How Is Kidney Cancer Treated
Treatment depends on the type of cancer, the stage, and grade of the tumor, and the patient’s age and overall health.
Surgery is the most common treatment for kidney cancer. Several surgical options may be considered, including:
- Partial nephrectomy: The surgeon removes just the part of the kidney that contains the tumor.
- Radical nephrectomy: The surgeon removes the whole kidney and some of the tissue around the kidney. Some lymph nodes in the area also may be removed.
When one kidney is removed, the remaining kidney usually is able to perform the work of both kidneys.
Surgery is the treatment of choice for most stages of kidney cancer. For chemotherapy for kidney cancer, there are many relatively new agents that block the blood flow to the tumor and put it into remission. These medications are typically taken by mouth and are generally well tolerated. The other approach is to use medication that activates the bodys own immune system to fight the tumor.
Some people with kidney cancer participate in clinical trials. Clinical trials are research programs conducted with patients to evaluate new medical treatments, drugs or devices. Clinical trials also are being conducted on new chemotherapy drugs and on new ways to use biological therapy for patients with kidney cancer.
What Is The Outlook For People With Kidney Cancer
The chance of recovery depends on the type and stage of cancer . The chance of recovery also depends on the patients general state of health.
Like most cancers, kidney cancer is most able to be treated if it is found in its early stages. In general, if the cancer is detected early, before it breaks through the outer covering of the kidney, kidney cancer is often curable.
For People At Increased Risk Of Kidney Cancer
People who have certain inherited conditions, such as von Hippel-Lindau disease, have a higher risk of kidney cancer. Doctors often recommend that these people get regular imaging tests such as CT, MRI, or ultrasound scans at younger ages, to look for kidney tumors. Kidney cancers that are found early with these tests can often be cured.
It is important to tell your doctor if any of your family members has or had kidney cancer, especially at a younger age, or if they have been diagnosed with an inherited condition linked to this cancer, such as von Hippel-Lindau disease. Your doctor may recommend that you consider genetic counseling and testing to see if you have the condition.
Before having genetic tests, its important to talk with a genetic counselor so that you understand what the tests can and cant tell you, and what any results would mean. Genetic tests look for the gene mutations that cause these conditions in your DNA. They are used to diagnose these inherited conditions, not kidney cancer itself. Your risk may be increased if you have one of these conditions, but it does not mean that you have kidney cancer. For more information on genetic testing, see Genetics and Cancer.
Some doctors also recommend that people with kidney diseases treated by long-term dialysis or those who have had radiation to their kidney in the past have regular tests to look for kidney cancer.
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About Normal Ranges And Interpreting The Numbers
When you look at a printout of your lab results, youll find the normal ranges for each blood test next to your personal results. For example, if your routine blood work includes a test for calcium in the blood, your lab may list the normal range for calcium as 8.3 to 9.9 milligrams per deciliter . If your result is a 9.1 mg/dL, right in the middle, you can feel confident that your calcium level is normal.
But what if a blood test result is at the very low or high end of normal, or even slightly outside the normal range? Is that a red flag? Dont jump to conclusions, warns Dr. Salamon. Blood test results can vary a little bit, depending on the lab. And many people are consistently on one side or the other of the normal range, and for them, thats healthy, says Dr. Salamon.
Take, for example, a routine measure of blood urea nitrogen , a waste product created as your body breaks down the protein in your diet. Excess urea is removed from the blood by the kidneys, so high levels of BUN in the blood can indicate that kidney function is declining. So, what does it mean if your BUN level is at the very high end of the normal range? If I see that its borderline high, I might ignore it, says Dr. Salamon. Its common for BUN to go up if you dont drink enough, and that can happen when someone is fasting before having blood drawn.
Minor fluctuations in test results may also reflect
- recent infections
Common Signs And Symptoms Of Kidney Cancer
When kidney cancer is in earlier stages, you might not have any symptoms. Some symptoms might not be of concern or could indicate another disease or medical problem. You should schedule an appointment with your doctor if you have risk factors for kidney cancer and are experiencing any of the following symptoms:
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Low back pain on one side that isnt the result of an injury
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Fever that doesnt go away and isnt due to an infection
If you have developed any of the symptoms above and theyre persistent or cause concern, you should seek the help of a medical professional. Most of the time, symptoms occurring singly or infrequently indicate a minor issue that will resolve on its own. You should not try to self-diagnose or assume the worst. Only an experienced doctor can examine you to determine whats causing your symptoms and perform testing for kidney cancer.
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Blood And Urine Tests For Kidney Cancer
To rule out other potential conditions, your physician will likely order several blood or urine tests. For instance, your physician may check your urine for the presence of albumin, measure the amount of creatinine in your blood and determine your glomerular filtration rate . This can help him or her determine how well your kidneys are working and also indicate whether another, more common condition might be the cause of your symptoms.
Imaging Tests To Look For Kidney Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests are done for a number of reasons, such as:
- To look at suspicious areas that might be cancer
- To learn how far cancer might have spread
- To help determine if treatment is working
- To look for possible signs of cancer coming back after treatment
Unlike most other cancers, doctors can often diagnose kidney cancer with fair certainty based on imaging tests without doing a biopsy . Some patients, however, may need a biopsy.
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Is It Possible To Prevent Kidney Cancer
Since the cause of kidney cancer is unknown, there isnt a definitive solution for preventing this disease. However, you might be able to reduce your risk of getting it by improving your overall health and taking certain precautions.
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Quit smoking – It is widely known that smoking can cause cancer and other types of diseases. You might be able to reduce your risk of kidney cancer if you quit. There are many options that could help you quit. This can be discussed with your doctor or while attending a support program.
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Lower blood pressure Schedule an appointment with your primary care physician to check your blood pressure. If its high, there are lifestyle changes you could make to lower it. Dietary changes, weight loss, and exercise could all help. If necessary, your doctor could prescribe medication.
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Maintain weight Obesity is a known risk factor for kidney cancer. If you are obese or overweight, you could try increasing your daily physical activity or cut high-fat foods out of your diet. A nutritionist or personal trainer could assist you with this issue.
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What Are The Stages Of Kidney Cancer
Your prognosis depends on your general health, as well as the grade and stage of your kidney cancer.
These are the stages of kidney cancer. The higher the stage, the more advanced the cancer.
Stage I
- A tumor 7 centimeters or smaller that is only in the kidney
Stage II
- A tumor larger than 7 centimeters that is only in the kidney
Stage III
- A tumor that is in the kidney and in at least one nearby lymph node
- A tumor that is in the kidney’s main blood vessel and may also be in nearby lymph node
- A tumor that is in the fatty tissue around the kidney and may also involve nearby lymph nodes
- A tumor that extends into major veins or perinephric tissues, but not into the ipsilateral adrenal gland and not beyond Gerota’s fascia
Stage IV
- Cancer has spread beyond the fatty layer of tissue around the kidney, and it may also be in nearby lymph nodes
- Cancer may have spread to other organs, such as the bowel, pancreas, or lungs
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Cancer has spread beyond Gerota’s fascia
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Immunotherapy Is Becoming The Standard Of Care For Advanced Kidney Cancer
Therapy using medication that targets blood vessels has been the standard treatment for advanced kidney cancer for over a decade. This is often called targeted therapy. Studies show these drugs can help control the disease, but often do not cure it. Today, immunotherapy is becoming the new standard approach based on clinical trials that show it has greater benefits than targeted therapy. Immunotherapy works by stimulating your immune system to fight the cancer. This approach can cure some people and allow others to control their disease for many years. More information is needed from clinical trials about how patients are doing after treatment, but over the next few years, it is likely that most to all patients with advanced kidney cancer will receive immunotherapy as part of their first treatment plan. Targeted therapy is still important because it is now being combined with immunotherapy, and it can be useful if immunotherapy does not work.
What Usually Causes Kidney Cancer
Its not known exactly, but like other cancers, kidney cancer is caused by gene mutations that are either inherited or acquired during life. Some risk factors that have been identified include smoking, obesity, high blood pressure, and workplace exposure to certain chemicals. Family history also plays a role, and certain genetic conditions are associated with a high risk of kidney cancer.
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Why Is It Important To Check Kidney Function
When your kidneys do not work as they should, waste can build up in your blood. This can make you sick. If you have long-term kidney disease, you may not have any symptoms until your kidney function is very low.
Blood and urine tests can help show how well your kidneys are working. They can help your doctor know:
- If the disease started all of a sudden or if you have had it a long time.
- The cause of the kidney damage.
- The best type of treatment to slow the damage.
- How well treatment is working.
- When to begin dialysis or have a kidney transplant.
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Blood Urea Nitrogen Test
The blood urea nitrogen test checks for other waste products in the blood, such as urea nitrogen.
Urea nitrogen occurs as proteins from food break down, and elevated levels may be a sign that the kidney is not filtering these waste products effectively.
A typical BUN level falls between 7 and 20 milligrams per deciliter. Higher values could be a sign of an underlying condition affecting the kidneys.
With that said, many other things can affect BUN levels, such as medications or antibiotics. A diet that is very high in protein diet may also affect levels.
Doctors will typically compare these results to the results of a creatine test to get a better understanding of how well the kidney is filtering this waste.
Imaging tests may help doctors identify any physical changes to the kidneys, such as injuries or kidney stones.
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Can Cancer Be Detected By A Blood Test
If your physician suspects cancer during physical examination or while taking a medical history, they might order certain cancer blood tests to guide the diagnosis. These blood tests are called tumor markers. Tumor markers could be specifically raised in certain cancers, and may give some idea about the origin of cancer and whether it is responding to the treatment protocol. These tests, however, are neither specific for certain cancers nor highly sensitive.
Other blood tests could be ordered. While these may not detect cancer or benign tumors, they can give a general idea about the functioning of the organ and indicate whether it has been affected by cancer.
How Is A Renal Panel Different From A Comprehensive Or Basic Metabolic Panel
There is considerable overlap between the measurements on a renal panel, basic metabolic panel , and comprehensive metabolic panel .
The BMP has 8 components, all of which are included in the CMP, which has a total of 14 measurements. The components of the BMP and CMP are more standardized than the renal panel, which can vary between laboratories.
The BMP, CMP, and most renal panels include measurements of glucose, electrolytes, calcium, and the waste products creatinine and urea nitrogen. The CMP and many renal panels also include measurement of albumin.
An important difference for the comprehensive metabolic panel is its inclusion of tests that help assess the condition of the liver. These are tests found on a typical liver panel test.
Because it is not as standardized, a renal panel test may include measurements, such as phosphorus or the anion gap, that are not found on the BMP or CMP.
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Tumors Metastatic To The Kidney
, female reproductive organs Overview of Female Reproductive System Cancers Cancers can occur in any part of the female reproductive systemâthe vulva, vagina, cervix, uterus, fallopian tubes, or ovaries. These cancers are called gynecologic cancers. The most common read more, intestine Tumors of the Digestive System read more, and pancreas Pancreatic Cancer Smoking, chronic pancreatitis, male sex, being black, and possibly long-standing diabetes are risk factors for pancreatic cancer. Abdominal pain, weight loss, jaundice, and vomiting are some read more leukemia Overview of Leukemia Leukemias are cancers of white blood cells or of cells that develop into white blood cells. White blood cells develop from stem cells in the bone marrow. Sometimes the development goes awry read more and lymphoma Overview of Lymphoma Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs. Lymphomas are cancers of a specific type of white blood cells known as lymphocytes. These read more.
Such spread usually does not cause symptoms. Spread is usually diagnosed when tests are done to determine how far the original cancer has spread. Treatment is usually directed at the original cancer. Occasionally, if the original cancer is treated and the tumor in the kidney is growing, the kidney tumor is removed.
Are There Early Signs Of Kidney Cancer
Knowing your risk
Kidney cancer isnt as common as breast or lung cancer. For most people, the chance of getting kidney cancer in their lifetime is less than 2 percent, according to the American Cancer Society .
Your risk increases if you smoke, are obese, or have been exposed to chemicals, such as asbestos and benzene. Sometimes, kidney cancer can run in families. If youre at high risk, talk to your doctor and watch out for symptoms.
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How Hard Is It To Detect Kidney Cancer
Hard to find Because the kidneys are so deep inside the body, its harder to find kidney cancer just by looking or feeling for growths. Although mammograms and colonoscopies can screen for breast and colorectal cancers, no screening test is available for kidney cancer in people who arent at high risk for the disease.
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Types Of Kidney Cancer
Some kidney masses are benign, or noncancerous, and require no treatment.
Renal cell carcinoma accounts for about 90 percent of all kidney cancers. This form of cancer develops in the cells that line the tubules, which are a part of the nephrons located throughout the kidney. The three major subtypes of renal cell carcinoma are categorized according to what the cells look like under a microscope:
- clear cell renal cell carcinoma, in which the cells appear pale or almost clear
- papillary renal cell carcinoma, in which the cancer cells form small projections that look like fingers
- chromophobe renal cell carcinoma, in which the cancer cells appear large and pale
Another form of kidney cancer, transitional or urothelial cell carcinoma, accounts for about 5 to 10 percent of all kidney cancers. This condition develops in the renal pelvis, where the ureters meet the kidney. This type is referred to as upper urinary tract transitional cell carcinoma, or upper urinary tract cancer. Diagnosis and treatment of upper urinary tract cancer differs somewhat from renal cell carcinoma.
Wilms tumor is another type of kidney cancer, but it is rare and occurs mostly in children.
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