The kidneys are two bean shaped organs, located in your lower abdomen on either side of your spine. The kidneys are highly effective at filtering out waste from the blood and producing urine. There are a number of different types of cancer that can affect the kidneys. The National Cancer Institute estimates that over 63,000 people were diagnosed with kidney cancer in the United States in 2017. The incidence of kidney cancer appears to be on the rise, according to the Mayo Clinic. One possible reason may be the increased frequency of screening by computerized tomography (CT) scans.
Symptoms of Kidney Cancer
Kidney cancer rarely causes noticeable symptoms in the very early stages. As the disease progresses, the most common symptoms include:
- persistent back pain, especially just below your ribs
- blood in your urine
- unexplained weight loss
- abdominal pain and swelling
- a lump in the abdomen
- recurring fevers
- flank pain
What are the main types of Kidney Cancer?
There are several types of cancer that can affect the kidneys. Adenocarcinoma of the kidney, also known as renal cell carcinoma, is one such example. It’s the most common type of kidney cancer in adults and starts in the are of the kidney that is responsible for filtering blood. Renal pelvis carcinoma starts in the area of the kidney where urine is collected and processed.
Wilms tumor, otherwise known as nephroblastoma, is the most common type of kidney cancer in children under the age of 5. There are other types of kidney cancer, but they are considerably rare. The cause of kidney cancer is currently unknown. However, the risk factors for kidney cancer frequently include:
- older age
- being male
- kidney disease
- family history
- being exposed to toxins in the workplace
There are also several inherited conditions that can increase your risk of kidney cancer. These hereditary conditions include von Hippel-Lindau disease and hereditary papillary renal cell carcinoma.
How is Kidney Cancer diagnosed?
A proper diagnosis of kidney cancer requires a complete medical history and physical exam. The doctor will look for abdominal swelling or a lump in your lower abdomen. For male patients, the doctor will also look for an enlarged, twisted vein, or varicocele, in the scrotum. The primary tests that can be used to detect kidney cancer include:
Complete blood count
The kidneys produce a hormone called erythropoietin which stimulates the production of red blood cells. A complete blood count can reveal if your red blood cell count is high, which would indicate polycythemia, or low, which would indicate signs of anemia.
Blood chemistry tests
Blood chemistry tests can help demonstrate how well your kidneys are functioning. Kidney cancer can also influence the levels of certain chemicals in your blood, such as liver enzymes and calcium.
A urinalysis can allow your doctor to determine if there’s blood present in your urine. It may also reveal other signs of an infection.
Ultrasound of the abdomen and kidneys
An abdominal ultrasound can measure the size and shape of your kidneys. If a tumor is present, an ultrasound may reveal its size and consistency.
In this test, the doctor inserts a catheter into a large artery in your leg or groin, to access the renal artery and inject a special dye into the artery. After the dye is injected, the doctor will take a series of X-rays. This helps your doctor see the blood supply to your kidneys in detail. If a tumor is present, the reduced blood supply to the tumor can be seen.
In this test, a healthcare provider will inject a special dye into one of your veins. The dye allows your kidneys to be seen more clearly with X-rays. This test can help your doctor find a tumor or obstruction.
CT scan of the abdomen
A CT scan is a noninvasive test that uses X-rays to create cross-sectional images of your body, allowing the following to be viewed:
- blood vessels
It can also be used to find out if cancer has spread beyond the kidney. The following tests are frequently used to determine whether kidney cancer has started to spread:
- an MRI scan of the abdomen
- a bone scan
- a chest X-ray
- a PET scan
- a chest or abdominal CT scan
Treatment options for Kidney Cancer
Treatment for kidney cancer focuses primarily on removing the tumor from the body. This is usually accomplished through surgery, but this surgery can be either radical or conservative, depending on the degree of spread.
A radical nephrectomy is a surgical procedure that removes your kidney. The entire organ is removed, along with some surrounding tissue and lymph nodes. The adrenal gland may be removed as well. The surgery can be done through a large incision or with a laparoscope, which consists of a thin tube with a tiny camera at one end.
Conservative nephrectomy removes only the tumor, lymph nodes, and some surrounding tissue. Part of the kidney is left behind. This is also known as a nephron-sparing nephrectomy. Tumor cells can also be killed by freezing, which is called cryosurgery, or radiofrequency ablation, which involves applying heat.
Metastatic kidney cancer
Metastatic kidney cancer can’t be treated with surgery alone. After as much tumor is removed as possible with surgery, other treatments may be necessary. These may include immunotherapy, targeted therapy, and radiation. The treatments can have side effects.
Immunotherapy uses synthetic versions of immunoactive chemicals found in the body. Interferon and aldesleukin (Proleukin) are examples of drugs used in immunotherapy.
Targeted medications are designed to block certain abnormal signals present in kidney cancer cells. Examples of targeted medications include:
- axitinib (Inlyta)
- bevacizumab (Avastin)
- pazopanib (Votrient)
- sorafenib (Nexavar)
- sunitinib (Sutent)
They help stop the formation of new blood vessels to supply nutrients to the cancer cells.
Long-term outlook for people with Kidney Cancer
The long-term outlook for people with kidney cancer varies from person to person. A positive outcome very much depends on how quickly the cancer is identified and how well it responds to treatment. Approximately 65 percent of kidney and renal pelvis cancers are diagnosed before they have spread to any great degree. The cancer can spread, or metastasize, to the other kidney, but it’s more likely to spread to the lungs. Metastatic cancer, however, is much more difficult to treat.
Kidney cancer can be further complicated by:
- high blood pressure
- high levels of calcium in the blood
- overproduction of red blood cells
- liver problems
Survival rates for kidney cancer are higher when the condition is treated in the early stages. For example, the American Cancer Society reports that the observed five-year survival rate for stage 1 kidney cancer is 81 percent. If diagnosed early, the odds of survival are very high.
Prevention of Kidney Cancer
Living a healthy lifestyle is the best way to reduce your risk of kidney cancer. Specific steps you can take to reduce your risk include:
- not smoking
- eating a balanced diet
- maintaining a healthy weight
- protecting yourself from chemical toxins at work
- controlling your blood pressure
As always, if you suspect that you may be at risk of this disease or any other, please contact your physician and book an appointment to discuss your concerns with a medical professional.