Renal Cancer
Cancer that starts in the kidneys, often affecting kidney function.
Cancer Treatment
Renal Cancer
Kidneys are two reddish-brown bean-shaped organs about the size of a fist located at the posterior side on either side of the spine, just below the ribcage. Their function is to filter blood to remove impurities, excess minerals and salts and extra water. Kidneys also produce hormones that control blood pressure and affect red blood cell production.
Renal cancer or kidney cancer originates from cells lining the proximal tubules of the kidney. Kidneys are made up of numerous nephrons, which are the microscopic structural and functional units of the kidneys.
The proximal tubule is a part of these nephrons which plays a vital role in kidney functions like absorption of glucose, amino acids and other solutes from blood and ultimately helps in the formation of urine that removes toxins from our body.
Symptoms of Renal Cancer
- Hematuria or blood in the urine
- Flank or back pain
- Lump in the abdomen or flank region
- Fever
- Advanced disease can present with non-reducing varicocele, lower limb swelling, weight loss, bony pains, neck lymph nodes etc.
Although most people have two functioning kidneys, both function independently of each other. Thus, if one kidney has become dysfunctional or has been removed (for any reason), that person can still survive with a single normal functioning kidney.
Causes of Renal cancer
Various risk factors that can increase the chances of kidneys being affected by renal cancer are:
- Smoking: Smoking has been shown to increase the risk of renal cancer. Extensive studies have shown about 38 to 40% increased risk of renal cancer in current and formal smokers.
- Obesity: Obese individuals are more at risk of developing renal cancer.
- Hypertension: Hypertensive individuals are at an increased risk of contracting renal cancer.
- Prolonged use of pain medications: Prolonged use of medications to reduce pain (analgesics), can also increase an individual’s risk of contracting renal cancer.
- Long-term dialysis: Need for long-term dialysis in patients with chronic renal failure, has also been revealed to increase the risk of contracting renal cancer.
- Genetic conditions: Inherited syndromes like von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, Tuberous sclerosis complex, Hereditary papillary renal cell carcinoma or Familial renal cancer increases an individual’s risk of acquiring renal cancer.
- Family history: A positive family history of renal cancer in first-degree relatives, has been associated with an increased risk of acquiring renal cancer.
Types of Renal Cancer
- Renal cell carcinoma: Renal cell carcinoma (RCC) is the most common type of kidney cancer affecting adults, making up 85 to 90% of all renal cancers. The major histological variants include clear cell carcinoma, papillary renal carcinoma types 1 & 2, chromophobe carcinoma and collecting duct carcinoma.
- Urothelial carcinoma: This is also called transitional cell carcinoma and accounts for only 5% of cases of all renal cancers. Transitional cells are present in the renal pelvis, which functions as a funnel for urine to flow to the ureter and then into the urinary bladder. Urothelial or transitional cell carcinomas, hence begin in the renal pelvis.
- Sarcoma: Renal sarcomas are rare and account for only 1-2 % of all renal cancers. Fibrosarcomas are the most common type and have a poor prognosis due to late diagnosis. Other types of renal sarcomas include rhabdomyosarcoma, leiomyosarcoma, liposarcoma, osteogenic sarcoma etc.
- Wilms tumour: Wilms tumour or nephroblastoma is the most common renal cancer affecting children. It usually affects children aged 3-4 years. Children affected with Wilms tumour experience excellent survival chances, with multi-modality treatments that are currently available
Prevention of Renal Cancer
Preventive measures to reduce the risk of contracting renal cancer are:
- Avoid smoking and exposure to tobacco substances
- Maintain a healthy weight through regular exercises and a proper diet.
- Regular health check-ups to ensure your blood pressure is under control. Follow doctor instructions concerning on-time medications, a salt-restricted diet, regular exercises, etc., to maintain normal blood pressure.
- Avoid excessive use of pain medications without appropriate medical consultations.
- Patients on long-term dialysis or those with inherited genetic syndromes having a higher risk of acquiring renal cancer should undergo regular screening with their doctors to detect renal cancers at early stages, thus ensuring excellent outcomes.
When to see the doctor?
The symptoms can appear in different forms as mentioned above and hence, if you are experiencing a combination of any of these symptoms, especially over longer periods, you should consult a doctor.
Treatment for Renal Cancer
The treatment for renal cancer depends upon cancer staging, the patient’s health and medical conditions, nutritional status etc.
The different treatment strategies include:
- Radical Nephrectomy: In large tumours involving most of the kidney or central part of the kidney, radical nephrectomy is performed. This procedure involves the removal of the entire kidney along with the surrounding fatty tissue and most often the ipsilateral adrenal gland. A radical lymph nodal dissection is usually performed simultaneously to remove all the draining lymph nodes in the surrounding region.
- Partial Nephrectomy or Nephron sparing surgery: A partial nephrectomy takes preference in patients with smaller tumours, usually located towards the upper or lower parts of the kidney. The objective is to remove the entire tumour with the diseased tissues while preserving the healthy tissues of the kidney.
- Cytoreductive Nephrectomy: A nephrectomy is usually not performed in patients with stage IV renal cancer but is necessitated in unique conditions wherein the patient is diagnosed with stage IV (metastatic) renal cancer, wherein the renal tumour is forming the main tumour bulk or the patient is experiencing significant pain and persistent hematuria, not improving with conventional treatments.
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