Kidney Cancer
Background
There are two kidneys, one on each side of the backbone, above the waist. Renal cell cancer, also called kidney cancer or renal adenocarcinoma, is a disease in which cancer cells are found in the lining of very small tubes in the kidney. The tiny tubules in the kidneys filter and clean the blood, taking out waste products and making urine. The urine passes from each kidney into the bladder through a long tube, called a ureter. The bladder stores the urine until it is passed from the body.
Symptoms
Possible signs of renal cell cancer include blood in the urine and a lump in the abdomen. These and other symptoms may be caused by renal cell cancer; other conditions may cause the same symptoms. There may be no symptoms in the early stages, but symptoms may appear as the tumor grows.
A doctor should be consulted if any of the following problems occur:
- Blood in the urine
- Lump in the abdomen
- Pain in the side that doesn't go away
- Loss of appetite
- Weight loss (non-intentional)
- Anemia
Staging
Stage I: The tumor is 7 centimeters or smaller and is found only in the kidney.
Stage II: The tumor is larger than 7 centimeters and is found only in the kidney.
Stage III: Cancer is found:
- in the kidney and in one nearby lymph node; or
- in an adrenal gland or in the layer of fatty tissue around the kidney, and may be found in one nearby lymph node; or
- in the main blood vessels of the kidney and may be found in one nearby lymph node.
Stage IV: Cancer has spread:
- beyond the layer of fatty tissue around the kidney and may be found in one nearby lymph node; or
- to two or more nearby lymph nodes; or
- to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes.
Treatment
Surgery
Surgery to remove part or the entire kidney is often used to treat renal cell cancer.
The following types of surgery may be used:
- Partial nephrectomy: A surgical procedure to remove the cancer within the kidney and some of the tissue around it. A partial nephrectomy may be done to prevent loss of kidney function when the other kidney is damaged or has already been removed.
- Simple nephrectomy: A surgical procedure to remove the kidney only.
- Radical nephrectomy: A surgical procedure to remove the kidney, the adrenal gland, surrounding tissue, and, usually, nearby lymph nodes.
- A person can live with part of one working kidney. If both kidneys are removed or not working, a person will undergo:
- Dialysis: a procedure to clean the blood using a machine outside of the body
- Kidney transplant: replacement with a healthy donated kidney. A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given, as needed.
Arterial embolization
When surgery to remove the cancer is not possible, a treatment called arterial embolization may be used to shrink the tumor. A small incision is made and a catheter (thin tube) is inserted into the main blood vessel that flows to the kidney. Small pieces of a special gelatin sponge are injected through the catheter into the blood vessel. The sponges block the blood flow to the kidney and prevent the cancer cells from getting oxygen and other substances needed to grow.
Even if a doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that remain. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
The National Cancer Institute provides more detailed information about kidney cancer.
References
Oregon Urology Institute
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