Kidney Cancer
introductionThe kidneys are a pair of bean shaped organs located in the abdomen. The function of the kidneys is to filter the blood of certain wastes creating urine. Normally, cells in the kidneys that are old or damaged will stop dividing and die before they can become cancerous. These cells are normally replaced by healthy young cells. Kidney cancer occurs when old or damaged cells continue to divide and multiply uncontrollably
Kidney cancer is most treatable and curable if
caught in the earliest stage of the disease.
Untreated and/or advanced kidney cancer
can spread from the kidney into surrounding
tissues and into the lymph nodes, lungs,
liver, bones and brain, where it can form
another cancerous tumor This is called
metastasis .
Kidney cancer is more common in men than in
women.
.
Diagnosing kidney cancer begins with taking a
thorough personal and family medical
history, including symptoms and risk
factors for kidney cancer. Diagnosis also
includes completing a physical
examination.
A test on the urine, called an urinanalysis, is
performed to check for blood in the urine
(hematuria) and to rule-out certain other
conditions with similar symptoms, such as
a bladder infection or kidney stones.
Rarely, a kidney biopsy may be necessary. A kidney
biopsy involves removing a sample of cells from the
kidney tumor with a very fine needle inserted
through the skin. The sample of cells is then
examined under a microscope for the presence of
cancer cells to confirm a diagnosis.
The prognosis for people with kidney cancer varies
depending on the stage of advancement of the
cancer, the specific type of kidney cancer, and other
factors. Treatment of kidney cancer may include
surgery, radiation therapy, targeted therapy,
immunotherapy and/or chemotherapy
The most common form of kidney cancer is renal cell
cancer.
Causes
Age and Gender as Risk Factors
The Genetic Connection
What’s Your History?
Lifestyle Links
Obesity and RCC
High Blood Pressure, Higher
Risk
Symptoms
Hematuria
Lower Back Pain
Lump
Anemia
Fatigue
Fever
Weight Loss
Other Symptoms
Physical examination:
FeverHigh blood pressure
Lab tests: Complete blood countUrinanalysisSerum calcium
DIAGNOSIS
Imaging tests:Ultrasound abdomen
Abdominal CT scanMRI scanPET scanRenal angiographyIntravenous pyelogramChest x rayBone scanBiopsy
Fine needle aspiration Core needle biopsy
STAGING (CONTINUED)
�҉N categories for kidney cancer: •N0: No spread to nearby lymph nodes
•N1: tumor has spread to nearby lymph nodes�҉ M categories for kidney cancer:
•M0: There is no spread to distant lymph nodes or other organs
•M1: Distant metastasis is present ,distant lymph nodes and to organs like lungs, bone, brain and liver
STAGING (CONTINUED)
HOW TO TREAT RENAL CANCER�҉ If only in kidneys, it can be cured
90% of the time with surgery.
�҉If it has spread outside the kidneys into the nodes or
the main vein, it must be treated with cytoreductive surgery.
�҉RRC is resistant to chemo and radiotherapy in most
cases�҉ May respond to immunotherapy
⃝PARTIAL NEPHRECTOMY: �҉For treating small renal tumors(<
4cm)
�҉ Bilateral renal cell carcinoma
�҉ It can be done via laproscopic techniques:
.
⃝RADICAL NEPHRECTOMY:�҉ Surgical removal of kidney along
with adrenal gland, retroperitoneal lymphnodes, perinephric fat and Gerota's fascia
�҉ In cases where the tumor has spread into the renal vein, IVC and right atrium, this portion of tumor can be surgically removed as well.
�҉ Medications like tyrosine kinase inhibitors including nexavar and rapamycin have shown to improve the prognosis for advanced RCC
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