Can Kidney Cancer Spread To Bones

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.

Exploring The Epigenetics Of Metastasis

In addition, the investigators explored the mechanisms by which the CXCR4 and CYTIP genes are switched on in kidney cancer cells to incite metastasis. Their study revealed that the genes undergo a series of epigenetic changes modifications in the proteins that package a cells DNA and regulate genes.

Unlike gene mutations, which alter a cells genetic code, epigenetic changes leave the DNA sequence unaffected. Nevertheless, such changes can influence a cells behavior by switching individual genes on or off.

Epigenetic modifications are commonly seen in many types of cancer and have recently been associated with more-advanced disease. However, little is known about the specific genes and mechanisms by which tumor cells may reconfigure their epigenetic makeup, causing a persons disease to progress and establish itself in new organs.

Our study has demonstrated with clear examples how epigenetic alterations can lead to the activation of metastasis-inducing genes, Dr. Vanharanta notes. This is a conceptual advancement that is likely to help us understand how metastasis occurs in kidney cancer as well as in other cancer types.

Pathophysiology Of Tumor Metastasis

Skeletal metastatic lesions are divided into three types: Osteolytic, osteoblastic and mixed. Activity of osteoclasts is responsible for osteolytic lesion and their activating mechanism varies according to different types of primary malignancies. Osteoclasts are derived from hematopoietic stem cells and mainly they resorb mineralized bone matrix by creating microenvironment and ultimately undergo apoptosis. In normal metabolism, bone micro-environment enhances osteoclast production by forming different molecules like macrophage colony stimulating factors and receptor activator of nuclear factor kB and its ligand by stromal cells, osteoblast, activated T-cells, tumor cells and osteoclast precursor cells. Bone metastases develop by occupation of bone erythropoietic system by cancer cells. Interaction of tumor cells and bone micro-environment induces immune cells to release factors that attract and stimulate osteoclasts thereby causing increased bone turnover and destruction .

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Targeted Therapy For Kidney Cancer

Targeted therapy drugs work on the changes in cells that cause cancer. These drugs affect mainly cancer cells and not normal cells in the body. They may work even if other treatments dont. They come as pills that you take at home or may be given through a vein. These drugs have different side effects than chemo.

Side effects of targeted therapy

Side effects of targeted therapy depend on which drug is used. These drugs can make you feel sick to your stomach and cause low blood counts. They can also cause high blood pressure and skin changes of the hands and feet. These side effects usually go away after treatment ends.

There are ways to treat most of the side effects caused by targeted therapy. If you have side effects, talk to your cancer care team so they can help.

Where Does Kidney Cancer Spread

Kidney cancer has the capacity to travel to lymph nodes, other organs , and to bones. This is called metastasis, meaning spread. The most common site is the lungs, representing about 45% of metastatic cases. The second most common site is bone, comprising roughly 30% of kidney cancer metastasis. When kidney cancer spreads to the bone, it is called kidney cancer bone metastasis, or bone mets.

Sometimes, kidney cancer bone mets are detected by imaging even before there are symptoms. However, for many kidney cancer patients, the first indication of bone mets may be one or more of the following:

• Pain
• High calcium levels

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Tumor Ablation For Kidney Cancer

Tumor ablation destroys the tumor without taking it out by surgery. It may be done if the person is too sick to have surgery. There are many ways to do this, such as heating the tumor with radio waves or microwaves, freezing the tumor, or killing the tumor by blocking the blood supply that feeds the kidney. Talk to your doctor about the planned treatment and what you can expect.

Surgery For Renal Cell Carcinoma

Removal of the diseased kidney is the standard treatment of renal cell carcinoma. People can live normally with one kidney if that kidney is healthy. The 3 main types of nephrectomy are as follows:

• Partial nephrectomy: The tumor and part of the kidney around the tumor are removed. The partial nephrectomy is performed mainly in people who have problems with their other kidney. This treatment is being investigated by surgeons to determine if it is as effective as the standard procedures to remove the kidney, as described below.
• Simple nephrectomy: The cancerous kidney is removed.
• Radical nephrectomy: The cancerous kidney, adrenal gland, and surrounding tissue are removed.

Nephrectomy may be performed with a large incision or via laparoscopy. Laparoscopy is a technique that removes the kidney through a very small incision. Laparoscopy leaves a smaller scar and requires less time in the hospital. It is used for people with small kidney cancers.

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What About Other Treatments That I Hear About

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

Reviewskeletal Metastasis In Renal Cell Carcinoma: A Review

Renal cell carcinoma account for 3% of all cancers.

It is a very destructive that may compromise bone integrity.

Most common metastasis in renal cell carcinoma occurs to lung, followed by bone , lymph nodes, liver, adrenal gland and brain.

Most common metastasis in renal cell carcinoma occurs to lung, followed by bone involvement in 2035%, lymph nodes, liver, adrenal gland and brain.

In metastatic disease median survival rate of patient is about eight months with 50% mortality rate within first year of life, five years survival rate is 10.

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Where Does Metastatic Kidney Cancer Spread

The most common type of kidney cancer, renal cell carcinoma, begins growing in the kidney and then it can spread to the surrounding tissues and organs. The most common locations where kidney cancer spreads are the lymph nodes, lungs, and bones, says, Randy F. Sweis, M.D., assistant professor of medicine at University of Chicago Medicine. In scarier cases, it can spread to the brain or liver. Where it spreads depends on the specific cancer in the individuals body, says Dr. Sweis.

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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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:

• Lungs .

• Adrenal glands

• Brain

When tumors reach these regions, people often have corresponding symptoms, like trouble breathing, bone pain, or neurologic issues.

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Will I Need Surgery

If most of the cancer is in the kidney and if surgery would leave little, if any, cancer behind, then its reasonable to consider surgery, says Moshe Ornstein, M.D., a kidney cancer medical oncologist at the Cleveland Clinic. Depending on the amount of cancer left, you and your oncologist will discuss whether to start additional drug therapy. However, for patients who have a lot of cancer outside the kidney , there is not much of a role for upfront surgery adds Dr. Ornstein, and medications should be started right away.

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Treatments For Advanced Kidney Cancer Include:

Active Surveillance :

In some people in whom the kidney cancer has spread, the cancer might be growing so slowly that the right first option is to watch carefully. This is especially the case when the cancer has been discovered by accident. If the cancer starts to grow quickly or cause symptoms then active treatments will be recommended. A small percentage of patients might live without symptoms from the cancer for a very long time, sometimes years, so your doctor might advise you to observe for a period of time.

Surgery to remove cancer that has spread:

In a very small number of people, the cancer spreads to only one or two places if this is the case it can be possible to try to cut out all the metastatic cancers . Some patients can live a very long time in these circumstances, but it really only applies to patients where there is only one or two spots elsewhere and they can all be safely removed.

Surgery to remove cancer in the kidney:

If your health is otherwise good, there is evidence that removing the original cancer in the kidney improves survival and helps other treatments work better. This cytoreductivenephrectomy would be performed by your urologist .

Clinical Trials:

Radiation therapy:

Palliative care:

Alternative Therapies:

Complementary Therapies:

Targeted Therapy

Medications that block cancers growth

Immunotherapy with cytokines

Immunotherapy with checkpoint antibodies

Think treatment, think trial

What Kind Of Cancer Does A Dog Have

Cancer symptoms in dogs vary with different types of cancer. Most of the symptoms are indistinct especially at the onset of the cancer. Kidney cancer in dogs generally affects older pets and is also known as renal neoplasia or renal adenocarcinoma. All breeds of dogs are equally susceptible to renal cancer although such cancer is rare in dogs.

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What Medical Therapies And Medications Treat Renal Cell Carcinoma

Treatment of renal cell cancer depends on the stage of the disease and the person’s overall health, which determines how well that person is able to tolerate various therapies. A medical team will devise a treatment plan that is tailored specifically for the individual. Therapies that are used for renal cell cancer include surgery, chemotherapy, biological therapy, hormone therapy, targeted agents, and radiation therapy. Historical trials of conventional chemotherapy and hormonal therapies have proved ineffective. Clinical trials may be appropriate for some patients with kidney cancer. A person may undergo a single therapy or a combination of therapies.

Generally, surgery is the best treatment for renal cell cancer that has not metastasized. For more information, see Surgery.

Chemotherapy is the use of strong drugs to kill cancer cells.

• Unfortunately, chemotherapy often has less benefit in renal cell cancer than other cancer diagnoses.
• Chemotherapy shrinks the tumor in some patients with kidney cancer, but this period of remission does not usually last long.
• Chemotherapy drugs may be given singly or in combinations.
• Chemotherapy typically has side effects such as nausea and vomiting, weight loss, and hair loss. Chemotherapy can also suppress production of new blood cells, leading to fatigue, anemia, easy bruising or bleeding, and increased risk of infection.
• Today, conventional chemotherapy has been largely replaced by targeted drug therapy

How Do Physicians Determine Staging Of Renal Cell Carcinoma

Staging of renal cell cancer is based on the size of the tumor and the extent of its spread outside the kidney. Like many cancers, renal cell cancer is staged according to the tumor , nodes , and metastases classification endorsed by the American Joint Committee on Cancer . The TNM classification system assigns a T code, an N code, and an M code to each tumor. An X is used if that feature cannot be determined. The combination of these 3 codes determines the disease stage.

• Primary tumor – 0, 1, 2, 3a, 3b, 3c, 4 based on size of tumor and parts of kidney and surrounding area involved
• Regional lymph nodes – 0, 1, 2 based on number of lymph nodes involved
• Distant metastasis – 0 , 1

AJCC Stages

• Stage I – T1N0M0 cancer is 7 cm or smaller in size and confined to the kidney
• Stage II – T2N0M0 cancer is larger than 7 cm and confined to the kidney
• Stage III – T1 or 2, N1M0 or T3a-c, N0-1, M0 cancer of any size that has spread to fatty tissue, blood vessels, or a lymph node near the kidney
• Stage IV – T4 or any T, N2M0 or any T, any N, M1 cancer has spread to multiple lymph nodes to nearby organs, such as the bowel or pancreas or to other parts of the body, such as the lung, brain, or bone

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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.

Screening Options For Kidney Cancer

Some types of kidney cancer are discovered before they have a chance to spread outside the kidney. Unfortunately, some arent found until they reach an advanced stage. The reasons that could happen are:

• Physical exams typically dont uncover small tumors since the kidneys are deep inside a persons body

• Symptoms might not develop until cancer becomes large

• Recommended screening tests are not available for someone who doesnt have an increased risk of developing the disease

Some tests could detect kidney cancer before it progresses, but since it isnt recommended for people at average risk, you might have to advocate for yourself and speak to a doctor if you develop any of the common symptoms.

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What Are The Treatments For Kidney Cancer

Treatment options which may be considered include surgery, radiotherapy, arterial embolisation and immunotherapy. The treatment advised for each case depends on various factors, such as:

• The stage of the cancer .
• The exact subtype or grade of the cancer.
• Your general health.

You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects and other details about the various possible treatment options for your type of cancer.

You should also discuss with your specialist the aims of treatment. For example:

• In some cases, the treatment aims to cure the cancer. Some kidney cancers can be cured, particularly if they are treated in the early stages of the disease.
• In some cases, the treatment aims to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
• In some cases, treatment aims to ease symptoms. For example, if a cancer is advanced then you may require treatments such as painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of a cancer, which may ease symptoms such as pain.

Signs Symptoms And Diagnosis

The most common signs of bone metastases are pain, fracture , spinal cord compression, and a high calcium blood level. Your provider will monitor you closely during treatment of your primary cancer for these signs and symptoms. You should notify your provider if you start to experience any symptoms of bone metastases.

Bone pain is usually the first symptom of bone metastases. The pain usually starts intermittently , is worse at night, and is usually relieved with movement. It may progressively worsen and become constant. There are many medications that can be used to treat the pain.

Bone metastases can weaken bones and even result in fractures . Fractures that are the result of bone metastases are called “pathologic” fractures. The fractures could be caused by trauma, but if the bone is weak enough, it can break just by doing an everyday activity.

Cancer that has spread to the spine can cause pressure on the spinal cord, which is called spinal cord compression. Signs of spinal cord compression include new or worsening pain in the back or neck, numbness and weakness in the body below the tumor and difficulty walking. Spinal cord compression can lead to nerve damage and even paralysis if not treated promptly.

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