Kidney cancer is a malignant cell growth (a tumour) in the kidneys. Its medical name is renal cell carcinoma. A tumour in the kidney can also be benign. Kidney cancer is a general term. There are many variations of tumours in the kidney and stages of the disease. If the tumour is limited to the kidney and has not spread, this is called localized kidney cancer. In locallyadvanced kidney cancer, the tumour has grown out of the kidneys into surrounding tissue and invaded veins, the adrenal gland, or lymph nodes. Doctors speak of metastatic disease if the cancer has spread either to distant lymph nodes or other organs. Men are more likely to be diagnosed with kidney cancer than women. Most people are diagnosed between the ages of 60 and 70.
All decisions about the right treatment pathway for you are taken after careful consideration of tumour classification, your prognosis, and the availability of treatment options in your hospital. The most important factor for selecting treatment is the stage of the disease. Kidney cancer can be treated by:
• Partial nephrectomy
• Radical nephrectomy
• Cytoreductive nephrectomy
• Active surveillance
• Radiofrequency ablation
• Antiangiogenic therapy
• Radiation therapy
What are the symptoms of kidney cancer?
Kidney cancer in most cases is asymptomatic, which means that there are no clear symptoms to indicate it. Most kidney tumours are found during routine ultrasound or similar imaging procedures for other conditions, such as back pain. As the tumour grows, you may feel constant pain in the affected side. You may feel a mass in the side of your body, from the ribs to the hip, or you may have blood in the urine. Other symptoms that you may experience are:
• High blood pressure
• Fever and night sweats • Loss of appetite
• Weight loss
• Anaemia These symptoms are referred to as paraneoplastic syndromes and are a reaction your body can have to any type of cancer.
The symptoms can point to various conditions. They are not necessarily a sign of cancer. If you have any of these symptoms, contact your doctor to find out what causes them.
Because there are several types of kidney tumours, the doctor does a series of tests to better understand your specific situation. These tests include a medical history and scans. Sometimes a family history is also taken. A CT scan or MRI scan will reveal the size of the tumour and if it has invaded local veins, lymph nodes, or surrounding organs. This is important to determine further treatment. The doctor may also perform a physical examination and take blood and urine for testing.
Kidney tumours are classified according to their stage, subtype, and the grade of aggressiveness of the tumour cells. These three elements are the basis for your possible treatment pathway. Tumour stage indicates how advanced the tumour is, and whether or not the tumour has spread to distant lymph nodes or other organs. This is based on the Tumour Node Metastasis (TNM) classification. The urologist looks at the size and invasiveness of the tumour (T) and determines how advanced it is, based on 4 stages. Whether any lymph nodes are affected (N) or if the cancer has spread to any other parts of your body (M) is also checked. There are various subtypes of kidney tumours. Most kidney tumours are renal cell carcinomas (about 80- 85%). Of these, the most common subtype is clear cell renal cell carcinoma (80%), 10% are papillary renal cell carcinomas, and 5% chromophobe renal cell carcinomas. The remaining 5% of renal cell carcinomas include collecting duct renal cell carcinoma (or Duct-Bellini-Carcinoma) and a variety of uncommon and hereditary carcinomas. Your doctor will also evaluate how aggressive the tumour cells are. The Fuhrman nuclear grade is the most commonly used system to determine this. The pathologist classifies your tumour in 1 of 4 grades.