Cancer is a disease in which the abnormal cells in the body grow uncontrollably which is caused due to changes in a section of DNA. Kidney cancer is a type of cancer in which the cells start growing uncontrollably in the kidney forming tumors. Kidneys are bean-shaped organs located on both sides of the upper back wall of the abdomen. The main job of the kidney is to remove an excess of salt and water and also to purify the blood.
Almost all kidney cancer 1st starts with the abnormality growing in the lining of the tubules of the kidney. The number of cases of kidney cancer has been increasing for several decades. Kidney cancer is twice more common in men than women. Most patients that are diagnosed with kidney cancer are older, most commonly between 65 to 74.
Kidney Cancer Symptoms
There are different types of renal cancers but the signs and symptoms are most common. The patients do not show symptoms of kidney cancer in the early stages, but in due course of time they develop the following signs and symptoms:
Constant pain in the lower back
Blood in urine
Loss of appetite
Sudden weight loss
A lump on the lower back or the abdomen
Kidney Cancer Causes
Cancer is caused due to changes in the DNA. It is the chemical with which genes are made up of and genes control the functioning of the cell. Although the exact cause of kidney cancer is still unknown, various factors contribute to it, they are:
Taking certain pain medication for a long period
High blood pressure
Long term dialysis
Types of kidney cancer
There are different kinds of kidney cancer
Renal carcinoma: This is the most common kind, around 85% of the patients are diagnosed with this kind of cancer. This is developed in the proximal renal tubes that function as filters in the kidney. These filters are present in thousands of numbers in each kidney. These usually grow as a single tumor in the kidney but sometimes there are two more in one kidney or sometimes in both the kidneys.
Urothelial carcinoma: This sums up around 5 to 10% of the diagnosis of kidney cancer. This type of cancer forms in the area where the kidney collects the urine before it reaches the bladder, this area is known as the renal pelvis. This cancer is treated like bladder cancer as the development of cancer begins in the same type of cells.
Sarcoma: This kind of cancer is rare; it sums up to less than 1% of the diagnosis. It is formed in the soft tissue of the kidney in the thin layer of the connective tissue which is rich in blood vessels that encircle the kidney, it is also known as capsules. Sarcoma is usually treated surgically. But the chances of reoccurring and spreading to other tissues and organs is high, hence chemotherapy is recommended after the surgery.
Lymphoma: This can be caused in both the kidneys due to the enlargement of the lymph nodes in the kidney. Rare cases are recorded of such cancer in the kidney. Doctors usually recommend chemotherapy rather than surgery for such cases.
Wilms tumor: It is very common among children and it sums up to 1% of kidney cancer cases. It is very rare among adults. These cancers are treated with radiotherapy and chemotherapy and have shown success rates.
Kidney Cancer Treatment
For cancer treatment, a team of doctors is required to work together and come up with a plan. For kidney cancer treatment the team usually consists of
Treatment of cancer depends on the type of cancer, the stage, and the possible side effects. Kidney cancer is treated with surgery, immunotherapy, chemotherapy, or combinations of these. If cancer has metastatic then there is a line of therapy recommended to stop the spread of cancer.
When the patients have chronic medical conditions like heart disease, lung disease, etc., along with cancer, then the doctor recommends active surveillance wherein they closely monitor the symptoms, the growth, and spread of tumor with regular diagnostic tests. This is effective for older patients who have small tumors. Further therapy medication can be recommended depending on the severity and spread of cancer.
Kidney Cancer Surgery
In surgical procedures, the doctors recommend removal of the tumor along with surrounding healthy tissue or the entire or part of the kidney along with the lymph nodes and nearby tissue depending on the spread of cancer. There are different kinds of surgeries available for the treatment of kidney cancer.
Laparoscopic and robotic surgery
Sometimes doctors don’t recommend surgeries due to the characteristics of cancer or the patients’ health conditions, instead, they recommend the following treatments:
Radiofrequency ablation: In this, a needle is inserted into the tumor to destroy the cells using electric waves.
Cryoablation: In this, the cancer cells are frozen with a metallic probe inserted through a small incision.
Therapy using medication
This medication is used to destroy cancerous cells. The medication is either given orally or intravenously. Medication therapy is recommended and handled by a medical oncologist.
Some of the medication therapy are:
Targeted therapy: This treatment targets the genes of the cancerous cells that help the cell grow and survive making the environment unstable for the growth of the cell. It blocks the growth of the cells while making sure there is minimum damage to the surrounding healthy tissues. Some targeted therapies are
Immunotherapy: This focuses on boosting the immune system of the patients. some therapies that are used are:
Interleukin-2 (IL-2, Proleukin)
Immune checkpoint inhibitors
Chemotherapy: These are drugs that are used to kill cancer cells. It stops the cells from dividing further into more cells. This treatment has a specific number of cycles that are given within a particular course of time. These are usually combinations of drugs given through I.V.
This uses high-energy rays to destroy cancer cells. This therapy is often monitored by a radiation oncologist. This treatment is rarely recommended as a primary course of action to treat cancer as it can damage the healthy tissues of the kidney. Mostly this treatment is recommended if the cancer is spread in the surrounding tissue as well.
Before any procedure begins the doctor first explains the procedure to the patient and the family, they also discuss the possible side effects and the recovery time. Some tests like a blood test to check the health of the patient, chest X-ray, ECG is done to check if there are any other conditions that the patient has so that they can plan the course of treatment.
Before any surgery a pre-assessment is done where the tests mentioned above are done, consent forms are signed, and also if any questions the patient or the family has, are answered. In some hospitals, some dietitians help the patient manage their diet before the surgery.
After the procedure, the patient is sent to the recovery room for observation where the blood pressure of the patient is monitored, and also for post-operation infection. The functions carried out by the kidney are closely monitored like urine output. The patient is hospitalized for 2 to 7 days depending on the severity of the case. Nutritionists are available that customize the diet of the patient for faster recovery. It is important to get out of bed and walk around to prevent blood clots and to pass bowels.
After the treatment is necessary to go for regular checkups to look out for the signs of cancer coming back. For surgeries, it takes around 4-6 weeks to completely recover from the surgery. Proper diet and movement are required for faster recovery. The 1st appointment of follow up is after 4 to 6 weeks. Since these procedures have some side effects the survivors tend to experience these effects for a long period. In some cases, the kidney is completely or partially removed hence the kidney functions need to be monitored for life.
One can ask following questions to doctor:
1. How many people are diagnosed with Kidney Cancer each year?
2. What is kidney cancer?
3. What are the symptoms of kidney cancer?
4. What are the symptoms of kidney cancer?
5. Can kidney cancer be cured?
6. What are the kidneys and what do they do?
7. What sort of surgery is recommended for kidney cancer?
8. What is Wilms’ tumour?
9. How Is Kidney Cancer Diagnosed?
10. What Is the First Sign of Kidney Cancer?
Pros & Cons
It can stop or control the spread of cancer
It gives relief from the painful symptoms
It increases the life span of the patient
The survival rate of kidney cancer is almost 75%
Some insurance does not cover cancers hence it can become expensive
The side effects of the treatment are very harsh and the recovery is also slow
There are chances of cancer coming back hence regular monitoring is needed
There is a complete lifestyle change and it also causes emotional as well as physical stress to the patient as well as the family.
There is a possibility that there might complications during the surgery.
Risk related to surgery: During surgery, the patient may react to the anesthesia, there could be blood clots formed or infections during surgery. Some patients experience pain after surgery. Some other risks could also be damage to the other organs, pneumothorax, kidney failure, incisional hernia.
Risk related to radiation therapy: Patients can experience a change in the skin (like sunburn), hair loss,
Risk related to Chemotherapy: chemotherapy drugs attack the cells that divide quickly to stop the growth of cancer, but it also attacks the cells of the hair follicles, lining of the intestines, and mouth as they are also fast-dividing cells. Hence patients experience hair loss mouth sores, loss of appetite, easy bruising.
Treatment in India
India is well known worldwide for its doctors and the advanced facilities available in the country for kidney cancer treatment. The average cost of kidney cancer treatment in India is 60 to 70% less than what is the cost in western countries. The cost of diagnostics and stay in hospitals are also low compared to the other countries.