Kidney Cancer

Kidney cancer is diagnosed and treated by the Urology Division of Premier Medical Group. Kidney cancer is a disease that affects thousands of adults throughout the United States. This form of cancer develops when malignant tumors form in the kidneys, usually in the tubules.

Early diagnosis of kidney cancer is important. As with most types of cancer, the earlier the tumor is discovered, the better a patient’s chances for survival. Tumors discovered at an early stage often respond well to surgical treatment. Survival rates in such cases are high. Tumors that have grown large or spread (metastasized) through the bloodstream or lymphatic system to other parts of the body are more difficult to treat and present an increased risk for mortality.

What causes kidney cancer?

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While doctors don’t know the causes of kidney cancer, it appears there are certain factors that increase the risk of developing it. Most often, kidney cancer occurs in people 40 and over.

Risk factors include:

  • Smoking: a smoker’s risk for kidney cancer is twice that of a nonsmoker; smoking cigars may also increase your risk.
  • Gender: males are about twice as likely as women to get kidney cancer.
  • Obesity: being overweight may cause changes to hormones that increase your risk.
  • Pain medications: long-term use of certain pain medications; including over-the-counter drugs as well as prescription drugs.
  • Advanced kidney disease: or being on long term dialysis.
  • Genetics: certain genetic conditions, such as von Hippel-Lindau (VHL) disease or inherited papillary renal cell carcinoma.
  • Family history: the risk is especially high in siblings.
  • Exposure to certain chemicals: asbestos, cadmium, benzene, organic solvents, or certain herbicides
  • High blood pressure: doctors don’t know whether high blood pressure or the medication used to treat it is the source of the increased risk.
  • Lymphoma: there is an increased risk of kidney cancer in patients with lymphoma.

What are the symptoms of kidney cancer?

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In many cases, people may have no early symptoms of kidney cancer. As the tumor grows larger, symptoms may appear. These could include:

  • Blood in your urine
  • A lump in your side or abdomen
  • A loss of appetite
  • A pain in your side that doesn’t go away
  • Weight loss that occurs for no known reason
  • Fever that lasts for weeks and isn’t caused by a cold or other infection
  • Extreme fatigue
  • Anemia
  • Swelling in your ankles or legs

Kidney cancer that spreads to other parts of your body may cause other symptoms, such as, shortness of breath, coughing up blood, or bone pain.

Kidney cancer patients are seen in Poughkeepsie, Fishkill, Kingston, Newburgh and Rhinebeck offices.

How is kidney cancer diagnosed?

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To confirm a diagnosis of kidney cancer, you will need a thorough physical exam, health history, and tests. The doctor will feel your abdomen and side for lumps and check for fever and high blood pressure, among other things. It’s important to share your health habits, past illnesses, and types of treatment.

To make a diagnosis of kidney cancer, some the following tests may be ordered:

  • Urine tests check for blood in your urine or other signs of problems.
  • Blood tests show how well your kidneys are working.
  • Intravenous pyelogram (IVP) involves X-raying your kidneys after the doctor injects a dye that travels to your urinary tract, highlighting any tumors.
  • Ultrasound uses sound waves to create a picture of your kidneys. It can help tell if a tumor is solid or fluid-filled.
  • A CT(CAT) This uses X-rays and a computer to create a series of detailed pictures of your kidneys. This may also require an injection of dye. CT scans have virtually replaced pyelogram and ultrasound as a tool for diagnosing kidney cancer.
  • MRI (Magnetic resonance imaging): This uses strong magnets and radio waves to create detailed images of soft tissues in your body. You may need an injection of a contrast agent to create better pictures.
  • Renal arteriogram: This test is used to evaluate the blood supply to the tumor. It is not given often but may help diagnose small tumors and has other uses as well.
  • In rare cases, a biopsy may be performed. It may be done to confirm the diagnosis. A needle biopsy is used to remove a sample of tissue, which is then examined under a microscope for cancer cells. This may also tell the grade of the cancer – how aggressive the cancer is likely to be.

Once your doctor makes a diagnosis of kidney cancer, you may need other tests to tell if the cancer has spread within your kidney, to the other kidney, or to other parts of your body. When cancer spreads from the place where it first started, it has metastasized. CT scan MRI, chest x-rays or a bone scan are all helpful diagnostic tools in telling if the cancer has spread.

What are the types of kidney cancer?

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Several types of cancer can develop in the kidneys. The most common among them is renal cell carcinoma (RCC). In RCC, cancerous (malignant) cells develop in the lining of the kidney’s tubules and grow into a mass called a tumor. In most cases, a single tumor develops, although more than one tumor can develop within one or both kidneys.

How is kidney cancer treated?

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Once you have a diagnosis and know your stage of kidney cancer, you and your doctor can plan treatment. Your doctor may refer you to a specialist for treatment. This could include a urologic surgeon or a medical oncologist.

Kidney cancer is one of the more common cancers to undergo spontaneous remission. However, the incidence is quite low (approximately 0.5%).

There are several standard types of treatment for kidney cancer:

Surgery

This is usually the first step. Even if surgery removes the entire tumor, though, your doctor may suggest an extra treatment to kill any remaining cancer cells that can’t be seen.

These are the main types of surgery for kidney cancer:

  • Radical nephrectomy removes the kidney, adrenal gland, and surrounding tissue. It also often removes nearby lymph nodes. It is the most common surgery for kidney cancer and can now be done through small incisions with a laparoscope.
  • Simple nephrectomy removes the kidney only.
  • Partial nephrectomy removes the cancer in the kidney along with some tissue around it. This procedure is used for patients with smaller tumors (less than 4 cm) or in those patients in which a radical nephrectomy might place too much strain on the other kidney.

Cryotherapy

Uses extreme cold to kill the tumor.

Radiofrequency ablation

Uses high-energy radio waves to “cook” the tumor.

Arterial embolization

Involves inserting material into an artery that leads to the kidney. This blocks blood flow to the tumor. This procedure may be done to help shrink the tumor before surgery.

Biologic therapy for kidney cancer

This therapy uses your immune system to fight cancer by boosting, directing, or restoring your body’s natural defenses. Substances for biologic therapy are made by your body or in a lab. Examples of biologic therapy for metastatic kidney cancer include interferon alpha or interleukin-2.

Targeted therapy for kidney cancer

This therapy uses drugs or other substances to find and target cancer cells without harming normal cells. One type of targeted therapy is anti-angiogenic agents. These keep blood vessels from feeding a tumor, causing it to shrink or stop growing. Another type of targeted agents is known as multikinase inhibitors or tyrosine kinase inhibitors. These are oral drugs that block an enzyme pathway which allows cancer cells to grow. A third type of targeted therapy is known as m-TOR inhibitors. There are two of these drugs available, one oral, and one by IV. They block a pathway which allows blood vessels to help tumor cells grow. Each of these drugs has a unique place in the management of advanced kidney cancer.

Radiation therapy for kidney cancer

Often used to help with symptoms of kidney cancer or in patients who cannot have surgery, this treatment uses high-energy X-rays or other types of radiation to kill cancer cells or halt their growth. External radiation therapy sends radiation to the cancer from a machine outside the body.

Chemotherapy for kidney cancer

This therapy uses drugs to kill cancer cells or stop them from multiplying. Less effective for kidney cancer than for other types of cancer, chemotherapy is used when other types of treatment do not work well.

Other treatments

May include tumor vaccines, gene therapy, and stem cell transplants. These are experimental. Researchers are testing them in clinical trials.