Renal Cancer

Definition

Kidney cancer, also known as renal-cell carcinoma, is a disease that will affect approximately 65,000 men and women this year.  Approximately 14,000 men and women will unfortunately die of this disease.  The disease is most common in men.

Risk Factors

  • Smoking
  • Misuse of pain medication
  • Obesity
  • Age
  • High Blood Pressure
  • Treatment for kidney failure
  • Family history

Symptoms

Although most people with early renal cancer do not have symptoms, some people may experience:

  • blood in the urine
  • abnormal physical examination
  • back pain
  • fatigue

Diagnosis

As with all cancers, the tumors need to be staged to determine how much cancer the patient has, and graded as to how aggressive the disease is.  Fortunately, the majority of cases are now diagnosed when they are still localized or confined to the kidney.  As a result, the patient’s survival increases.  As mentioned, most of these masses are found incidentally on routine imaging studies.  Other ways of diagnosing Renal Cancer include:

  • Urine tests
  • Blood tests
  • CT scan
  • MRI
  • Kidney ultrasound

Treatment

For the most part, surgical intervention is needed in order to cure patients of renal-cell carcinoma.  However, an in-depth discussion with one’s doctor will establish whether a patient is a candidate for surgical intervention, based upon the patient’s medical history as well as the size and location of the tumor.

Kidney tumors can be destroyed by using hot or cold energy delivered by a needle placed through the skin.   Cryoablation uses a very cold gas to freeze the tumor and kill the cancer cells.    Microwave ablation, which uses heat energy to destroy the tumor, and radiofrequency ablation, have also been used to treat kidney cancer.  Typically smaller tumors(<4cm) and those located in the back of the kidney are best suited for treatment with ablative therapies.

Research studies indicate that the more kidney tissue one has as they go through life, the better the long term outcomes are.  When possible we try to remove only the tumor and leave the remaining normal kidney tissue behind.    It is because of this that we perform roboti-assisted laparoscopic partial nephrectomies.  This procedure is performed through small keyhole-sized incisions where the tumor is accurately removed from the normal surrounding kidney tissue.  Fortunately, hospitalization is dramatically decreased, and patient’s pain levels are also dramatically decreased with this mode of therapy.  Occasionally however, the tumor is either too large or poorly located to allow us to safely remove it, and the entire kidney must be removed.

In cases where the tumors may be too large to be taken through the keyhole-sized incisions of laparoscopic surgery, open surgery through a single large incision may be necessary.  Additionally, circumstances may be that the patient has other medical problems, or the location of the tumor necessitates an open approach.

Medical oncologists are consulted in the treatment of certain renal cancers.  Fortunately research continues to provide newer and newer drugs to target and destroy these cancers.  We also provide nutritional and counseling support if and when the patient desires such intervention.

 

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