kidney (renal) cancer 

Facts about kidney (renal) cancer | Kidney Cancer Treatment 

Q 1 what is kidney (renal) cancer? 

The kidneys are a pair of bean-shaped organs on either side of the abdomen. Cancer can affect the right or left kidney or both the kidneys simultaneously. Kidneys remove the waste product from the body and produce urine.  Urine produced from kidneys passes through soft tubes called ureters. Ureters are connected to the urinary bladder. 

Q 2 What causes the kidney (renal) cancer?

  • Smoking 
  • Hypertension
  • Obesity
  • Occupational exposure — Exposure to toxic compounds, such as cadmium, asbestos, and petroleum byproducts
  • Analgesics (Pain killers) — the prolonged ingestion of analgesic combinations, particularly phenacetin and aspirin.  
  • Genetic diseases like  
  • Inherited polycystic disease
  • Hereditary papillary renal carcinoma
  • Hereditary leiomyomatosis and renal cell cancer syndrome

Q 3 what are the types of kidney (renal) cancer? 

  • Clear cell It is the most common type
  • Papillary 
  • Chromophobe 
  • Oncocytic 
  • Collecting duct 

Q 4 what are the symptoms of kidney (renal) cancer? 

  • Flank pain
  • Blood in the urine (hematuria)
  • Swelling in abdominal
  • Advanced disease may present with symptoms suggestive of organs involved. An example includes cough and difficulty in breathing due to lung involvement, bone pains due to bone involvement by cancer, anemia, and fever. 

A word of caution

All of these symptoms can also be caused by conditions that are not cancer. Kindly consult your doctor first. 

Q 5 How is kidney (renal) cancer diagnosed? 

  • CT scan of abdomen or ultrasonography  

If CT scan is suggestive of cancer, then further tests are done to look for further spread of cancer

  • Blood tests – to assess the state of liver, kidneys and bone marrow
  • CT scan chest 
  • Bone scan 
  • Sometimes PET scan: To know the distant spread of disease  

Q 6 What is the role of a biopsy in kidney cancer? 

  • If cancer is suspected in the kidney on imaging like CT scan and it is found not to spread to the surrounding structure, then a biopsy is never done and the surgeon directly proceeds for surgery. 
  • A biopsy is only done in advanced cases where the operation is not possible. 

Q 7 What is kidney cancer staging? 

Staging is a measurement of how far cancer has spread.

After all the tests have been completed and the results are known, it should be possible to predict what stage the cancer is. The higher the stage, further cancer has spread.

Four main stages

  • Stage 1 – The cancer is within the kidney. And is less than 7 cm in size. 
  • Stage 2 – The cancer is larger than 7 cm but is still confined to the kidney. 
  • Stage 3 – Cancer has moved nearby outside the kidney, but has not spread to distant organs. 
  • Stage 4 – The kidney cancer has spread widely outside the kidney, to the abdominal cavity, the adrenal glands, and distant lymph nodes or to other organs, such as the lungs, liver, bones, or brain. 

A word of caution 

The above staging is a simplified version for your basic understanding. The reader is advised to follow the TNM staging system developed by the American Joint Committee on Cancer (AJCC) in which 

  • T stands for the size and location of the primary tumor
  • N stands for nodes. It tells whether cancer has spread to the nearby lymph nodes
  • M stands for metastasis. It tells whether cancer has spread to distant parts of the body

Q 8 How kidney cancer is treated? 

Kidney cancer is curable if diagnosed at an early stage. Surgery is the only curative option. 

When deciding treatment options for a particular patient, the doctor will consider the following factors and will decide individual treatment plan:

  • The size of the cancer
  • The stage of the cancer
  • The location of the cancer
  • Your overall health and ability to recover from surgery, radiation therapy or chemotherapy
  • Your personal preferences

Following are the general guidelines but treatment may vary from patient to patient:  

  • Localized renal cell carcinoma (stage 1, 2 & 3) 

Surgery only: Two types of surgery 

  • Radical nephrectomy: Complete removal of kidney
  • Partial nephrectomy: Partial removal of kidney 
  • The choice of surgical procedure depends upon the extent of disease, as well as patient-specific factors such as age and associated diseases like diabetes or hypertension.  
  • Surgery may be carried out through an open approach or by a minimally-invasive approach such as laparoscopy.
  • Advanced renal cell carcinoma (stage 4) 
  • Immunotherapy
  • Targeted therapy 
  • Sometimes surgery in selected cases 
  • Radiation therapy (RT) to relieve symptoms and improve the quality of life.