WHAT YOU SHOULD
KNOW
This type of cancer is relatively
rare, accounting for no more than 2 percent of adult cancer
cases. Like all forms of cancer, it is the result of
unrestrained multiplication of cells. Normal cells divide in a
planned way, creating more cells only when needed. Cancerous
cells reproduce without order or limits, often creating excess
tissue that becomes a tumor. As the cancer progresses, the
cells may also invade healthy nearby tissues, or break away and
travel through the bloodstream or lymph system to other parts
of the body in a process called metastasis.
Kidney cancer typically affects
only one of the body's two kidneys. The cancer is prone to
spread, or metastasize, to the lymph nodes in the pelvic
region, and to the lungs, liver, colon, pancreas, bone, or
brain. If the cancer is discovered before it spreads, surgical
removal of the diseased kidney offers a good chance of a cure.
If metastasis has occurred, the prospects for successful
treatment are much poorer.
The most common form of this
disease is renal cell carcinoma, or adenocarcinoma of the
kidney. It strikes men twice as often as it does women. In rare
cases, cancer can also develop near the exit from the kidney or
in the ureter that drains urine from the kidney to the
bladder.
Causes
There is no known cause of kidney
cancer, but some scientists speculate that it may be linked to
cancer-causing agents in the air or food supply. Other risk
factors include smoking, a high-fat diet, excess weight, and
exposure to substances such as asbestos and cadmium, which is
found in paint, batteries, and welding
materials.
Signs/Symptoms
Blood in the urine is the most
common warning sign. Pain in the side or on one side of the
lower back is also likely. Other potential symptoms include
fever, high blood pressure, fatigue, loss of appetite and
weight, and swelling of the ankles and legs. In some cases, a
smooth, hard lump can be felt on the side of the abdomen. Keep
in mind, however, that these symptoms can also result from less
serious conditions. To determine their exact cause, you have to
see a doctor.
Care
Surgery is the primary treatment
for kidney cancer. This type of cancer does not respond well to
other standard forms of cancer treatment, such as chemotherapy
and radiation.
The type of surgery you will need
depends on the extent, or stage, of the disease, the size of
the cancerous tumor or tumors, your overall health, and the
condition of the kidney.
Your doctor will first perform a
series of tests to confirm the diagnosis of kidney cancer.
These tests typically include blood tests, urine tests, x-rays,
and a computed tomography (CT) scan to obtain a cross-sectional
view of the interior of the kidney. The doctor may also order
magnetic resonance imaging (MRI) and ultrasound (a procedure
that bounces sound waves off the kidney to build an image of
the organ).
To pin down the nature and extent
of the cancer, you may also need special x-rays taken with a
contrasting dye in the bloodstream (arteriography or an
intravenous pyelogram). These x-rays outline the blood vessels
feeding the kidney tumor and help the doctor evaluate the
damage the cancer may have caused.
Several types of surgery are
possible:
-
Radical nephrectomy: In this operation, the entire
kidney is removed, along with the adrenal gland that sits
on top of the kidney, nearby fatty tissue, and nearby lymph
nodes. Complete removal of an entire kidney is an option
because the remaining kidney can do all the work of
two.
-
Partial nephrectomy: In this procedure, the surgeon
removes only the part of the kidney containing the cancer
and leaves the rest of the organ in place. This type of
surgery may be performed if the cancer is present in both
kidneys, if you only have one kidney, or if the tumor is
very small. Even if a portion of both kidneys needs to be
removed, they can still function adequately.
-
Total nephroureterectomy: This type of surgery is
needed when the cancer is in or near the ureter. The
operation removes the kidney, the ureter, and a portion of
the bladder.
The doctor may also suggest
certain nonsurgical treatments:
-
Hormone therapy: Natural hormones sometimes promote
the growth of cancer cells. Special drugs are available to
block or remove these natural hormones and slow the
cancerous growth.
-
Arterial embolization: This procedure blocks the
artery feeding the cancer. It may be performed prior to
surgery to kill some of the cancer cells, or may be used
alone for patients who cannot undergo
surgery.
-
Immunotherapy: This approach uses the body's own
immune system to better fight off and destroy cancer cells.
However, it's a fairly new treatment option and may produce
severe side effects. It is important to weigh this option
carefully and seek a doctor experienced in this type of
treatment.
Risks
Left untreated, kidney cancer
will eventually spread. Surgery often has a good chance of
eliminating the problem, but only if performed during the
early, more treatable, stages of the disease.
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