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?
How Does The Doctor Know I Have Kidney Cancer
Kidney cancers dont usually cause any signs or symptoms, but sometimes they might. Symptoms of kidney cancer may be:
- Blood in the urine
- Losing weight, if youre not trying to lose weight
- Fever thats not from a cold and that doesnt go away
Talk to a doctor if you notice any of these problems. Your doctor will ask you questions about your health and do an exam.
If signs are pointing to kidney cancer, more tests will be done. Here are some of the tests you may need:
Urinalysis: Urine is checked in the lab to see if there are blood or cancer cells in it
Blood chemistry tests: These tests show how well the kidneys are working.
Complete blood count :This test measures the number of blood cells in the blood, like white blood cells, red blood cells, and platelets. People with kidney cancer often have low red blood cell counts.
Chest x-ray: X-rays may be done to see if the cancer has spread to your lungs.
CT scan: This is also called a CAT scan. It uses a special kind of x-ray that takes detailed pictures of your insides to see if the cancer has spread.
MRI scan: This testuses radio waves and strong magnets instead of x-rays to make pictures that look at the soft tissue parts of the body. This test may be used to see if the cancer has spread.
There are many types of biopsies. Ask your doctor what kind you may need. Each type has risks and benefits. The choice of which type to use depends on your own case.
Grading kidney cancer
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 .
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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.
Mind & Body Therapies
These combine mental focus, breathing, and body movements to help relax the body and mind. Some examples are:
- Meditation: Focused breathing or repetition of words or phrases to quiet the mind
- Biofeedback: Using simple machines, the patient learns how to affect certain body functions that are normally out of one’s awareness
- Hypnosis: A state of relaxed and focused attention in which a person concentrates on a certain feeling, idea, or suggestion to aid in healing
- Yoga: Systems of stretches and poses, with special attention given to breathing
- Tai Chi: Involves slow, gentle movements with a focus on the breath and concentration
- Imagery: Imagining scenes, pictures, or experiences to help the body heal
- Creative outlets: Interests such as art, music, or dance
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How Kidney Cancer Is Staged
In Australia, the TNM system is the method most often used for staging kidney cancer. The TNM stands for tumournodesmetastasis. This system gives numbers to the size of the tumour , whether or not lymph nodes are affected , and whether the cancer has spread or metastasised . Based on the TNM numbers, the doctor then works out the cancers overall stage .
Other Types Of Kidney Cancers
Other types of kidney cancers include transitional cell carcinomas, Wilms tumors, and renal sarcomas.
Transitional cell carcinoma: Of every 100 cancers in the kidney, about 5 to 10 are transitional cell carcinomas , also known as urothelial carcinomas.
Transitional cell carcinomas dont start in the kidney itself, but in the lining of the renal pelvis . This lining is made up of cells called transitional cells that look like the cells that line the ureters and bladder. Cancers that develop from these cells look like other urothelial carcinomas, such as bladder cancer, when looked at closely in the lab. Like bladder cancer, these cancers are often linked to cigarette smoking and being exposed to certain cancer-causing chemicals in the workplace.
People with TCC often have the same signs and symptoms as people with renal cell cancer blood in the urine and, sometimes, back pain.
For more information about transitional cell carcinoma, see Bladder Cancer.
Wilms tumor : Wilms tumors almost always occur in children. This type of cancer is very rare among adults. To learn more about this type of cancer, see Wilms Tumor.
Renal sarcoma: Renal sarcomas are a rare type of kidney cancer that begin in the blood vessels or connective tissue of the kidney. They make up less than 1% of all kidney cancers.
Sarcomas are discussed in more detail in Sarcoma- Adult Soft Tissue Cancer.
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If I Have Cancer In One Kidney What Are The Chances Of It Spreading To The Other One
Like many forms of cancer, kidney cancer can potentially spread to other parts of the body, such as lymph nodes, bones and other organs. When this occurs, the condition is known as metastatic renal cell carcinoma. Patients with a personal history of kidney cancer in one kidney are at slightly higher risk of development of kidney cancer in their other kidney, but the absolute risk for this is relatively small.
The Type Of Kidney Cancer
The type of cancer is another issue to concern when it comes to discussing whether kidney cancer is slow or fast growing. There are a number of cancer types that can affect the kidneys. And renal cell cancer is the most common type.
Renal cell cancer
Alternative names are hypernephroma and renal cell adenocarcinoma. In adults, this type is the most common kidney cancer.
Renal cell cancer is classified into several types, the main ones include:
Renal medullary carcinoma and carcinoma of the collecting ducts are other types of renal cell cancers these types are very rare.
Transitional cell carcinoma
Its also often called as transitional cell cancer of renal pelvis . TCC affects about 7-8 percent of kidney cancers. Interestingly, the treatment for this type is similar to bladder cancer treatment.
This kind of kidney cancer usually occurs in children and it is not same with kidney cancer in adults. It was first discovered by Dr Max Wilms in 1899. It is categorized into group of rare cancers. But in children, it is one of common cancers they can get.
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How Does Kidney Cancer Spread
The likelihood that kidney cancer will spread to other organs and tissues depends on the size and histology, as well as other individual factors. Tumors that are large or fast-growing tend to be more likely to spread to other parts of the body.
In general, cancerous cells can spread from a kidney to another area of the body in one of three ways:
- Through the lymphatic system Cancerous cells can break away from a kidney tumor and enter the lymphatic system, which is a network of lymph nodes that are located throughout the body. The lymph nodes, which filter bodily fluids to fight off infections, can also allow cancerous cells to circulate throughout the body, ultimately accumulating and forming tumors in distant organs and tissues.
- Via the bloodstream Cancerous cells can break away from a kidney tumor and enter the bloodstream, where they can be carried to and then deposited in distant organs and tissues.
Early evaluation and treatment are key factors in preventing kidney cancer from spreading. In the Urologic Oncology Program at Moffitt Cancer Center, our scientists and clinicians are committed to developing treatment or monitoring plans that are best suited for each patient to maximize both the quantity and quality of a patients lives. Working hand-in-hand with our oncologists, the members of our research team are continually seeking novel advances in learning about improved ways to treat and manage those affected by kidney cancer.
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.
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What Is The Prognosis For People With Ccrcc
The estimate of how a disease will affect you long-term is called prognosis. Every person is different and prognosis will depend on many factors, such as
- Where the tumor is in your body
- If the cancer has spread to other parts of your body
- How much of the tumor was taken out during surgery
If you want information on your prognosis, it is important to talk to your doctor. NCI also has resources to help you understand cancer prognosis.
Doctors estimate ccRCC survival rates by how groups of people with ccRCC have done in the past. Because there are so few pediatric ccRCC patients, these rates may not be very accurate. They also dont take into account newer treatments being developed.
With this in mind, ccRCC patients with smaller tumors have a better chance of survival than patients with larger tumors. The 5-year survival rate for patients with ccRCC is 50-69%. When ccRCC is already large or has spread to other parts of the body, treatment is more difficult and the 5-year survival rate is about 10%.
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 you’re 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.
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Kidney Tumor With Suspicion Of Spread
You may have been told that the kidney cancer has spread. This could be to lymph nodes, the lungs, liver, bone, or even the vena cava â the largest vein in your body.
About 1/3 of patients find that the cancer has spread even without any symptoms.
For those with symptoms, you may have experienced abdominal or back pain, blood in the urine, bone pain, seizures, or even bad headaches. After a full evaluation of the extent of spread a treatment plan should be formulated.
This can get quite complicated and a multidisciplinary team who specialize in kidney cancer would be best to help with this. It is important that an urologist and medical oncologist collaborate in constructing an optimal plan for your care. This multidisciplinary approach is most important for cancers with a high suspicion of spread! This is because today there are numerous options and combinations for patients with metastatic kidney cancer.
These options can include:
Surgery – In certain settings, removal of the kidney even when the cancer has already spread has been shown to improve survival. This can often be done laparoscopically so the patient can recover rapidly and promptly receive additional therapy.
Immunotherapy – IL-2 can be a good option for some patients and can deliver excellent results for some patients. Interferon-alpha is another option.
How Is Renal Cell Carcinoma Diagnosed
If your doctor suspects that you may have RCC, theyll ask about your personal and family medical history. Theyll then do a physical exam. Findings that can indicate RCC include swelling or lumps in the abdomen, or, in men, enlarged veins in the scrotal sac .
If RCC is suspected, your doctor will order a number of tests to get an accurate diagnosis. These may include:
- complete blood count a blood test conducted by drawing blood from your arm and sending it to a lab for evaluation
- CT scan an imaging test that allows your doctor to take a closer look at your kidneys to detect any abnormal growth
- abdominal and kidney ultrasounds a test that uses sound waves to create a picture of your organs, allowing your doctor to look for tumors and problems within the abdomen
- urine examination tests used to detect blood in the urine and to analyze cells in the urine looking for evidence of cancer
- biopsy the removal of a small piece of kidney tissue, done by inserting a needle into the tumor and drawing out a tissue sample, which is then sent to a pathology lab to rule out or confirm the presence of cancer
If you are found to have RCC, more tests will be done to find out if and where the cancer has spread. This is called staging. RCC is staged from stage 1 to stage 4, in order of ascending severity. Staging tests can include a bone scan, PET scan, and chest X-ray.
Approximately one-third of individuals with RCC have cancer that has spread at the time of diagnosis.
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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.
The Kidneys And Ureters
The kidneys are two bean shaped organs, each about the same size as a fist. They are near the middle of your back, one on either side of your spine.
The renal pelvis is in the middle of the kidney. Urine collects here and then drains through a tube called the ureter and into the bladder. When you empty your bladder, the urine leaves the body through a tube called the urethra.
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Rare Types Of Kidney Cancer
Rare kidney cancers occur most frequently in children, teenagers, and young adults.
Papillary renal cell carcinoma
- 15% of all renal cell carcinomas
- Tumor located in the kidney tubes
- Type 1 PRCC is more common and grows slowly
- Type 2 PRCC is more aggressive and grows more quickly
Translocation renal cell carcinoma
- Accounts for 1% to 5% of all renal cell carcinomas and 20% of childhood caces
- Tumor located in the kidney
- In children, TRCC usually grows slowly often without any symptoms
- In adults, TRCC tends to be agressive and fast-growing
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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