(Renal Cell Carcinoma)
Definition
Definition
Kidney cancer is a disease in which cancer cells grow in the kidneys. The kidneys are two bean-shaped organs. They are located just above the waist, on each side of the spine. Their main function is to filter the blood and produce urine.
There are 2 main types of kidney cancer: Wilms tumor, which occurs mainly in children, and renal cell carcinoma in adults. The cells that line the ureter may also give rise to transitional cell cancer, and the connective tissues of the kidney may produce sarcomas, which are rare.
Cancer Cell GrowthCopyright © Nucleus Medical Media, Inc.
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Causes
Causes
Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but it is probably a combination of genetics and environment.
Risk Factors
Risk Factors
Kidney cancer is more common in men, and in people over 50 years old. Other factors that may increase your risk for kidney cancer include:
- Smoking
- Family history of certain hereditary forms of kidney cancer
- Obesity
- Certain occupational exposures, such as asbestos and aniline
- Tanning products
- Exposure to some toxins, such as astrolachia, which is an herb that is common in some Chinese herbal preparations
- Balkan nephritis
- Chronic kidney stones
- Phenacetin abuse
- Tuberous sclerosis
- Dialysis treatment
- Von Hippel Lindau syndrome
Symptoms
Symptoms
Kidney cancer may cause:
- Blood in the urine
- Lower back pain or new pain elsewhere
- Shortness of breath or a cough
- A lump in the abdomen
- Unplanned, significant weight loss
- Fever
- Swelling of ankles, legs, and/or abdomen—edema
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Your bodily fluids and tissues may be tested. This can be done with:
- Blood tests
- Urine tests
- Biopsy—a sample of kidney tissue is taken and evaluated under a microscope
Other tests evaluate the kidneys and other structures. These may include:
- Bone scan
- Chest x-rays
- IV pyelogram
- Renal angiography
- CT scan
- MRI scan
- Renal ultrasound
- Laparoscopy
- Cytoscopy
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, kidney cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Treatment
Treatment
Cancer treatment varies depending on the stage and type of cancer. Surgery is the most important component of any approach to cure kidney cancer. There is some information suggesting immunotherapies may be of some benefit. Radiation therapy can be used to treat kidney cancer that has spread to the lung, bones, or brain, but it is not a cure. Chemotherapy is not a very effective form of treatment.
Surgery
Surgery involves the removal of a cancerous tumor, nearby tissue, and possibly nearby lymph nodes. Surgeries to treat kidney cancer include:
- Radical nephrectomy—removal of the entire kidney, adrenal gland, and nearby fatty tissue and lymph nodes
- Partial nephrectomy—removal of the cancerous part of the kidney only to treat smaller tumors that have not spread locally
- Removal of metastases—removal of cancerous tissue that has spread to other parts of the body, particularly when causing symptoms
Radiation Therapy
This is the use of radiation to kill cancer cells and shrink tumors. External radiation therapy is directed at the tumor from a source outside the body.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including pill, injection, and through a tube called a catheter. The drugs enter the bloodstream and travel through the body destroying mostly cancer cells but also some healthy cells.
Immunotherapy
This procedure involves the use of drugs like interleukin-2 and interferon alpha to help the immune system fight and destroy cancer cells.
Targeted Therapy
Targeted therapy includes using medications called tyrosine kinase inhibitors. These medications have been shown to increase the survival rate in people with kidney cancer. Another class of drugs called mammalian target of rapamycin (mTOR) inhibitors may also help people with kidney cancer live longer.
Medication
These medications may be prescribed to adults with advanced kidney cancer:
- Everolimus
- Pazopanib
Prevention
Prevention
Measures to prevent kidney cancer are limited. In general:
- Avoid using tobacco products
- Eat a healthful diet
- Try to avoid occupations that may expose you to harsh chemicals
RESOURCES:
CANADIAN RESOURCES:
References:
http://www.kidneycancer.org/knowledge/learn/about-kidney-cancer
Updated January 29, 2013. Accessed August 13, 2014.
Kidney cancer (adult)—renal cell carcinoma. American Cancer Society website. Available at:
http://www.cancer.org/acs/groups/cid/documents/webcontent/003107-pdf.pdf
Accessed August 13, 2014.
Kidney cancer—for patients. National Cancer Institute website. Available at:
http://www.cancer.gov/types/kidney
Accessed August 13, 2014.
Renal cell carcinoma. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated July 2, 2014. Accessed August 13, 2014.
10/1/2014 DynaMed’s Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed:
Bhaskaran K, Douglas I, Forbes H, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.
Last Updated: 10/1/2014