The bean shaped organs sitting in the lower abdomen on either side of the spinal cord are the Kidneys. They clean the blood by removing/filtering the waste from it and making urine. Kidney Cancer is a medical condition when the cells inside the kidneys become cancerous and multiply in more than required numbers. The over population of these cancerous cells form tumours in kidneys, starting with the lining of small tubes in the kidneys. Kidney cancer tumours may not be detected when they are small and in initial stages but the good news is, kidney cancer is treatable as long as it has not ‘metastasized’ (spread to other organs or parts of the body).
What causes kidney cancer?
The exact cause of kidney cancer is not known but what puts people at risk of Kidney cancer are listed below:
- Smoking – Smoking tobacco and cigars puts people at increased risk of various cancers including kidney cancer.
- Men are twice likely to get kidney cancer than women as per statistics.
- Overweight or being obese causes changes in the hormones released by the body, leading to different types of cancers.
- Using pain medications – If you are taking pain medication because of a doctor’s prescription or on your own, pain killers will put you at higher risk of getting kidney cancer.
- Genetic conditions and Family history – If your parents had kidney cancer, you may inherit it.
- High blood pressure – It is not clear if high BP can lead to kidney cancer or the medications used to treat high BP leads to kidney cancer.
- If you are suffering from lymphoma, you are at higher risk of suffering from kidney cancer.
Symptoms of kidney cancer
Unfortunately, symptoms of kidney cancer may not appear until the tumours grow larger inside the kidneys. Common symptoms of kidney cancer include:
- Blood in urine. (This cannot be the only symptom because, blood in urine can be seen in cases due to stones in kidneys, bladder etc)
- A lump on the sides or abdomen. The person also feels persistent pain on that side.
- Loss of appetite and weight loss for no known reason.
- Fever without any infection
- Feeling fatigued all the time
- Swelling of ankles or legs.
The above symptoms will be seen when the cancer has not ‘metastasized’ to other parts of the body. If it spreads to other parts, more symptoms will be seen depending on which body part it has affected. Coughing up of blood, Shortness of breath indicates that the lungs are also affected. Weak bones and bone fracture indicates that the cancer has reached the bone marrow. If the brain is affected, neurological symptoms will be seen.
Diagnosing Kidney Cancer
If you happen to have any of the symptoms mentioned above, please get in touch with a good urologist immediately for a physical examination. An expert urologist can detect if something is not quite right with a simple yet thorough physical test. He/she may ask for other symptoms, your current medication and health history of your family members. Fever, high blood pressure, your health habits may indicate your doctor about the possibility of kidney cancer. He/she may then order for any of the following tests:
- Urine test – to check if there is any presence of blood in it
- Blood test – tells whether the kidneys are functioning properly.
- Intravenous Pyelogram (IVP), currently treated as an old procedure after the usage of CT and MRIs but some doctors still go for this testing. This involves injecting a dye that travels to the urinary tract and then an X ray is taken to take a clear look at the complete urinary system.
- Ultrasound – gives a picture of the kidneys, tumours and the contents of the tumours. (they can be either solid or fluid filled).
- CT Scan & MRI – used to generate a detailed picture of kidneys.
- Renal Arteriogram – This is used to evaluate the blood supply to the tumours.
- Biopsy – A specialist will be almost certain about the cancer without going for a biopsy. But, sometimes, he/she may need to take a small tissue from the tumours and examine it under a microscope to look for cancer cells. This also gives him/her an idea about the cancer and it’s ability to spread to other parts of the body.
After diagnosis of the cancer, it is important to check the stage of kidney cancer. He/she will require more tests to check if the cancer has spread to other parts of the body. CT Scans or MRIs may be required along with chest X rays.
Stages of kidney cancer
Instead of long boring text, we thought it would be easier to put into a tabular form.
Treatment options for kidney cancer
Depending on the stage of the cancer, your expert urologist may chalk out a treatment plan for your kidney cancer. You can discuss all you want with the doctor. Before going ahead with the treatment, you can go for a second opinion also with another specialist and take his/her inputs about the treatment plan. First most common treatment will be a surgery to remove the tumour. Once the tumour is removed, further treatments will be advised to kill any other cancer cells that might be left over.
Types of surgeries for Kidney Cancer
- Radical Nephrectomy – Removal of the kidney, adrenal gland and the surrounding tissue. More often, surrounding lymph nodes may also be removed. The surgery is performed by making a small incision and by using a laparoscope.
- Simple Nephrectomy – Removal of the kidney alone.
- Partial Nephrectomy – This procedure is used for patients with smaller tumors (typically less than 4cms in size) or in cases where complete removal of kidney may affect the other kidney. In this surgery, kidney is removed along with some surrounding tissue.
What if both the kidney are to be removed?
If one kidney is fully or partially functional, the patient can live with it. In case, when both the kidneys are to be removed, the patient will need a machine to clean the blood. (dialysis). Or a kidney transplantation needs to be done.
When surgery alone doesn’t remove the entire cancerous area, additional treatments may be advised such as:
- Cryotherapy – Where extreme cold is used to kill the tumour.
- Radiofrequency Ablation – Using high energy radio waves to kill the tumour cells.
- Arterial Embolization – Certain substances are injected into the arteries in the kidney to block the blood flow to the tumour. This shrinks the tumour and typically done before the surgery.
- Biologic Therapy – Body’s natural immune defences will be boosted in this procedure using certain substances.
- Targeted Therapy – This therapy uses certain medicines or substances to find and target cancer cells.
- Radiation Therapy – High energy waves are used to kill cancer cells.
- Chemotherapy – Usage of drugs to kill cancer cells or at least halt their growth. This is a less effective procedure for kidney cancer compared to treating other types of cancer.
Prevention is better than cure – How can you prevent kidney cancer?
Since the exact cause is not known, no specialist can tell you what not to do to prevent kidney cancer. However, if you are smoker, it is highly recommended to quit smoking. Weight management is another important aspect to focus on. Keep your blood pressure in check and avoid exposure to harmful chemicals. Should you see any of the symptoms or run a fever without any infection or other symptoms in addition to pain in your lower abdomen area on the back, you must rush to a good urologist for a check up.