An overview of Kidney Cancer

The abnormal cell growth in your kidney tissue is known as kidney cancer. These cellseventually gather into a mass known as a tumor. Cancer occurs when somethingtriggers a change in the cells, and they divide out of control.

A malignant or cancerous tumor has the potential to spread to nearby tissues andcrucial organs. Metastasis is the medical term for this.

There are different types of kidney cancer, including:

Renal cell carcinoma (RCC) : Adults most frequently develop renal cellcarcinoma (RCC), which makes up 85% of all cases of kidney cancer. Usually asolitary tumor in one kidney, renal cell carcinoma can also affect the other kidney.The tubules in your kidney's lining are where the cancer first appears (tiny tubesthat return nutrients and fluid back to your blood). Clear cell renal cell carcinomais the most prevalent kind of RCC (ccRCC).

Transitional cell cancer : Between 6% and 7% of kidney malignancies are causedby transitional cell carcinoma. This cancer typically starts where your ureterattaches to the bulk of your kidney. Your renal pelvis is where this is located.Your ureters may also develop transitional cell cancer.

Renal sarcoma : This is the least frequent kind of kidney cancer, accountingfor about 1% of kidney cancer occurrences. If left untreated, it can spread tosurrounding organs and bones from the connective tissues of your kidneys, where itstarts.

Wilms tumor : The most typical type of kidney cancer in children is called awilms tumor. An estimated 5% of kidney malignancies are caused by it.

Most cancers are grouped by stage, a description of cancer that aids in planningtreatment. The stage of a cancer is based on:

1. The location and size of the tumor.

2. The extent to which your lymph nodes are affected.

3. The degree to which the cancer spread, if at all, to other tissue and organs.

Your healthcare provider uses information from various tests, including CT, MRI andbiopsy, to determine the stage of cancer.

Stage I : The tumor is 7 centimeters (cm) across or smaller and is only inyour kidney. It hasn’t spread to lymph nodes or other tissue. (Lymph nodes are small“filters” that trap germs and cancer cells and store infection-fighting cells.).

Stage II : The tumor is larger than 7 cm across but is still only in yourkidney. It hasn’t spread to lymph nodes or other tissue.

Stage III : The tumor has spread to your major blood vessels — your renal veinand inferior vena cava — or into the tissue surrounding your kidney or to nearbylymph nodes.

Stage IV : The tumor has spread outside of your kidney to your adrenal gland(the small gland that sits on top of your kidney), or to distant lymph nodes orother organs.

Tumors are also graded, which is a way of rating a tumor based on how abnormal itscells look. Tumor grading can also tell your healthcare provider how fast the tumoris likely to grow. Tumors whose cells don’t look like normal cells and dividerapidly are called high-grade tumors. High-grade tumors tend to grow and spread morequickly than low-grade tumors.

It's not clear what causes most kidney cancers.

Doctors know that kidney cancer begins when some kidney cells develop changes(mutations) in their DNA. A cell's DNA contains the instructions that tell a cellwhat to do. The changes tell the cells to grow and divide rapidly. The accumulatingabnormal cells form a tumor that can extend beyond the kidney. Some cells can breakoff and spread (metastasize) to distant parts of the body.

Kidney cancer usually doesn't have signs or symptoms in its early stages. In time,signs and symptoms may develop, including:

1. Weakness or fatigue

2. Blood in your urine, which may appear pink, red or cola colored

3. Pain in your back or side that doesn't go away

4. Loss of appetite

5. Fever

6. Weight loss

Factors that can increase the risk of kidney cancer include:

Older age : Your risk of kidney cancer increases as you age.

Family history of kidney cancer : The risk of kidney cancer is higher if closefamily members have had the disease.

Certain inherited syndromes : People who are born with certain inheritedsyndromes may have an increased risk of kidney cancer, such as those who have vonHippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis complex,hereditary papillary renal cell carcinoma or familial renal cancer.

Treatment for kidney failure : People who receive long-term dialysis to treatchronic kidney failure have a greater risk of developing kidney cancer.

High blood pressure (hypertension) : High blood pressure increases your riskof kidney cancer.

Obesity : People who are obese have a higher risk of kidney cancer than peoplewho are considered to have a healthy weight.

Smoking : Smokers have a greater risk of kidney cancer than nonsmokers do. Therisk decreases after you quit.

If you have kidney cancer symptoms, your healthcare provider will perform a completemedical history and physical exam. They also may order certain tests that can helpin diagnosing and assessing cancer. These tests may include:

Urinalysis : A sample of your urine (pee) is tested to see if it containsblood. Even very small traces of blood, invisible to the naked eye, can be detectedin tests of urine samples.

Blood tests : These tests count the number of each of the different kinds ofblood cells, as well as look at different electrolytes in your body. A blood testcan show if there are too few red blood cells (anemia), or if your kidney functionis impaired (by looking at the creatinine).

CT scan : This is a special X-ray that uses a computer to create a series ofimages, or slices, of the inside of your body. This test is often done withintravenous contrast (dye). People with impaired kidney function may not be able toreceive the dye.

Ultrasound : This test uses high-frequency sound waves that are transmittedthrough body tissues to create images that are displayed on a monitor. This test ishelpful in detecting tumors, which have a different density from healthy tissues.

Renal mass biopsy : During this procedure, a thin needle is inserted into thetumor, and a small sample of your tissue is removed (biopsy). A pathologist willlook at the tissue under a microscope to see if there are any cancer cells. Becausebiopsies for kidney cancer aren’t always completely reliable, your healthcareprovider may or may not recommend this test.

Kidney cancer treatment depends on the stage and grade of the tumor, as well as yourage and overall health. Options include surgery, ablation, radiation therapy,targeted drug therapy, immunotherapy and sometimes chemotherapy.

Chemotherapy : Chemotherapy isn’t a standard treatment for kidney cancer. Butit can be helpful in some cases — usually only after trying immunotherapy andtargeted drug therapy. Chemotherapy medications are taken by mouth or given througha vein (intravenously) and are generally well tolerated.

Immunotherapy : Immunotherapy uses certain medications to boost your ownimmune system. In turn, this helps your body recognize and destroy cancer cells moreeffectively. Immunotherapy may be given as a standalone treatment or along withsurgery.

Targeted therapy : Targeted drug therapy blocks certain characteristics thathelp cancer cells thrive. For example, these drugs can stop the growth of new bloodvessels or proteins that feed cancer.Targeted drug therapy is often used whensurgery isn’t an option. In some cases, these medications may be given after surgeryto reduce the risk of cancer coming back.

Radiation therapy : Your healthcare provider may recommend radiation therapyif you only have one kidney or if you’re not eligible for surgery. Radiation therapyis most often used for easing kidney cancer symptoms, such as pain.

Surgery : Surgery is the treatment of choice for most stages of kidney cancer.Several surgical options may be considered, including Partial nephrectomy where Yoursurgeon removes the part of your kidney that contains the tumor or Radicalnephrectomy where Your surgeon removes your entire kidney and some of the tissuearound it. They may also remove some lymph nodes in the area. When one kidney isremoved, the remaining kidney is usually able to perform the work of both kidneys.

Ablation : Sometimes, heat and cold can destroy cancer cells. People whoaren’t candidates for surgery may benefit from cryoablation or radiofrequencyablation.