CANCER OF THE KIDNEY-(renal carcinoma)

By Kemboi Kibet Eldoret September 7, 2012

Kidney cancer starts in the kidney.The kidney is a pair of bean-shaped organs on either sides of the spine in the lower abdomen. Each kidney is about the size of a fist. It is part of the urinary tract that make urine by removing waste and extra water from the blood. The most common form of kidney cancer in adult is renal cell carcinoma although some other rare forms do occur.Wilms tumor is the most common type of childhood kidney cancer

CAUSES

The exact cause of renal cell carcinoma is unknown . Doctors however know that a mutation in the DNA in the kidney cells cause them to divide uncontrollably and form a tumor. The tumor may spread beyond the kidney and affect other organs or tissues

RISK FACTORS

Some factor may make you more susceptible to kidney cancer. These include

Smoking tobacco Cigarette smokers have twice the risk of developing kidney cancer than non smokers.

Age Your risk of kidney cancer increases with age

Obesity People with obesity have high risk for this type of cancer

Gender Males are more likely to be diagnosed with kidney cancer than females

High blood pressure ( hypertension) This condition increases your risk for kidney cancer

Long term dialysis Dialysis is a treatment for people with kidneys that are not working well. It removes waste from the blood. People who receive long-term dialysis to treat chronic kidney failure are susceptible to kidney cancer

Von Hippel-Lindau disease It is caused by changes in the VHL gene. An abnormal VHL gene increases the risk of developing several kinds of tumor including kidney cancer

Hereditary papillary renal cell carcinoma This inherited condition makes it more likely you’ll develop one or more kidney cancers.

Family history of the disease increases your chances of getting it too

TYPES OF KIDNEY CANCER

Renal cell carcinoma RCC. This is the most common type of kidney cancer. It develops in the lining of the kidney tubules and grow into a mass called a tumor. It typically grows as a single mass however tumors can be found in both kidneys at the same time

There are several subtypes of renal cell carcinoma. They include

Clear cell renal cell carcinoma . It is the most common form of RCC. Cells look very pale when viewed under the microscope
Papillary renal cell carcinoma These cancers form little finger-like projections (called papillae) and are the second most common type of RCC
Chromophobe renal cell carcinoma The cells of these cancers are also pale, but are much larger and the third most common type of RCC
Collecting duct renal cell carcinoma The cancer cells can form irregular tubes. This is a rare subtype
Unclassified renal cell carcinoma They are unclassified because their appearance does not fit into any of the other categories

Transitional cell carcinoma: They begin in the renal pelvis.About 5% to 10% of cancers in the kidney are transitional cell carcinomas.The cells look like bladder cancer cells under the microscope and act very much like bladder cancer.This cancer is linked to cigarette smoking and treatment usually involves surgically removing the entire kidney and the ureter, as well as the section of the bladder where the ureter is attached.

Wilms tumor This type of cancer is almost always found in children and is very rare in adults.About 5% to 6% of all kidney cancers are Wilms tumors

Renal sarcoma It’s a rare type of kidney cancer that begins in the connective tissues or blood vessels.

SYMPTOMS

This types of cancer rarely causes any symptoms in the early stages. Symptoms usually show up when cancer is advanced. Some symptoms include

blood in urine. This makes urine pink,slighty rusty or red
weight loss
fatigue
back pain below the ribs that does not go away
intermittent fever
a lump in the side or abdomen
swelling of veins around the testicles

DIAGNOSIS AND TEST

Blood and urine tests Blood and urine test will determine the cause of your symptoms. Blood work check for levels of creatinine. A high level of creatinine may mean the kidneys are not working well.

Physical exam The doctor feels the abdomen and side for tumors.

Biopsy In some cases a biopsy may be done. A sample of kidney tissues is removed and checked under the microscope for cancer cells. The results are not conclusive because it could be false negative.

Imaging test. These include

CAT scan An x-ray machine takes detailed pictures of the kidney to check for abnormalities

Ultrasound The ultrasound device uses sound waves to create a picture called a sonogram. A tumor shows up during an ultrasound

Intravenous pyelogram (IVP): Dye is injected into a vein and a series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.

Surgery Based on the imaging test results, the doctor will recommend either removing part or all of the kidney

STAGING

Staging is done to determine the extend or stage of the cancer. This is done with the help of the imaging test such as CAT scan

Stage I Early stage of kidney cancer.Tumor is confined to the kidney.The tumor measures up to 2 3/4 inches (7 centimeters).

Stage II Tumor is still confined to the kidney but larger than 2 3/4 inches (7 centimeters).

Stage III Tumor has spread beyond the kidney and may be found in nearby lymph node.Tumor has invaded the adrenal gland or the layers of fat and fibrous tissue that surround the kidney. Cancer may also be found in nearby blood vessels

Stage IV Cancer has spread to organs like lungs, bone, brain and liver

TREATMENT

Cancer treatment option depend on the stage of the cancer, they type of cancer, your overall health and your preference

Surgery

It is the number one treatment option for most kidney cancers.

Removing the affected kidney (nephrectomy). There are different types of nephrectomy and the type used depends on the stage of the cancer

Simple nephrectomy Surgeon removes only the kidney. It an option for people with stage I kidney cancer

Radical nephrectomy The entire kidney along with the adrenal gland and some tissue around the kidney are removed. Some lymph nodes in the area may also be removed. This is the common treatment option for kidney cancer.

Partial nephrectomy Only part of the kidney that has the tumor is removed.This is usually an option when the patient has only one kidney or when both kidneys are affected.

Treatment to freeze cancer cells (cryoablation). In this process, a special needle containing gas is used to freeze or cool down the cancer cells. It is reserved for people who can’t undergo surgery or who have small kidney tumors

Treatment to heat cancer cells (radiofrequency ablation) An electrical current is run through the needle and into the cancer cells, to heat them up or burn them.

Arterial embolization A type of local therapy that shrinks the tumor and is sometimes done before surgery to make surgery easier

Radiation therapy High-energy rays is used to kill cancer cells. It affects cancer cells only in the treated area.

Biological therapy uses your body’s immune system to fight cancer. Drugs used for this include interferon and aldesleukin (Proleukin).

Chemotherapy Anticancer drugs enter the bloodstream and travel throughout the body.However anticancer drugs have shown limited use against kidney cancer.

PREVENTION

quit smoking
eat more fruits and vegetables
control your blood pressure
maintain healthy weight
avoid exposure to environmental toxins

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