What Side Effects Can I Expect And How Do I Manage Them
Common side effects associated with immunotherapy include diarrhea, shortness of breath, a persistent cough, or a skin rash. Common side effects linked with targeted therapy include fatigue, high blood pressure, mouth sores or nausea. Depending on what drug you are taking, there are various ways to manage the side effects, including reducing the dose, putting the therapy on hold, or prescribing other medications that can curtail the side effects. Its important to ask your doctor what to expect so you can let them know right away if you encounter any.
The Following Stages Are Used For Renal Cell Cancer:
In stage III, one of the following is found:
- the cancer in the kidney is any size and cancer has spread to nearby lymph nodes or
- cancer has spread to blood vessels in or near the kidney , to the fat around the structures in the kidney that collect urine, or to the layer of fatty tissue around the kidney. Cancer may have spread to nearby lymph nodes.
In stage IV, one of the following is found:
- cancer has spread beyond the layer of fatty tissue around the kidney and may have spread into the adrenal gland above the kidney with cancer or to nearby lymph nodes or
- cancer has spread to other parts of the body, such as the bones, liver, lungs, brain, adrenal glands, or distant lymph nodes.
Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for kidney cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the kidney.
- Regional: The cancer has spread outside the kidney to nearby structures or lymph nodes.
- Distant: Includes cancers that have spread to distant parts of the body such as the lungs, brain, or bones.
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How Are Adrenal Metastases Detected
CT scan demonstrating a left adrenal metastasis from colorectal cancer . Dr. Carling performed a successful partial, cortex-sparing operation via the Mini Back Scope Adrenalectomy since the patients had a previous right adrenalectomy. Most adrenal metastasis do not cause symptoms. This is true for about 90-95% of cases. Most adrenal metastasis are detected on a scan, such as CT, MRI or PET scan performed before or during treatment for the underlying cancer. Sometimes, the adrenal metastasis is diagnosed due to symptoms, such as back/flank or abdominal pain, bleeding into the tumor, or rarely due to adrenal insufficiency of both adrenal glands are destroyed by the cancer. If you have a scan suspicious for adrenal metastases, you do not necessarily need any further evaluation, especially if you have metastases to other regions of your body. In some cases, your doctor may wish to be certain that a mass in your adrenal gland is due to metastatic cancer and recommend a CT-guided biopsy. This is one scenario when performing aa biopsy of an adrenal gland is appropriate. Read about about adrenal mass biopsy here.
Questions To Ask The Doctor
What treatment do you think is best for me?
Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
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Adjuvant And Neoadjuvant Therapy
Adjuvant therapy, which refers to therapy given after a primary surgery, has not been found to be beneficial in renal cell cancer. Conversely, neoadjuvant therapy is administered before the intended primary or main treatment. In some cases neoadjuvant therapy has been shown to decrease the size and stage of the RCC to then allow it to be surgically removed. This is a new form of treatment and the effectiveness of this approach is still being assessed in clinical trials.
How To Manage Your Symptoms
Palliative care can relieve symptoms like pain, fatigue, and nausea. This treatment won’t cure your cancer, but it can help you feel better. You can still get your other cancer treatments while you’re getting palliative care.
Palliative care can include:
- Pain relievers and other medicines
- Relaxation techniques
Ask your doctor if your hospital or cancer center offers palliative care services.
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What Are The Treatment Options For Stage 4 Kidney Cancer
The type of treatment your doctor delivers mainly depends on the stage of your cancer. In stage 4, the cancer has already advanced to distant sites. Surgery is generally not an option in this stage.
Surgery is possible in cases where the tumor and metastasis can be differentiated so that the cancerous cells are successfully removed by isolation.
If the cancer has spread to the lungs, lung removal partially may help remove the cancer.
But, your doctor will also consider your overall health condition to determine whether it is possible and safe for you to go through a major surgery such as partial lung removal.
If surgery isnt an option to treat stage 4 kidney cancer, other options may be considered. These may include such as:
- embolization: it is the blocking of blood flow to the cancer cells
- radiation therapy: it uses high-energy radiation beams to target cancer cells. But, its not usually successful when the cancer has spread to several locations.
It is important that you follow your doctors advice. Attend to the appointments regularly and on time, and take your medications. Follow the lifestyle changes your doctor advises
Tatheer Zehra Zaidi is a clinical pharmacist and pharmacologist with a masters degree in pharmacy practice. She aims to deliver a positive contribution in the field of healthcare and research. She received her bachelors and masters degrees from Jamia Hamdard New Delhi and then joined Spirant Communication Private LTD as a Medical content writer.
How Does Kidney Cancer Spread
The cancer can breakaway and spread from where it started to another area of the body. The original area where it grows for the first time is called primary site and the original cancer is called primary cancer.
When it has spread, it may cause a new growth of tumor called secondary cancer . The secondary, metastatic cancer has the same type of cancer cells where they come from, the primary cancer.
For instance when kidney cancer spreads to the lung, the cancer cells in the lung are kidney cancer cells it is metastatic kidney cancer or called secondary lung cancer not primary lung cancer. The process of the cancer cells moves from the original /primary site to other parts of the body and create a new abnormal growth is called metastasis.
The metastasis of kidney cancer can occur in several different ways direct invasion, hematogenous spread, and through lymphatic system.
With this way, the cancer spreads and grows into surrounding tissues or structures. For instance, kidney cancer can easily spread to the adrenal gland a small, essential gland located on top of each kidney.
The cancer cells can break free from the primary tumor and travel through bloodstream to a new location in the body. With this hematogenous metastasis, they can spread far away from where they started.
Lymphatic system spread
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The Effects Of Metastatic Renal Cell Carcinoma On The Body
Your kidneys are two bean-shaped organs located near your back. Each day, they filter wastes and extra water from your blood to produce urine. The kidneys also release hormones that regulate blood pressure and other body functions. Renal cell carcinoma can start in the filtering tubes of your kidneys. From there, it can grow and spread to other parts of your body.
Renal cell carcinoma is a type of cancer that starts in the tiny filtering tubes of the kidneys. Metastatic means the cancer has spread outside of the kidneys. It may have reached lymph nodes or organs like the brain and lungs. When cancer spreads, it can affect many different parts of your body.
Metastatic Brain Cancer Treatment
It is important to know that metastatic brain tumors are often treatable, and can be well-controlled. Generally, the faster you start treatment, the better the chances of killing or controlling the disease.
The treatment options for brain metastases may include:
- Clinical trials
In many cases, surgery or radiation therapy can improve or entirely get rid of symptoms. Read more about brain tumor treatment.
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Causes Of Kidney Cancer
The exact cause of kidney cancer is unknown, but some things can increase your chances of getting it, including:
- family history youre more likely to get kidney cancer if you have a close relative with it
- some inherited genetic conditions
- long-term dialysis a treatment for chronic kidney disease where a machine does some of the jobs of the kidneys
Keeping to a healthy weight, a healthy blood pressure and not smoking is the best way to reduce your chances of getting kidney cancer.
What Happens When Cancer Spreads To The Brain
Cancer cells can break away from the primary tumor and travel to the brain, usually through the bloodstream. They commonly go to the part of the brain called the cerebral hemispheres or to the cerebellum, where they form a mass.
Some metastatic brain tumors appear many years after the primary cancer. Others metastasize so quickly that they are identified before the primary cancer.
When the cancer cells reach the brain and form a tumor, it may lead to a variety of symptoms that can be shared by nonmetastatic brain tumors as well.
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Types Of Cancers That Are More Likely To Go Undetected
Some cancers are more easily detected than others. For example, certain types of skin cancer can be diagnosed initially just by visual inspection though a biopsy is necessary to confirm the diagnosis.
But other cancers can form and grow undetected for 10 years or more, as one study found, making diagnosis and treatment that much more difficult.
This table provides an overview of common cancers that often display little or no symptoms early on, and how theyre typically detected and diagnosed:
|Type of cancer|
Other Aggressive Forms Of Kidney Cancer
Low grades of kidney cancer tend to be slow-growing, while high grades can multiply fast. The other types that are found to be more aggressive are papillary , chromophobe, medullary and oncocytic.
These variations of kidney cancer have a higher chance to metastasize, or spread, to other parts of the body. The most common places that kidney cancer can spread to are the lung and lymph nodes.
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Distribution And Prognosis Of Distant Metastatic Sites
The main metastatic sites of kidney cancer were the bones, brain, liver, and lungs, which composed of 7,891 of all patients. The information of the four main distant metastatic organs is summarized in Table 2. It was found that 5,465 patients were diagnosed with lung metastasis, 1,865 patients with liver metastasis, 3,386 patients with bone metastasis, and only 999 patients with brain metastasis. We plotted the distribution of four main metastatic organs in the Venn diagram . The detailed metastatic sites of patients with more than one organ metastasis are presented in the overlapping area of the Venn diagram.
Table 2. Characteristics of patients and metastatic organs of original cohort.
Figure 2. Venn diagram of distributions of main distant metastatic organs in metastatic kidney cancer. KaplanMeier Curves and log-rank test for the survival analysis in the original cohort. Comparing the overall survival between the surgery and no surgery groups among patients with bone metastasis status , brain metastasis status , liver metastasis status , and lung metastasis status , respectively.
Those patients with different metastatic sites were extracted separately, and OS was compared between the surgery and no surgery groups. The KaplanMeier analysis indicated that patients receiving surgery had OS benefits among those patients with bone metastasis status , brain metastasis status , liver metastasis status , and lung metastasis status , respectively.
How Common Is Metastatic Kidney Cancer
Nearly a third of people with renal cell carcinoma have already reached stage 4 cancer by the time they are diagnosedkidney cancer symptoms are notoriously invisible, so many people dont realize they have it until the advanced stages. And in those with earlier stages of kidney cancer, metastatic cancer reappears in about one in four cases, usually in the first three years after initial treatment.
Renal cell carcinoma that has reached the stage of metastatic cancer spreads through the blood or lymphatic system , so tumors can pop up almost anywhere. Heres where kidney cancer travels most often:
When tumors reach these regions, people often have corresponding symptoms, like trouble breathing, bone pain, or neurologic issues.
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My Kidney Cancer Has Spread To Other Parts Of The Body: What Treatment Could I Take
In people with advanced kidneycancer, where the cancer has spread to distant organs, the cancer is usually not completely curable. The goal of treatment is therefore to make life as long and as normal as possible. Combinations of different treatments may be recommended by different doctors, including urologists, medical oncologists who prescribe anti-cancer medications, and radiation oncologists who treat people with radiation. Throughout, this team of specialists will work with you and your family doctor to help you control your symptoms and live as normal a life as possible.
Extended Survival Observed In Patients With Solitary Brain Metastasis From Rcc
Although patients who develop brain metastases from renal cell carcinoma typically have poor outcomes, investigators from Yale University have identified a subset of patients who demonstrated extended survival.< sup> 1< /sup> Those patients with a single metastasis were less likely to develop central nervous system\ recurrence after local therapy. This is an encouraging development because these patients have historically been excluded from participating in clinical trials and receiving aggressive treatment regimens.
Alfredo Suarez-Sarmiento, Jr, MD
Although patients who develop brain metastases from renal cell carcinoma typically have poor outcomes, investigators from Yale University have identified a subset of patients who demonstrated extended survival.1Those patients with a single metastasis were less likely to develop central nervous system recurrence after local therapy. This is an encouraging development because these patients have historically been excluded from participating in clinical trials and receiving aggressive treatment regimens.
There are no guidelines for screening and surveillance for brain involvement, so we sought to document our single institution experience, said lead author Alfredo Suarez-Sarmiento, Jr, MD, an associate research scientist at Yale University School of Medicine during the 2018 American Urological Association Annual Meeting.
TABLE. Treatment Options for Patients with Brain Metastases From Renal Cell Carcinoma
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Signs And Symptoms Of Kidney Cancer
Most people with kidney cancer have no symptoms. Doctors find most kidney cancers when they are checking for something else. Signs and symptoms can include:
- blood in your urine this may be obvious, or the urine may look dark, rusty or brown
- pain in your lower back or side
- a lump in your abdomen
- constant tiredness
- unexplained weight loss
- fever .
Not everyone with these symptoms has kidney cancer. If you have any of these symptoms or are worried, always see your doctor.
Cancer May Spread From Where It Began To Other Parts Of The Body
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if renal cell cancer spreads to the bone, the cancer cells in the bone are actually cancerous renal cells. The disease is metastatic renal cell cancer, not bone cancer.
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Radiation Therapy For Metastatic Brain Tumors
Radiation therapy treats metastatic brain tumors by using X-rays and other forms of radiation to destroy cancer cells or prevent a tumor from growing. It is also called radiotherapy.
These painless treatments involve passing beams of radiation through the brain, which can treat cancers in areas that are difficult to reach through surgery. Procedures may include any one or a combination of the following:
- External beam radiation therapy delivers radiation from a machine and through the body to reach metastatic tumors.
- Whole-brain radiation targets the entire brain to hit multiple tumors or any metastatic disease that hides from an MRI scan.
- Stereotactic radiosurgery directs a high dose of radiation targeted to the specific shape of the tumor, sparing surrounding healthy tissue from unnecessary radiation exposure.
- Proton therapy uses protons to treat metastatic brain tumors. Like stereotactic radiosurgery, proton therapy minimizes harm to healthy tissue surrounding a tumor.
These procedures may be performed after surgery to prevent tumors from recurring at the surgical site and growing into other brain tissue.
Because radiation therapy has been so successful in treating brain metastases and because many live long lives after treatment studies are now looking at how to manage the long-term effects of treatment.