Kidney cancer guide

16/08/2022

Icon searchWhat is kidney cancer?

Each person has two kidneys, which are located above the waist on both sides of the spine. Each of them is the size of a tiny fist Kidneys filter blood, removing impurities, minerals, salts, and excess water. These organs filter about 200 litres of blood daily, producing 2 litres of urine. Kidneys also produce hormones that help control blood pressure, erythrocyte production and other body functions.

What is kidney cancer?Kidney cancer - is an uncontrolled and abnormal increase in cells in one or both kidneys, resulting in a tumour. The following types of kidney cancer are common:

  • Kidney carcinoma - is the most common kidney cancer in adults, accounting for about 85% of diagnoses. It develops in the renal canals that make up the kidney filtration system.
  • Urothelial carcinoma - is also called transitional cell carcinoma. The share of this cancer type accounts for 5% to 10% of cases diagnosed in adults and begins in the kidney area where urine gathers before entering the bladder called the renal pelvis.
  • Sarcoma - is a rare type that develops in soft kidney tissues, a layer of connective tissue, or surrounding fat.
  • Wilms Tumour- is the most common type in children. It accounts for about 1% of kidney cancer cases.
  • Lymphoma - this type is associated with an increase in lymph nodes in different parts of the body, including the abdominal cavity.

Kidney cancer is a widespread disease that ranks sixth among diagnosed cancers in men and ninth among women. It mainly affects adults from 60 to 70 years old and is quite rare in people under 50. However, the number of kidney cancer has been steadily growing by about 1% per year in recent decades.

Icon microscopeDiagnostic tests

Kidney cancer usually has no symptoms and is usually detected when the patient undergoes any diagnosis. However, as the tumour grows, the patient may have:

  • Blood in urine;
  • Lower back pain;
  • Unexplained weight loss, night sweating, fever or fatigue.

In addition to the physical examination by a doctor, the following tests will be used:

  • Blood and urine tests - this test checks the number of red blood cells in the blood and the presence of blood, bacteria or cancer cells in the urine. These tests may indicate the presence of kidney cancer but cannot be used to make an accurate diagnosis.
  • X-ray - obtaining a picture of structures inside the body using a small amount of radiation.
  • CT scan (computer tomography) - is a detailed scan in which several X-rays are taken, a computer brings them together, and the doctor receives a three-dimensional image of the kidneys. In addition, the doctor can administer a contrast agent in advance for more precise kidney visualization.
  • MRI scan (magnetic resonance imaging) - uses strong magnetic fields and radio waves to obtain a detailed image of the kidneys.
  • PET-CT scan (positron emission tomography) - is a detailed body scan that can be useful for investigating confirmed cases of kidney cancer. Also, it helps to determine whether cancer has spread and how well it responds to treatment.
  • Cystoscopy and nephroureteroscopy - a tiny illuminated tube is inserted into the bladder through the ureter and lifted into the kidney. The procedure can be used to obtain tumour cells for further investigation.
  • Biopsy - is the seizure of a small amount of tissue for research under a microscope. Only a biopsy can make an accurate diagnosis. Then the pathologist analyzes the sample and writes a report describing the results.

After the diagnostic tests are finished, the doctor will consider all the results. Next, the staging process will be carried out, which describes cancer in terms of its localization and degree of spread and helps doctors determine the best treatment strategy.

Icon doctorTreatment methods

The type of treatment to be recommended depends on the cancer stage and the general health. The type of tumour also has a significant impact.

  • Systemic chemotherapy - uses anticancer drugs administered intravenously or taken as tablets. It enters the bloodstream and reaches almost all body parts, making this treatment suitable for cancer that has spread (metastasized) to organs outside the kidney.
  • Targeted therapy - is aimed at finding changes in the structure of tumour cells. Thus, the method is harmless to healthy cells, as only malignant cells are destroyed.
  • Immunotherapy - certain drugs are used to strengthen the patient's immune system to increase her ability to fight abnormal cells.
  • Radiation therapy - is a method in which high-energy radiation is used to target cancer cells to destroy them.
  • Surgical treatment - is the primary treatment for many types of kidney cancer. Kidney surgery can be performed in various types.
    • Radical nephrectomy - during this operation, the surgeon removes the entire kidney, attached adrenal gland, nearby lymph nodes and fatty tissue around the kidney. Most people do a great job with only one working kidney.
    • Partial nephrectomy (kidney preservation surgery) - the surgeon removes only the part that contains cancer, leaving the rest of the kidney.

Icon plusNew treatment options

Today, the treatment of kidney cancer looks very different from just ten years ago. According to the American Cancer Society, modern scientific achievements and the creation of new drugs have changed treatment methods and, in many cases, the disease statistics.

  • Renal artery embolization (RAE) - is a procedure in which the kidney artery that supplies the tumour is blocked. The doctor places a thin tube (called a catheter) in a large blood vessel in the groin and blocks blood flow to the kidney tumour. Without nutrients and oxygen, the kidney tumour will decrease.
  • Transarterial chemoembolization (TACE) for metastases - chemotherapeutic drugs block the tumour blood supply and keep chemotherapy inside it. Introduction of drugs directly into the tumour focus on blood vessels that feed cancer.
  • Transarterial chemoperfusion (TACP) for metastases - antitumor drugs are injected into the kidney tumour through blood vessels. It ensures a more extended stay and exposure to the tumour of a higher drug concentration.
  • Ablation (RFA, MWA, Ethanol) - a needle or probe affects the kidney tumour with electric current, thermal energy or ethanol. It leads to the reduction and destruction of kidney formation.
  • Proton therapy - is the use of high-energy X-rays to destroy cancer cells.
  • Surgical treatment (robot-assisted kidney surgery da Vinci®) - the surgeon makes several small incisions in the abdominal cavity, not one large incision, as in a traditional surgical procedure. The surgeon then inserts the equipment into these small incisions. The doctor uses robotic tools to operate. As a rule, such an operation is less painful.

The treating team can offer one or a set of treatment methods and procedures, including both traditional and the latest ones.

Icon chartStatistics and prognosis

In the United States alone, there are almost 17 million kidney cancer survivors, so it is essential to help patients with active treatment. In this aspect, survival prediction is significant, as it allows us to look at the future in overcoming kidney cancer through a statistical prism.

The American Cancer Society, using information from the database from 2011 to 2017 to the National Cancer Institute, provides the following data. For patients with localized kidney cancer (cancer has not spread outside the organ), the total 5-year survival rate is 93%. When cancer spreads outside the kidney to nearby lymph nodes for regional disease, the survival rate is about 71%. When cancer spreads to remote parts of the body (metastatic kidney cancer), the survival rate is 14%.

Statistics and prognosis

References:

  1. American Cancer Society: Survival Rates for Kidney Cancer
  2. American Cancer Society: Radiation Therapy for Kidney Cancer
  3. ONCOLINK: Radiation Therapy for Kidney Cancer
  4. Canadian Cancer Society: Arterial embolization for kidney cancer
  5. National Kidney Foundation Inc: Kidney Cancer
  6. Cancer Research UK: Living with advanced kidney cancer
  7. Everyday Health: 6 Strategies for Thriving as a Kidney Cancer Survivor
  8. Cancer.Net: Kidney Cancer: Risk Factors and Prevention
  9. NHS: Treatment - Kidney cancer
  10. Healthline Media: What’s the Connection Between Kidney Cancer Stage and Five-Year Survival Rates?