A pair of kidney bean-shaped kidneys, located above the waist on either side of the spine, filter and clean blood and produce urine. Each weighing about 150 grams is protected by a large pad of fat, lower ribs and several muscles from injury. The kidneys constantly decompose non-recyclable waste from recyclable waste in the body, and at the same time clean the blood.
What is Kidney Cancer?
Kidney cancer is a type of disease in which kidney cells become malignant, that is, cancerous, and form a tumor out of control. The source of kidney cancer is the abnormal growth of cells in the kidneys. Almost all kidney cancers first form in the lining of the small tubes (tubules) in the kidney, this type of kidney cancer is called renal cell carcinoma.
Renal cell carcinomas (RCCs) account for about 90 percent of kidney cancer, while other types of kidney cancer include:
- Transitional cell carcinoma, or cancer of the renal pelvis that begins on the inner surface of the renal pelvis
- Wilms tumor (nephroblastoma), the most common cancer in children aged 14 years and younger
- A rare renal sarcoma develops in the soft tissue of the kidney.
What are Benign (Non-Cancerous Lesions in the Kidney)?
Benign kidney tumors and kidney cancers can be treated by destroying them with many methods such as surgery or radiofrequency ablation. The choice of treatment depends on many factors, such as the size of the tumor, whether it is causing a symptom, the number of tumors, whether tumors are present in both kidneys, and the person’s general health.
Angiomyolipoma
The most common benign kidney tumors are angiomyolipomas. It is more common in women and can develop in people with the genetic condition tuberous sclerosis.
These tumors are made up of different types of connective tissue (blood vessels, smooth muscle, and fat) and can usually be monitored closely if they are not causing any symptoms. When they start to cause problems such as pain or bleeding, they may need to be treated.
Oncocytoma
Oncocytomas are uncommon, benign kidney tumors that can sometimes grow quite large, are more common in men and do not spread to other organs.
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What are the Causes of Kidney Cancer?
Kidney cancers make up about 2.5 percent of cancer types in men; It is twice as common in women. The risk of kidney cancer increases with advancing age, and most kidney cancer cases are observed in patients over 50 years of age. Although the exact cause of kidney cancer is not known, the following factors may increase the risk of developing it.
Smoking: The risk of developing kidney cancer in smokers is almost twice that of non-smokers, and about one-third of all types of kidney cancers are thought to be smoking-related.
Obesity: Obesity can cause changes in certain hormones that can lead to kidney cancer.
High blood pressure: High blood pressure can increase the risk of kidney cancer.
Kidney failure: People with kidney failure have a higher risk of developing kidney cancer.
Family history of cancer: People with a parent, brother, or sister (first-degree relative) of kidney cancer are at increased risk.
Hereditary conditions: About 2-3 percent of kidney cancers develop in people with certain inherited syndromes, including von Hippel-Lindau disease, hereditary papillary RCC, Birt-Hogg-Dubé syndrome, and Lynch syndrome.
Radiation exposure: The risk of developing kidney cancer may be increased in people who have previously undergone radiation therapy for treatment or have been exposed to long-term radiation for other reasons.
Exposure to toxic substances in the workplace: There may be a higher risk of developing kidney cancer after regular exposure to chemicals such as some metal degreasers, arsenic or cadmium used in mining, farming, welding and painting.
What are Kidney Cancer Patients?
Kidney cancer usually does not cause any obvious or disturbing symptoms in the early stages. Small tumors in the early stages can be detected by chance, especially in abdominal ultrasonography or tomography performed for another disease.
As the kidney tumor grows, the symptoms listed below may appear:
- Sometimes blood can be seen in the urine.
- A lump or mass in the kidney area
- Non-severe, persistent pain, especially in the lumbar region
Less common symptoms of kidney cancer may include:
- Tiredness
- Loss of appetite
- Weight loss
- High fever
High blood pressure or a low-than-normal red cell count (low RBC) (anemia) can also indicate a kidney tumor, but these symptoms are not common.
On the other hand, if the tumor has spread to organs such as bones and lungs, symptoms related to cough, bloody sputum, and bone pain may also be seen due to this spread.
How Is Kidney Cancer Diagnosed?
Because kidney cancer is usually asymptomatic, that is, asymptomatic, the tumor can often be detected when the patient undergoes medical testing for another reason. For example, in the ultrasound and computerized tomography examinations performed in any complaint of the patient, a kidney tumor that he is not aware of can be detected while the disease is still in its early stages. For example, when the patient consults a doctor with a complaint of gallbladder and is directed to ultrasound by an internist, there is a possibility of detecting a developing kidney tumor during the ultrasound.
Computed Tomography (CT) and MRI scans are often the only tests doctors need to diagnose kidney cancer, sometimes also performing what’s known as a percutaneous biopsy when physicians need more information about a tumor before recommending a treatment. In this procedure, the doctor numbs the skin with a local anesthetic, then uses a small needle to pull out some of the tissue.
Doctors may use CT scans or ultrasound (using sound waves to create an image on a computer monitor) to locate the tumor and guide needle insertion and withdrawal. The pathologist (the doctor who studies diseases in the lab) examines tissue samples under a microscope for signs of cancer.
Urine tests do not diagnose kidney cancer, but the physician may want to see if there is blood in the urine, which is a common sign of advanced kidney cancer, while blood tests help doctors determine whether the kidneys are working properly, but are not used to diagnose kidney cancer.
What are the Stages of Kidney Cancer?
Staging is an important part of the process of determining the extent of cancer and diagnosis. Because the most appropriate treatment options are determined according to the stage of the cancer. Stages of kidney cancer range from Stage I (least severe stage) to Stage IV. The doctor will discuss staging when patients are confirmed to have kidney cancer.
Stage I (Least severe stage)
The tumor is 7 cm or smaller and is found only in the kidney and has not spread to lymph nodes or distant organs.
Stage II
The tumor is larger than 7 cm and is found only in the kidney and has not spread to lymph nodes or distant organs.
Stage III
In stage III, the tumor extends to surrounding tissues other than the kidney and may have spread to regional lymph nodes.
Stage IV
The tumor has spread to areas outside Gerota’s fascia, the connective tissue layer that compresses the kidneys and adrenal glands, and extends into the adrenal gland. Cancer can also spread to multiple lymph nodes or to distant parts of the body, such as the bones, liver, and lungs.
How Is Kidney Cancer Treated?
It is possible that the options in the treatment of kidney cancer depend on a number of factors such as the general health of the patient, the type of kidney cancer he has, whether the cancer has spread, and treatment choices. The standard technique in the treatment of kidney cancers is surgery. The purpose of the procedure is to destroy the cancer while preserving, if possible, normal kidney function. The stage of the cancer, the size of the mass, the region of the kidney and the number of the mass are taken into account. If the cancer has spread beyond the kidney, additional treatments may be recommended.
Removal of the affected kidney (nephrectomy)
A complete (radical) nephrectomy involves removal of the entire kidney, the margin of healthy tissue, and sometimes additional nearby tissue such as lymph nodes, adrenal gland, or other structures.
The surgeon may perform a nephrectomy through a single incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen (laparoscopic or robotic assisted laparoscopic nephrectomy).
Removal of the tumor from the kidney (partial nephrectomy)
This procedure, also known as kidney-sparing or nephron-sparing surgery, is a common treatment for early-stage tumors. Kidney-sparing surgery aims to preserve as much kidney function as possible and reduce the risk of later complications such as kidney disease and the need for dialysis.
The effectiveness of non-surgical treatments such as chemotherapy and radiation therapy is not high in the treatment of kidney cancer.
Immunotherapy works to strengthen your body’s own immune system, a treatment option for patients with advanced kidney cancer. Cytokines (proteins that activate the immune system) can be administered intravenously or orally and can shrink the cancer, as well as targeted therapies for advanced kidney cancers. Targeted therapies target specific molecules, while targeted therapy drugs are usually given in tablet form or intravenously. Tyrosine kinase inhibitors (TKIs) have been tested in patients with advanced kidney cancer and have been shown to cause fewer side effects than chemotherapy drugs.
Note: Da Vinci Robotic Surgery provides great advantages to the person in kidney tumor surgeries. In cases such as partial removal of the kidney or removal of the tumorous part of the kidney, the problem is resolved by entering 4-5 holes through the abdomen, separating the tumorous tissue, without the need for a major surgical incision and without compromising oncological and surgical principles.
Frequently asked Questions
The surgeon inserts a catheter and inserts a synthetic material into the blood vessel, which blocks blood flow to the kidney, which deprives the tumor of oxygen and nutrients and causes it to shrink.
Since the causes of kidney cancer are not fully known, it is not possible to prevent the disease one hundred percent, but maintaining a healthy lifestyle, a healthy diet and a combination of regular exercise will help prevent obesity, which is an important risk factor for kidney cancer.
Recovery status in the process of kidney cancer varies according to the stage of the cancer. Although the average life expectancy of kidney cancer cases is determined by the stages of the cancer, this may differ from person to person.
