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 patient’s 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.
What Makes Yale Medicines Approach To Diagnosing Renal Cancer Unique
Yale Medicine is unique in the sense that the people who are here are the best in their fields, Dr.;Adeniran says. Our clinicians, urologists and pathologists;have specialized training that allows us to make rare, specialized diagnoses.
Our state-of-the-art technology and equipment enable us to do molecular studies and immunostains that take the diagnosis to the cellular level, he says. We can then personalize the treatment to the patient in ways that cant be done at most other places. Because of all this, we are leaders in the field.
Yale Medicine also offers patients the ability to receive advanced therapies before they are widely available elsewhere. Our pathologists and urologists and oncologists often participate in multi-institutional studies, Dr. Adeniran says, where we can try things out on a limited number of patients.
Dr. Adeniran believes that Yale Medicines conferences multidisciplinary gatherings where experts from all related specialties meet to present and discuss specific cases are of great value. In many institutions, a pathologists job is done once a disease is diagnosed. But thats not the case at Yale Medicine. We dont just make the diagnosis how we treat the patient, and what we treat the patient with, depends on the diagnosis we pathologists make, says Dr. Adeniran. Here, we are part of the treatment.
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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Kidney Cancer Symptoms To Watch For
In some cases, the first sign of kidney cancer is bloody urine, which may appear dark red, orange or pink in color. As kidney cancer progresses, it may produce other symptoms, such as:
- Persistent pain or pressure felt just below the ribs
- Intense fatigue
- Anemia
- A palpable mass or thickening in the side or back
The kidneys play an important role in the bodys metabolic and digestive processes. Cancer can affect kidney function, which in turn could impair the bodys ability to break down, absorb and dispose of food. This could become apparent in symptoms such as loss of appetite or unintended weight loss.
While kidney cancer can produce any of these symptoms, its important to understand that none are exclusive to kidney cancer. More often, the symptoms are related to a less serious issue. Even so, they should never be ignored. An early kidney cancer diagnosis can help ensure the best possible outcome and quality of life.
What To Do If You Have Kidney Cancer Symptoms
Any symptoms of kidney cancer should be promptly brought to the attention of a physician, who can order tests to help determine the cause. The diagnostic process may include a physical examination, urinalysis and blood tests to check kidney, liver and metabolic function. If a lump or mass is found, a biopsy will be recommended.
If youd like to discuss your kidney cancer symptoms with a specialist in the Urologic Oncology Program at Moffitt Cancer Center, you can do so with or without a referral. To request an appointment, call or complete a new patient registration form online.
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Tumors Metastatic To The Kidney
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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.
Signs Vs Symptoms Of Cancer
Signs and symptoms of disease can be two different things:
- A sign is something that can be observed by another person, such as a change in skin color or wheezing.
- A symptom is something you feel, such as fatigue or pain, that isnt obvious to others.
The nature of cancer signs and symptoms differ greatly, depending on where the cancer is located.
Bladder cancer, for instance, causes blood in the urine, while brain cancer triggers terrible headaches.
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What Are The Symptoms Of Kidney Cancer
Kidney cancer may not produce any noticeable symptoms in its early stages. However, as the tumor grows, symptoms may begin to appear. For that reason, kidney cancer is often not diagnosed until it has begun to spread.
Symptoms of kidney cancer can include:
- Blood in the urine .
- A lump or mass in the kidney area.
- Pain in the side.
- A general sense of not feeling well.
- Loss of appetite and/or weight.
- Low-grade fever.
- Anemia .
Medical History And Physical Exam
If you have any signs or symptoms that suggest you might have kidney cancer, your doctor will want to take your complete medical history to check for risk factors and to learn more about your symptoms.
A physical exam can provide information about signs of kidney cancer and other health problems. For example, the doctor may be able to feel an abnormal mass when he or she examines your abdomen .
If symptoms or the results of the physical exam suggest you might have kidney cancer, more tests will probably be done. These might include lab tests,imaging tests, or biopsies of the kidney.
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What Usually Causes Kidney Cancer
It’s 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.
Questions For Your Doctor
You and your healthcare provider need to work together. Here are some questions to start the conversation.
- Do I have kidney cancer?
- Has my cancer spread beyond my kidneys?
- Can my kidney cancer be cured?
- What are my treatment options?
- How long will treatment last?
- Are there any risks or side effects associated with my treatment?
- What will my recovery be like?
- How long will it take for me to recover from treatment?
- What are the chances of cancer coming back?
- Should I also see a nephrologist ?
- Will you be partnering with a nephrologist about my care?
- Should I get a second opinion?
- How much experience do you have treating this kind of cancer?
- Are there any clinical trials I should think about?
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Kidney Cancer May Cause No Symptoms Or Only Subtle Symptoms
Every person has 2 kidneys. These fist-sized organs filter blood to remove impurities, excess minerals and salts, and extra water. They also produce hormones that help control blood pressure, red blood cell production, and other bodily functions. Because your kidneys are located in the back of your abdomen surrounded by fat, a tumor may not cause symptoms in its early stages. As it grows, common symptoms can include pain in the side or blood in the urine. Often, people with kidney cancer have blood in their urine only 1 time. Thats why the cause of any blood in your urine needs to be investigated right away by your primary care doctor or a urologist, a doctor who specializes in treating conditions of the urinary tract. Early detection of kidney cancer is key to successful treatment. There are only a few well-identified risk factors for kidney cancer aside from smoking, and most people dont have an inherited form of the disease. So paying close attention to symptoms and having them evaluated by a medical professional is essential
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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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.
How Are Samples Collected
Requirements for urine sampling vary depending on the test/s being performed. Often the timing of collection is random, as dictated by the logistics of a doctor consult or access to a laboratory service. However, depending on the purpose of the test, certain urine voids of the day may be preferred. Collection of urine from all voids over a defined time period or sample collection at specific times after eating may also be necessary.
Urine samples are usually obtained by spontaneous voiding, using the clean-catch, midstream urine collection method. This involves voiding the first portion of urine into the toilet, collecting the midstream portion into a clean container, then voiding the remaining portion into the toilet. This method greatly reduces the risk of contaminants entering the sample. Less commonly, an invasive method of urine collection, such as placement of a urinary catheter, may be required.
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What Is The First Sign Of Kidney Cancer
Early-stage kidney cancer usually does not produce noticeable symptoms. Because the kidneys are located deep within the body, signs of kidney cancer may not become apparent until a tumor grows very large and affects surrounding tissues or kidney function. In many cases, kidney cancer is detected in a diagnostic test or imaging study performed for an unrelated reason.
Staging Of Kidney Cancer
In addition to taking a complete medical history, performing a physical exam, and obtaining laboratory tests, your physician may order various imaging tests. These studies are to characterize the kidney tumor and evaluate if the cancer has spread outside of the kidney .
- Chest X-ray. Evaluation of the chest for any lung involvement.
- Ultrasound Examination. Uses high-frequency sound waves to generate images of your internal organs, such as your kidneys.
- Computerized Tomography or Magnetic Resonance Imaging scan.;CT scans use computers for focused X-rays to create a detailed image. MRI scans use magnetic fields and radio waves to generate cross-sectional pictures of your body.
- Bone Scan. Uses a very small amount of a radioactive substance with imaging to detect bone involvement.
- Sestamibi Spect/CT Scan. Nuclear medicine scan to detect less aggressive renal tumors. This is being offered on a research protocol to determine if this aids decision making.
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PET/CT Scan. Uses special dye containing radioactive tracers with a CT scan .
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How Do Cancer Clues Get Into Urine
There are two main ways for cancer to end up urine through the kidneys or from the bladder and ureters .
Molecules released by cancer cells can travel to the kidneys via the blood. But to pass through the kidneys delicate filtering system and enter the bladder, these molecules need to be small. Theyre usually molecular building blocks that make up cancer cells, like proteins.
And a useful clue doesnt have to come from the cancer directly. There are promising studies that show that the human papillomavirus , a virus responsible for the majority of cervical cancer cases, can be detected in the urine.
Larger clues like entire cancer cells or their DNA are too big to pass through the kidneys and will have to come from the bladder or ureters. Pee contains normal bladder cells that have dropped off from the lining of the urinary tract as part of the normal cell lifecycle. If you have disease, diseased cells will be there too, says Bryan, whose research is looking for the DNA of bladder cancer cells in urine.
Staging Factors Of Kidney Cancer
The;most important factor in predicting prognosis, as well as the treatment options, is the “stage” or extent of the cancer. Staging is the process of gathering information from physical examinations and diagnostic tests to determine the size and location of the tumor and how widespread a cancer is.
Important Staging Factors in Kidney Cancer are:
- Tumor size
- Spread to tissues surrounding the kidney
- Spread to contiguous organs
- Spread to nearby lymph nodes
- Spread to other organs like lung, bone, liver
Common staging systems for Kidney Cancer:
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How We Diagnose Kidney Cancer:
Initial diagnosis of renal cell carcinoma can be difficult due to the lack of presenting symptoms. As stated, it is often found by accident. If your urologist is suspicious of renal cell carcinoma, potential tests they may order include:
- Urine analysis/cytology– to examine the urine for blood or specific tumor markers.
- Imaging tests : These are often the most specific and sensitive for targeting renal cell carcinoma.
- Fine needle aspiration : may be utilized to take a sample of the concerning area on the kidney. In other words, an ultrasound of the kidney.
- Fuhrman grade: is based on the nuclear characteristics of the cancer and gives an indication of prognosis. It is rated 1-4 in which a higher grade implies a worse prognosis.
Coping With The Diagnosis
Being diagnosed with cancer can be very distressing. The news can be difficult to take in and make sense of.
Talking to your friends or family may help, although you might also;find it useful to speak to a counsellor, a;psychiatrist or other people in a similar situation to you.
Cancer UK has more information and advice on coping with kidney cancer.
Page last reviewed: 03 December 2019 Next review due: 03 December 2022
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The Most Common Tests That May Be Ordered Include:
Blood & Other Tests
In addition to a physical exam and medical history, your doctor will order some lab tests to complete your evaluation.
Blood samples will be collected as a part of a routine physical exam to evaluate kidney function and overall health.
Urinalysis will be done to collect and test urine. Microscopic tests can detect small amounts of blood or infection in the urine.
Chest X-ray
A plain x-ray of the chest may be done to see if the cancer has spread to the lungs. If something notable is seen on the x-ray, the doctor may order a CT scan of the chest to help determine what it is.
Computed Tomography
A CT scan is a highly specialized x-ray that can visualize internal organs and provides a very accurate cross section picture of specific areas of the body. It is one of the primary imaging tools for assessing RCC. To enhance the image of the abdominal organs, dye may be given orally or intravenously before the scan. The IV dye may cause a hot flushing sensation or an allergic reaction, especially in individuals who are allergic to iodine.
Magnetic resonance imaging