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Kidney Cancer :

The kidneys are two bean-shaped organs, each about the size of a fist. They are located in the lower abdomen on each side of spine. The important job of Kidney is purification of blood, removing extra fluid from the body, removing waste products, drugs, and toxins through the urine. Kidneys also removes acid which is generated by the body cells and helps to maintain balance of water, minerals and salts in the blood.

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What Is Kidney Cancer?

Kidney cancer (Renal cancer) is a disorder in which kidney cells become cancerous and grow beyond control, developing in a tumour. Nearly all kidney cancers initially emerge in the lining of tiny tubes (tubules) in the kidney. Most of kidney cancers are detected before they spread to nearby organs. Early detected Cancers can be successfully treated. However, these tumours if not detected initially can grow to larger extent.

Risk factors for kidney cancer :

  • Smoking. Cigarette smoking increases the risk of Kidney cancer.
  • Men are more prone to kidney cancer as compared to women.
  • Obesity: Hormonal changes due to extra weight can increase risk of Kidney cancer.
  • Medications: Consumption of specific pain medicines for a long time.
  • Dialysis: Having advanced kidney disease or being on long-term dialysis.
  • Genetic conditions: Having certain genetic conditions, such as von Hippel-Lindau (VHL) disease or inherited papillary renal cell carcinoma.
  • Family history: Having a family history of kidney cancer. The risk is especially high in siblings.
  • Exposure: Being exposed to certain chemicals, such as asbestos, cadmium, benzene, organic solvents, or certain herbicides
  • Blood pressure: Having high blood pressure. It is unclear that whether high blood pressure or medication used to treat it is the source of the increased risk.
  • Having Lymphoma: For an unknown reason, there is an increased risk of kidney cancer in patients with lymphoma.

Symptoms of Kidney Cancer :

In many cases, no early symptoms of kidney cancer are seen. But as the tumour grows, the symptoms may appear.

A person may have kidney cancer symptoms like:

  • Blood in the urine
  • A lump in the side or abdomen
  • Loss of appetite
  • Side pain that persists
  • Unknown reason for Weight loss
  • Fever lasting for weeks and not caused due to cold or other infection.
  • Extreme fatigue
  • Anaemia
  • Swelling in Ankles or legs.

Kidney cancer that spreads to other parts of the body may cause other symptoms like:

  • Shortness of breath
  • Coughing up blood
  • Bone pain

Stages of Kidney Cancer :

Your prognosis depends on your general health, as well as the grade and stage of your kidney cancer. These are the stages of kidney cancer. The higher the stage, the more advanced the cancer.

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  • A tumour 7 centimetres or smaller that is only in the kidney.

  • A tumour larger than 7 centimetres that is only in the kidney.

  • A tumour that is in the kidney and in at least one nearby lymph node.
  • A tumour that is in the kidney's main blood vessel and may also be in nearby lymph node.
  • A tumour that is in the fatty tissue around the kidney and may also involve nearby lymph nodes.
  • A tumour that extends into major veins or perinephric tissues, but not into the ipsilateral adrenal gland and not beyond Gerota's fascia.

  • Cancer has spread beyond the fatty layer of tissue around the kidney, and it may also be in nearby lymph nodes.
  • Cancer may have spread to other organs, such as the bowel, pancreas, or lungs.
  • Cancer has spread beyond Gerota's fascia (including contiguous extension into the ipsilateral adrenal gland)

Treatments for Kidney Cancer :

The treatment is prescribed by the doctor based on the diagnosis report and the stage of kidney cancer.

There are various common treatments for Kidney cancer and surgery is the first step in maximum cases. Though surgery removes the complete tumour, the doctor may prescribe an additional treatment to kill the remaining cancer cells that can't be seen with naked eye.

A) Surgery for kidney cancer:

The type of surgery depends on stage of the cancer. There are three types of surgeries to remove Kidney cancer.

  • Radical nephrectomy : It removes the kidney, adrenal gland, and surrounding tissue. It also often removes nearby lymph nodes. It is the most common surgery for kidney cancer and can now be done through a small incision with a laparoscope.
  • Simple nephrectomy : It removes the kidney only.
  • Partial nephrectomy : It removes the cancer in the kidney along with some tissue around it. This procedure is used for patients with smaller tumours (less than 4 cm) or in those patients in which a radical nephrectomy might hurt the other kidney.

A person can survive with just one kidney till the time it is working. If the surgeon removes both kidneys, then a machine is used to clean the blood (dialysis) or implant a new kidney (kidney transplant).

Kidney transplant is feasible if the cancer is detected only in a person’s kidney and also if a donated kidney is available.

B) Biologic therapy for kidney cancer :

This therapy uses a person’s immune system to battle with the cancer by directing, boosting, or reinstate your body's natural defences. Examples of biologic therapy for metastatic kidney cancer include interferon alpha or interleukin 2.

C) Targeted therapy for kidney cancer :

This therapy uses drugs or other substances to detect and spot the cancer cells with less degree to normal cells. One type of targeted therapy is anti-angiogenic agents which keep blood vessels from feeding a tumour, allowing it to shrink or protect it from growing.

Multikinase inhibitors or tyrosine kinase inhibitors are the second type of targeted agent which are oral drugs that obstructs an enzyme route which aids in the growth of cancer cells.

M-TOR inhibitors is the third type of targeted therapy for Kidney Cancer.

D) Radiation therapy for kidney cancer:

Radiation therapy is regularly used to detect the symptoms of kidney cancer or is used in case of those patients who cannot have surgery. High-energy X-rays or other types of radiation are used in this treatment to kill cancer cells or obstruct their growth. In External radiation therapy it sends radiation to the cancer through a machine outside the body.

E) Chemotherapy for kidney cancer:

In Chemotherapy (chemo) Oral tablets /pills are given or anti-cancer drugs are inserted into the vein (IV). The drugs enter the blood and spread almost all over the body, which makes this treatment certainly useful for cancer that has spread (metastasized) to organs beyond the kidney.

Chemo is not a quality treatment for kidney cancer because kidney cancer cells normally do not respond well to chemotherapy. Chemo is generally used for kidney cancer only after the trail of the use of Immunotherapy or targeted drugs.

Doctors give chemotherapy in cycles, with duration of treatment followed by interval to permit the time to the body to recover. Chemo cycles generally last a few weeks.