Kidney Cancer

Overview

Kidney cancer develops when cells in the kidney grow uncontrollably. It is associated with symptoms such as blood in urine, pain in the side, fatigue, and weight loss as the disease progresses in stages. Risk factors of this condition include smoking, obesity, and family history. Early detection and treatment of kidney cancer can improve the chances of their recovery. Hence, doctors recommend tests such as blood tests, urine tests, and imaging scans to confirm their presence. Accordingly, they determine the appropriate treatment options, which mostly include surgery, chemotherapy, immunotherapy, and targeted therapy.

What is Kidney Cancer?

Kidney cancer is the rapid growth and division of cells in the kidney tissue. In the early stages of the disease, these cells form a mass or a tumour. With a mutation in the cells, they divide uncontrollably, leading to the development of malignant cancer. Thus, these cancerous cells spread to adjacent tissue or vital body organs (metastasis), leading to the spread of cancer all over the body.

Types of Kidney Cancer

The following are the different types of kidney cancer:

Renal Cell Carcinoma (RCC): This cancer type accounts for 85% of kidney cancer cases. It develops as a single tumour in a kidney, affecting both the kidneys eventually. Cancerous cells divide and grow rapidly in the cells that line one's kidneys’s tubules. Clear cell renal cell carcinoma (ccRCC) is the most common RCC type.

Transitional Cell Cancer: It causes 6% to 7% of kidney cancers, wherein cancer cells develop in the area where the ureter connects to the kidneys's main part (renal pelvis). These cancerous cells can also begin in the bladder or ureters.

Wilms Tumour: It is the most common kidney cancer type in children, accounting for about 5% of cancer cases. Also known as nephroblastoma, the tumour begins in cells of the kidney, affecting only one kidney.

Renal Sarcoma: They account for only 1% of all kidney cancers and are the least common cancer type. It occurs in the kidneys' connective tissues, which, if not treated in the early stages, can spread to nearby bones and organs.

Symptoms of Kidney Cancer

An individual may not experience any noticeable symptoms in the early stages of kidney cancer. However, with the gradual growth of the tumour, the symptoms may start appearing in an individual. These may include flank pain, a mass or lump in the kidney area, blood in pee (hematuria), high calcium, anaemia, high blood pressure, bone pain, appetite loss, weight loss, tiredness and a general sense of not feeling well.

Causes of Kidney Cancer

Medical experts have not found the exact causes of kidney cancer. However, certain lifestyle and environmental factors can increase an individual's risk of getting the disease. These include an individual being obese, having a habit of smoking or having medical conditions such as diabetes or high blood pressure. A family history of kidney cancer can also increase the risk of developing the cancer.

Gene mutations are one of the other major risk factors. Additionally, a medical history of exposure to radiation therapy or long-term dialysis treatment may raise the chances of the development of kidney cancer. Other medical conditions that increase the risk of cancer include the tuberous sclerosis complex and von Hippel-Lindau disease (VHL).

Various other risk factors include being male and having chronic kidney disease (CKD), kidney stones, sickle cell train or long-term hepatitis C infection. Prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) and exposure to toxins such as asbestos, herbicides and trichloroethylene in the workplace can also raise the risk.

Diagnosis of Kidney Cancer

The diagnosis of kidney cancer starts with a physical examination. The doctor looks for a lump in the abdomen or abdominal swelling. They may also look for twisted veins, enlargements or varicoceles in men's scrotum. Upon that, a medical expert may ask the individual to carry out certain tests including urinalysis, ultrasound of the kidneys and abdomen, complete blood count (CBC), arteriogram, blood chemistry tests, intravenous pyelogram and an abdomen CT scan.

Some other tests that can help a doctor determine if the cancer has spread to other organs or the lymph nodes may include a PET scan, chest x-ray, bone scan, chest CT scan and an abdomen MRI scan. A doctor may also consider renal mass biopsy to determine if the abnormal cell growth is cancerous.

Doctors stage kidney cancer to understand the size of the tumour, its presence in the body and if it has spread across other vital body organs. These factors help a healthcare professional in determining treatment plans. Following are the different stages of kidney cancer:

• Stage I: The cancerous cells are limited to the kidney, where the tumour grows not more than 7 cm in diameter.
• Stage II: The tumour may have spread to the tissues or fat of the kidney, growing larger than 7 cm. However, the cancerous cells have not spread to other organs or the lymph nodes.
• Stage III: The tumour has grown larger and extended to the major blood vessels of the body (renal vein and inferior vena cava). However, it has not reached the lymph nodes or other organs.
• Stage IV: In the first half of stage IV (IV a), the cancer has spread to adrenal glands, present near the lymph nodes or the adjacent organs. In the later stages (IV b), the cancer has metastasised to distant organs or lymph nodes.

Tumours are also rated based on how the cancerous cells look, this is also called grading of tumour. It also helps a doctor understand how fast the tumour can grow and spread. High-grade tumours divide, grow and spread more rapidly than low-grade tumours.

Treatment for Kidney Cancer

The treatment for kidney cancer depends on factors such as its stage and grade, including the overall health and age of the patient. Surgery is a common treatment choice for most kidney cancer stages, which may include radical nephrectomy and partial nephrectomy.

Ablation testament follows the destruction of cancer cells through exposure to extreme heat or cold; including radiofrequency ablation and cryoablation. Other treatment options include radiation therapy, targeted drug therapy (lenvatinib or lenvima), chemotherapy and immunotherapy (pembrolizumab or keytruda and nivolumab or opdivo).

Prevention of Kidney Cancer

Kidney cancer cannot be prevented since the exact causes of it are unknown. However, one may be able to alleviate the risk of kidney cancer by incorporating lifestyle changes (limiting smoking and alcohol) and managing health conditions such as obesity, diabetes and high blood pressure.

Myths and Facts Related to Kidney Cancer

Here are some of the myths and facts about kidney cancer:

Myth 1: Kidney Cancer Cannot be Diagnosed Early
Fact: Regular check-ups and screenings can help detect kidney cancer early, leading to more effective treatment and better outcomes.

Myth 2: Smoking Cannot Lead to Kidney Cancer
Fact: Smoking is a major risk factor for kidney cancer, increasing the chances of developing the disease.

Myth 3: Women are at a Higher Risk for Kidney Cancer
Fact: Studies show that men are twice as likely to develop kidney cancer as women.