Overview

 

Kidneys are one of the vital organs of the human body which help purify the blood by removing waste from the bloodstream and passing them as urine. The presence of cancerous cells in the kidney is called kidney cancer or renal cell cancer(RCC). This condition is caused when kidney cells stop replicating normally and begin to grow rapidly to form a tumour that can be cancerous (malignant) or rarely benign (noncancerous). Most often, kidney cancer affects the lining of tubules (the tiny tubes of the kidney responsible for absorption and water regulation). This is called renal cell carcinoma.

Kidney cancer is usually diagnosed at an early stage which helps in quick and easy treatment. However, if left unnoticed, it multiplies and spreads to different organs.

The incidence of kidney cancer has remained steady throughout the last two decades. About 73,750 new cases of kidney cancer (45,520 in men and 28,230 in women) will be diagnosed. About 14,830 people (9,860 men and 4,970 women) will die from this disease.

Most people with kidney cancer are older. The average age of people when they are diagnosed is 64 with most people being diagnosed between ages 65 and 74. Kidney cancer is very uncommon in people younger than age 45. Recent screening programs have started identifying people younger than 45yrs with RCC.

Kidney cancer types
  •  Renal cell carcinoma (RCC): This is the most common type of kidney cancer. There are several sub-types of RCC based on the genetic changes in the cancer cells. These include clear cell, papillary, chromophobe and collecting duct carcinomas, among others. Clear cell carcinoma accounts for 80% of all RCC cases, and most treatments are focused on this type.
  •  Wilms’ tumor: This is childhood cancer, responsible for 95% of paediatric kidney cancer cases.
  •  Urothelial cell cancer of the renal pelvis and ureter : Cancer of the urinary tract that occurs in the part of the kidney that collects urine or in the ureter is called urothelial carcinoma. Although it is frequently called kidney cancer, it is more like bladder cancer, since most bladder cancers also form urothelial cells

 

A small number of kidney cancer cases can be passed down from one generation to the next. Genetic counseling is an absolute necessity then.

Stages of kidney cancer

Kidney cancer stages are defined by the severity of the disease. This entirely depends on the size of the tumour, the location, and whether cancer has spread to other parts of the body. Kidney cancer is divided into four stages which are:

Stage I: This is the beginning stage of cancer where the cancer is limited only to the kidney. The size of the tumour present at this stage is roughly upto 7 cms.

Stage II: At this stage, the tumour found in the kidney has grown more than 7 cms and is still limited to the kidney.

Stage III: At this stage, cancer has begun to spread to parts around the fatty areas of the kidney, lymph nodes and surrounding tissues. It also spreads to major veins and perinephric tissues.

Stage IV: Cancer is at its last stage where cancer cells have vigorously grown beyond the fatty layer of tissue present around the kidney. Nearby lymph nodes, organs such as the bowel, pancreas, liver and lungs are infected too. This leads to the bones and brain being infected at the final stage.

The treatment for kidney cancer gets difficult if not diagnosed at the early stages. The survival rate also decreases drastically at later stages despite various treatment methods available.

Prevention of kidney cancer
  • The causes of kidney cancer are unknown yet; hence its prevention is not certain. Depending on the risk factors associated with RCC, the following are a few steps to maintain healthy kidneys and prevent the occurrence of kidney cancer.
  • Quit Smoking: there is a proven record that smoking doubles their chances of kidney cancer by 30 % in men and 25% in women.
  • Eat nutritious food: a balanced diet with all nutrients helps build a stronger immune system in the body. Meals should ideally include fresh fruits and vegetables.
  • Stay active and maintain a healthy weight: obesity increases the chances of kidney cancer due to hormonal changes. It is important to exercises for at least 30 mins a day.
  • Toxic chemicals exposure: hazmat protocol to be followed in all occupations dealing with toxic chemicals.
  • Control of BP and sugar.

Symptoms

 

Renal cancer symptoms are not evident in early stages; however, it becomes very evident as it grows bigger.

 

Common symptoms are:

 

  •  Constant pain in the back particularly below the ribs
  •  Hematuria – the presence of urine in blood
  •  Lump in the tummy
  •  Abdominal pain
  •  Fatigue feeling of tiredness weakness
  •  Unexplained persistent fever
  •  Loss of weight
  •  Loss of appetite
  •  Swelling of the legs (mostly late stages)
  •  Bony pain
  •  Shortness of breath
  •  Coughing up of blood

Risk and Causes

 

Anything that increases your chance of getting kidney cancer is called a risk factor.

 

The known risk factors for kidney cancer include:

 

  •  Smoking: This is the biggest risk factor for kidney cancer. Chemicals in tobacco smoke are absorbed into the blood, and then pass through the kidneys and collect in the urine. These chemicals can damage the kidneys and increase the risk of developing kidney cancer. Increases the risk of cancer by 50%.
  •  Age: Most cases occur after age 50
  •  Gender: Men are more than twice as likely to get kidney cancer as women
  •  Obesity
  •  Exposure to Toxic Chemicals – certain profession are at higher risk
  •  High blood pressure
  •  Advanced kidney disease and long-term kidney dialysis
  •  Race: African-Americans have a slightly higher rate of papillary kidney cancer.
  •  Rare inherited conditions including von Hippel-Lindau disease or hereditary papillary renal cell carcinoma
  •  Family history of kidney cancer

 

Not everyone with risk factors gets kidney cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor.

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