Kidney Cancer

There are two main sub-types of kidney cancer:

  • Renal cell carcinomas begin in the parenchyma of the kidney.
  • Urothelial carcinoma arises in the lining of the kidney and/or ureter. 

Each sub-type has unique DNA changes and is treated with different surgical and biological therapies. Our research team has developed much of the basic science about the differences between sub-types.

Blood in the urine, pain in the flank or a mass felt on physical examination are typical indications a person may have cancer. However, far more common conditions, like urinary tract infections, kidney stones, kidney cysts, or other medical problems, can cause these symptoms as well. The majority of kidney cancers are now detected using ultrasound, CT or MRI scans performed for reasons that may or may not be related to kidney symptoms.

Treatments for Kidney Cancer

Surgery is the primary treatment, particularly for patients with localized disease. When possible, treatment with preservation of the functioning portion of the kidney is performed.

Multiple options for kidney-sparing surgery exist, including minimally invasive, as well as open, partial nephrectomy. Depending on the size and location of the tumor, percutaneous ablation is another possibility.

For larger tumors, removal of the entire kidney may be necessary. For advanced stage cancer, systemic drugs are used to treat cancer that has spread outside of the kidney or to prevent it from spreading.

Ablation
Ablation uses high-energy radio waves to heat the tumor and destroy cancer cells. This outpatient procedure is useful if you are too sick to have surgery.

Active Monitoring
Also called "watchful waiting," you can forego the side effects of treatment with careful monitoring of the stage of this cancer.

Biologic Therapy
This procedure uses your body's immune system to fight your cancer. This is done by either stimulating your immune system to attack cancer cells or by introducing agents it needs, like antibodies, to kill them.

Chemotherapy
This well-known cancer treatment uses medicines taken intravenously or by mouth to kill cancer cells throughout the body. Chemotherapy may be given before surgery to shrink tumors, or after to fight cancer cells that have potentially spread.

Kidney-Sparing Surgery
Surgery meant to remove cancerous growths or tissues on the kidney while also saving as much of the organ as possible.  

Radical Nephrectomy
This surgery is the complete removal of the kidney. Often the adrenal gland surrounding the infected lymph nodes is removed as well. 

Robotic–Assisted Surgery
We have staff surgeons who specialize in using the daVinci(R) robotic system to treat various UGI cancers. Allowing greater dexterity and precision, robotic-assisted surgery can reduce complications and speed recovery.

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What Is Kidney Cancer?

The kidneys are reddish-brown bean-shaped organs located just above the waist, one on each side of the spine. As part of the urinary system, their main jobs are filtering blood and making urine to get rid of body wastes. Renal cell carcinoma is a certain type of kidney cancer. It accounts for 90% to 95% of kidney cancers, but it’s not very common (occurs in 1 of 10,000 people yearly). Twice as many men as women have it, usually between 50 and 70 years old.

What Causes Kidney Cancer?

The cause is unknown. However, risk factors include cigarette smoking, radiation, and on-the-job exposure to petroleum products, asbestos, or steel plant emissions. People with von Hippel-Lindau disease, tuberous sclerosis, and polycystic kidney disease have an increased risk for this cancer.

What Are the Symptoms of Kidney Cancer?

Early disease may cause no symptoms. As the tumor grows, symptoms may include blood in the urine, lump or mass in the kidney area, tiredness, loss of appetite, weight loss, fevers, and pain in the abdomen (belly).

How Is Kidney Cancer Diagnosed?

The health care provider makes a preliminary diagnosis by using special x-rays including computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography. The only way to confirm the diagnosis is with a biopsy. For a biopsy, the doctor removes a small piece of the kidney and checks it with a microscope. CT or MRI is also used to learn the stage or extent of disease, which helps plan treatment. Staging tells the health care provider whether the cancer has spread and if so how far, such as to lymph nodes (glands) or lungs.

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How Is Kidney Cancer Treated?

The most common treatment is an operation to remove the kidney (nephrectomy). The whole kidney, adrenal gland, tissue around the kidney, and lymph nodes may be removed. A procedure called arterial embolization may be used to shrink the tumor. It blocks the main blood vessel to the kidney so the tumor doesn’t get the oxygen-carrying blood and other substances that it needs to grow.

Radiation therapy (or radiotherapy) uses high-energy radiation to kill cancer cells. It can also be used to relieve pain (as palliative therapy) when kidney cancer spread to bones.

Chemotherapy (drugs for killing cancer cells) is generally not very helpful against kidney cancer. Immunotherapy involves the use of biological agents such as interferon, sunitinib, and bevacizumab. It is a newer treatment modality that has shown some success in the treatment of advanced kidney cancer.

DOs and DON’Ts in Managing Kidney Cancer:
  • DO understand that diagnosis and treatment of this cancer will need a team of doctors including your primary care health care provider, surgeon, oncologist (specialist in cancer), and maybe radiation oncologist (specialist in use of radiation to treat cancer).
  • DO call your health care provider if you see blood in your urine or you have pain or a lump in your abdomen.
  • DO call your health care provider if you have fever after surgery.
  • DO call your health care provider if you see drainage from the surgical incision site.
  • DON’T forget that all treatments have side effects. For example, surgery can cause pain and infection. Radiation can cause dry, red, itchy skin. Chemotherapy can cause nausea, vomiting, hair loss, easy bruising, easy bleeding, and infections.
  • DON’T be afraid to ask for a second opinion.
FOR MORE INFORMATION

Contact the following sources:

  • National Cancer Institute
    Tel: (800) 422-6237
    Website: http://www.cancer.gov
  • American Cancer Society
    Tel: (800) 227-2345
    Website: http://www.cancer.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor