood pressure and promote red blood cell production. While both kidneys function independently, a person can survive with just one kidney, and dialysis can replace kidney function if both kidneys fail.

What is Kidney Cancer?

Kidney cancer occurs when cells in the kidney grow uncontrollably, forming a mass or tumor. These tumors may either be benign (non-cancerous) or malignant (cancerous). Kidney cancer can occur in different forms, such as:

1. Renal Cell Carcinoma (RCC):

• This is the most common type of kidney cancer in adults, making up about 85% of cases. It originates in the renal tubules, which are part of the kidney’s filtration system.

2. Urothelial Carcinoma:

• Also called transitional cell carcinoma, this cancer accounts for 5-10% of kidney cancers. It starts in the renal pelvis, where urine is collected before being passed to the bladder.

3. Sarcoma:

• This is a rare cancer that originates in the kidney’s connective tissue, such as the capsule surrounding the kidney or nearby fatty tissues.

4. Wilms Tumor:

• This type of cancer mainly affects children and accounts for 1% of kidney cancers.

5. Lymphoma:

• Although less common, kidney lymphoma can also occur in certain individuals.

Statistics

In India, approximately 16,861 people are diagnosed with kidney cancer each year, making it the 21st most common cancer. Additionally, kidney cancer is responsible for 9,897 deaths annually, ranking 22nd in cancer-related mortality rates.

Survival Rates

In the United States, the 5-year survival rate for kidney cancer is approximately 77%. This means that 77 out of every 100 people diagnosed with kidney cancer will still be alive after five years.

Risk Factors

Several factors can increase the risk of developing kidney cancer. These include:

1. Smoking:

• Smokers are twice as likely to develop kidney cancer. Among men, 30% of kidney cancer cases are linked to smoking, and among women, 25% are attributed to smoking.

2. Gender:

• Men are 2-3 times more likely to develop kidney cancer than women.

3. Age:

• The majority of cases are diagnosed in people between the ages of 50 and 70.

4. Obesity:

• Being overweight increases the risk of kidney cancer.

5. Chronic Kidney Disease:

• People with long-term kidney issues are at a higher risk of developing cancer.

6. Dialysis:

• Those undergoing long-term dialysis treatment for kidney failure have an increased risk.

7. Family History:

• Individuals with a family history of kidney cancer have a higher risk of developing the disease.

Symptoms

Kidney cancer often doesn’t present symptoms in its early stages. However, as the cancer progresses, common symptoms include:

1. Blood in the urine (hematuria)

2. Persistent pain in the side or lower back

3. A lump or mass in the abdomen or side

4. Swelling in the legs and feet

5. High blood pressure

6. Fatigue or general weakness

7. Loss of appetite

8. Unexplained weight loss

9. Persistent fever

Diagnosis

To diagnose kidney cancer, several tests are performed:

1. Blood Tests:

• Used to check for anemia or abnormal kidney function.

2. Urine Tests:

• To check for blood in the urine.

3. Biopsy:

• A small sample of kidney tissue is removed and examined under a microscope to confirm the presence of cancer cells.

4. CT Scan and MRI:

• Imaging techniques used to visualize the kidney and surrounding structures.

5. X-rays:

• Sometimes used to see if cancer has spread to the lungs.

6. Cystoscopy and Nephro-Ureteroscopy:

• Procedures used to examine the bladder, ureter, and kidney for signs of cancer.

Stages of Kidney Cancer

1. Stage I:

• The tumor is less than 7 cm in size and confined to the kidney.

2. Stage II:

• The tumor is larger than 7 cm but still confined to the kidney.

3. Stage III:

• The tumor may have spread to nearby lymph nodes but not distant organs, or it has spread to major veins or nearby tissues.

4. Stage IV:

• The cancer has spread to distant organs like the lungs, liver, or bones.

5. Recurrent:

• Cancer that returns after treatment.

Treatment Options for Kidney Cancer

1. Active Surveillance:

• For small tumors, especially in older adults, doctors may monitor the tumor’s growth before starting treatment.

2. Surgery:

• Radical Nephrectomy: Complete removal of the affected kidney and surrounding tissues.

• Partial Nephrectomy: Only the tumor and part of the kidney are removed, sparing kidney function.

• Laparoscopic or Robotic Surgery: Minimally invasive options.

• Cytoreductive Nephrectomy: Removal of the kidney in patients with metastatic cancer.

• Metastasectomy: Removal of cancerous tissue from other organs.

3. Non-Surgical Treatments:

• Radiofrequency Ablation: A needle is inserted into the tumor, and electric current is used to destroy cancer cells.

• Cryoablation: A probe freezes and destroys the tumor.

4. Targeted Therapy:

• Drugs like Bevacizumab, Axitinib, Pazopanib, and Sunitinib target specific genes and proteins to attack cancer cells.

5. Immunotherapy:

• Uses the body’s immune system to fight cancer cells. Drugs such as Nivolumab, Ipilimumab, and Pembrolizumab are used for advanced kidney cancer.

6. Radiation Therapy:

• High-energy radiation is used to destroy cancer cells. Radiation is usually not the primary treatment for kidney cancer but may be used when surgery is not an option or for palliative care.

Follow-Up Care for Kidney Cancer

Regular follow-up tests are crucial after treatment to monitor for recurrence or manage any side effects. Follow-up includes routine physical exams, blood tests, and imaging tests such as CT scans or MRIs to ensure the cancer has not returned.

‍