In this overview, we explore the diagnosis, prognosis and effective treatment options for kidney cancer, also known as renal cell carcinoma.
Though it isn’t as talked about compared to other cancers, renal cell carcinoma is still a relatively common form of cancer. On average, 1.3 million people are diagnosed with cancer annually, reports the Kidney Cancer Association, and of these 1.3 million, 50,000 are diagnosed with kidney cancer. While receiving a cancer diagnosis is never good news and is always quite scary, kidney cancer is highly treatable, particularly when caught early, so here we explain some of the effective treatment options for kidney cancer.
Unfortunately, renal cell carcinoma often goes undetected for extended periods, as this type of cancer commonly has few initial symptoms. Kidney cancer often presents itself in the form of a tumor, and this tumor often has no observable outward impact until it grows in size. By being cognizant of some of the earliest symptoms of kidney cancer, individuals can improve their chances of catching the malady as early as possible. One of the most common and most telling symptoms of kidney cancer is blood in the urine. Some individuals, especially those of a slight frame, notice lumps in their sides of abdomen. In some cases, the individual experiences pain in and around the kidney area or back, commonly occurring below the ribs. Loss of appetite or unexplained weight loss may also be a sign of kidney cancer. Extreme fatigue can result from kidney cancer and, for some, is an early sign. Some less common though equally telling signs include newly onset anemia and swelling in the lower extremities. Because catching kidney cancer early is vital to ensuring the most positive prognosis, individuals who experience any of these symptoms are encouraged to seek medical attention immediately.
When doctors suspect the presence of kidney cancer, a battery of tests is performed in an attempt to confirm the presence of the cancer and determine the severity. The first and least invasive test is traditionally a urine test. When performing a urine test, doctors are looking first for signs of blood in the urine and then for any other indicators of kidney distress. Following a urine test, doctors typically administer a blood test. When testing the blood, doctors seek to determine how well the kidneys are functioning.
If the results of these largely non-invasive tests indicate that kidney cancer is a possibility, doctors often move on to imaging testing, and there are a number of imaging tests that doctors may perform, each with its own advantages. When looking for tumors, doctors often perform an intravenous pyelogram (IVP). In this type of imaging test, dye is injected into the patient’s urinary tract. The doctor then x-rays the kidneys to see how the dye is moving through the kidneys and detect a tumor if one is present. If a tumor is present, doctors often perform an ultrasound. With this type of test, doctors can ascertain the makeup of the tumor. Because solid and liquid-filled tumors are treated differently, this is an important part of the diagnostic process.
Some doctors may elect to skip the two-part testing in favor of performing a CT scan. When performing a CT scan, doctors may or may not inject dye. The benefit of using a CT scan instead of performing an IVP and an ultrasound is that the CT scan provides both the ability to detect tumors and the ability to judge the makeup of any tumors found. Similarly, an MRI (magnetic resonance imaging) allows doctors to see all soft-body tissues and detect tumors. As with a CT scan, this test may or may not require the injection of contrasting agents.
Once a tumor has been detected, doctors may decide to perform a renal arteriogram. This test helps medical professionals evaluate the blood supply to the tumor. It can also help detect small tumors and, while not commonly used for this purpose, whether the other tests failed to indicate the presence of a tumor.
The prognosis varies from patient to patient, as early detection plays a large role in determining the likelihood of overcoming this form of cancer. Doctors generally report prognosis by sharing the stage in which they have caught the sufferer’s cancer. Chances of recovery are best for individuals whose kidney cancer is caught in Stage I. Stage I kidney cancer sufferers have a tumor that is up to 2.75 inches in diameter and is isolated to the kidney, so there are several effective treatment options for kidney cancer at this stage.
Stage II patients have a tumor that is larger in size than those who are in stage I, but the cancer is still confined to the kidney. These patients still have a good chance of recovery with kidney cancer treatment.
Stage III kidney cancer patients have a tumor that extends outside of the kidney along with signs of the cancer spreading to lymph nodes.
Stage IV patients, the most severe, have cancer that has spread outside of the kidney to distant parts of the body, potentially including the liver or lung. This is known as kidney cancer metastasis.
Stage III and stage IV patients have the worst prognosis for recovery, though patients with stage IV kidney cancer can and do overcome the cancer and ultimately go into remission. There are still effective treatment options for kidney cancer at this stage, so no form of diagnosis, even kidney cancer metastasis, should be viewed as impossible to overcome.
One of the first steps in the treatment for kidney cancer is usually surgical removal of the tumor. Depending upon the size and location of the tumor, kidney tumor surgery can take on several different forms.
If the tumor is small, the cancer may be removed with a procedure called a partial nephrectomy. In this procedure, surgeons remove the tumor along with a small amount of tissue around it. If the tumor has grown too large to be treated in this manner, a simple nephrectomy may be required. In this procedure, surgeons remove the entire impacted kidney.
If the cancer has spread beyond the kidney, it may be necessary to utilize the most extensive form of kidney tumor surgery, the radical nephrectomy. In this procedure, doctors remove the kidney and the adrenal gland, along with surrounding tissue. In some cases, surgeons may also remove lymph nodes that rest in close proximity.
While this form of surgical treatment for kidney cancer is the most extensive, it is also the most common of the effective treatment options for kidney cancer, as it is the form that most ensures the full removal of all cancerous tissue. Though the radical nephrectomy does call for the removal of quite a bit of tissue, it can be done via a laparoscope, making it less invasive than one would expect.
In cases where surgical removal of the cancerous tissue is impossible, doctors may employ one of several different effective treatment options for kidney cancer intended to kill the tumor. One such method is cryotherapy. In this treatment for kidney cancer, the tumor is exposed to extreme cold in an attempt to freeze and ultimately kill the tumor.
Another method is radiofrequency ablation. In this method, doctors use radio waves to heat the tumor in an attempt to kill it with extreme heat.
The final, and most invasive of this type is arterial embolization. When performing this procedure, doctors insert a material to block the artery that leads to the kidney. This is done in an attempt to block blood flow to the tumor and kill or shrink it. In some cases, this method is used in tandem with a surgical option in attempt to shrink the tumor to make surgically removing it easier.
Drugs may be used to treat kidney cancer, either in isolation or as a part of a larger kidney cancer treatment plan. Some doctors prescribe drugs like interferon or aldesleukin, which serve as synthetic versions of chemicals naturally produced in the human body. These drugs are used as a biological therapy option in which doctors seek to trigger the immune system to fight the cancer.
Another pharmaceutical option is targeted therapy. When performing a targeted therapy, doctors attempt to use drugs to block signals in the cancer cells that allow them to reproduce. The drugs axitinib, pazopanib, sunitinib and temsiroliumus may be used for this type of kidney cancer treatment.
Though chemotherapy is commonly used in the treatment of cancer, it isn’t common to utilize this type of treatment when treating kidney cancer patients. Chemotherapy has proven to be one of the less effective treatment options for kidney cancer, than it is for treating other kinds of cancers, so doctors rarely utilize this course of treatment.
Just as with most other forms of cancer, certain lifestyle choices can increase your likelihood for developing kidney cancer. The notoriously cancer-causing practice of smoking has an impact on the likelihood of developing kidney cancer, as smokers are two times more likely to be diagnosed with this form of cancer than nonsmokers are.
Obese individuals are also more at risk for developing this form of cancer. It is believed that this increased likelihood is due to hormonal changes that occur resulting from prolonged obesity.
Taking pain medication, both over the counter and prescription, in excess has been tied to increased risks of kidney cancer. In addition, exposure to certain chemicals, including asbestos, cadmium, benzene and some herbicides increases the likelihood of kidney cancer development. Though nothing can entirely prevent the development of kidney cancer, limiting exposure to these potential cancer causers and leading a healthy lifestyle can be effective treatment options for kidney cancer prevention.
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