KIDNEY CANCER

Most people are born with two kidneys, each located above the waist on either side of the spine. The kidneys remove waste products from our blood through tiny filters called tubules. Renal cell cancer (RCC) is a cancerous growth that originates in these tubules and cells of the kidney.

Since the 1990s, the diagnosis of kidney cancer has increased due to the introduction of more advanced diagnostic technology, such as ultrasound and CT scans, which identify some cancers that might not have been found otherwise. The American Cancer Society indicates that kidney cancer is among the 10 most common cancers in both men and women. Overall, the lifetime risk for developing kidney cancer in men is about 1 in 46 (2.02%). The lifetime risk for women is about 1 in 80 (1.03%).

The cause of most kidney cancers is unknown, but various risk factors have been identified: cigarette smoking, long term exposure to certain pain medications (NSAIDS) obesity, high blood pressure, family history, history of radiation exposure, genetic mutations, and those on dialysis.

You may experience the following common symptoms:

• Blood in the urine (hematuria)
• Flank mass
• Flank pain or pain in the side
• High blood pressure
• Anemia or low blood counts
• General symptoms: fatigue, weight loss, low-grade fevers, bone pain

Testing usually includes blood work, urinalysis, CT scans, MRIs, and biopsy. A CT scan can identify a mass in the kidney. Once the diagnosis is confirmed, further tests (blood test to check the health of the liver, chest X-ray, bone scan) help determine if the cancer has spread beyond the kidney.

Knowing the stage of the disease helps decide the treatment plan:

• Stage I: Tumor is less than 7 cm in the kidney.
• Stage II: Tumor is larger than 7 cm and not extending outside the kidney.
• Stage III: Tumor extending locally into major veins or tissues directly around the kidney.
• Stage IV: Cancer has spread beyond the kidney to distant areas, like other organs or bone.

Kidney cancer treatment is based on each patient’s unique situation.

Treatments for local growth (stages I and II) include:

• Active surveillance: Small kidney tumors (less than 3 cm) and elderly patients with multiple medical issues may elect to take an active surveillance approach, with follow-up to monitor symptoms and physical examination. Repeat imaging will observe the mass for growth and other changes.
• Surgery: Depending on the tumor’s size, the stage of the disease, and the patient’s overall condition, the surgeon removes all or part of the kidney surrounding the tumor. This surgery is by far the most common treatment. Minimally invasive techniques using laparoscopy or robotics can often replace larger-incision approaches, reducing pain, hospitalization, and recovery time.
• Percutaneous therapy: Small tumors can be treated with cryoablation (freezing) or radiofrequency (heating) ablation through a puncture in the skin with a long needle.

Treatments for metastatic growths (stages III and IV):

• Surgery: While not curative, surgical removal of the kidney before starting chemotherapy or immunotherapy may enhance the effectiveness of the treatment.
• Chemotherapy and immunotherapy: New treatments are available, with encouraging results in initial studies, including targeted molecular therapies