What Are The Treatments For Kidney Cancer
Once you have a diagnosis and know your stage of kidney cancer, you and your doctor can plan treatment. You may want to gather information to help you feel more informed about your decision. Your doctor may refer you to a specialist for treatment. This could include an urologist, a medical or radiation oncologist, or a surgeon. Before beginning treatment, many people find it helpful to get a second opinion about the diagnosis of kidney cancer and the treatment plan.
Kidney cancer is one of the more common cancers to undergo spontaneous regression, in which it may return to an eralier stage. However, the incidence is quite low .
There are several standard types of treatment for kidney cancer. In most cases, surgery is the first step. Even if surgery removes the entire tumor, though, your doctor may suggest an extra treatment to kill any remaining cancer cells that can’t be seen.
Surgery for kidney cancer
These are the main types of surgery for kidney cancer. Which type you have depends on how advanced your cancer is.
You can survive with just a part of one kidney as long as it is still working. If the surgeon removes both kidneys or if both kidneys are not working, you will need a machine to clean your blood or a new kidney . A transplant is possible if your cancer was found only in your kidney and a donated kidney is available.
If surgery can’t remove your kidney cancer, your doctor may suggest another option to help destroy the tumor.
Biologic therapy for kidney cancer
For People At Average Risk Of Kidney Cancer
Some tests can find some kidney cancers early, but none of these is recommended to screen for kidney cancer in people at average risk.
A routine urine test , which is sometimes part of a complete medical checkup, may find small amounts of blood in the urine of some people with early kidney cancer. But many things other than kidney cancer cause blood in the urine, including urinary tract infections, bladder infections, bladder cancer, and benign kidney conditions such as kidney stones. Sometimes people with kidney cancer do not have blood in their urine until the cancer is quite large and might have spread to other parts of the body.
Imaging tests such as computed tomography scans and magnetic resonance imaging scans can often find small kidney cancers, but these tests are expensive. Ultrasound is less expensive and can also detect some early kidney cancers. One problem with these tests is that they cant always tell benign tumors from small renal cell carcinomas.
Often, kidney cancers are found by accident during imaging tests for some other illness or symptom. These cancers usually are not causing pain or other symptoms when they are found. The survival rate for these kidney cancers is very high because they are usually found at a very early stage.
How Dermatologists Help Patients With Kidney Disease
Kidney doctors, called nephrologists, often care for patients with kidney disease. When a kidney disease affects the skin, a nephrologist may team up with a dermatologist. Some skin conditions that develop due to kidney disease can be difficult to control. For example, if a patient has extremely itchy skin, it may be impossible to sleep through the night. A board-certified dermatologist can help a patient get some relief. This may involve using the right balance of moisturizers and medication that you apply to the skin. Some patients get relief with a treatment called UVB phototherapy.
The right skin care may also help. If the kidney disease is causing extremely dry skin, these tips from dermatologists may help:
1 Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2019. Page last reviewed Mar. 11, 2019. Last accessed Feb. 27, 2020.
ImagesImage 1: Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Images 4, 5, 7, 8, 11: Journal of the American Academy of Dermatology
ReferencesAmin A, Burgess EF. Skin manifestations associated with kidney cancer. Semin Oncol. 2016 43:408-12.
Centers for Disease Control and Prevention. Chronic kidney disease in the United States, 2019. Page last reviewed Mar. 11, 2019. Last accessed Feb. 27, 2020.
Galperin TA, Cronin AJ, et al. Cutaneous Manifestations of ESRD. Clin J Am Soc Nephrol. 2014 9:201-18.
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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
How Do I Know If I Have Kidney Cancer
Maybe you’ve had kidney cancer symptoms such as pain in your side, weight loss, or extreme fatigue. Or maybe your doctor has found a lump in your side during a routine exam or a sign of kidney cancer during a test for another disease. Regardless, to confirm a diagnosis of kidney cancer, you will need a thorough physical exam, health history, and tests.
Your doctor will feel your abdomen and side for lumps and check for fever and high blood pressure, among other things. You will also answer questions about your health habits, any past illnesses, and types of treatment. To make a diagnosis of kidney cancer, your doctor will also order one or more tests like these:
Unlike with many other cancers, your doctor may be pretty certain about a diagnosis of kidney cancer without a biopsy. Sometimes, a biopsy will be done to confirm the diagnosis. A doctor may use a needle biopsy to remove a sample of tissue, which is then examined under a microscope for cancer cells. The biopsy may also tell the grade of the cancer — how aggressive the cancer is likely to be. Often the surgeon will simply remove the entire tumor and then have a sample of tissue examined.
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Next Steps After Finding A Spot On The Lungs
A pulmonary nodule may be first detected on a chest X-ray. After that, you may need further testing to better characterize the nodule to help determine if its benign or cancerous.
Your doctor may request your medical history and your history of smoking. Additionally, your doctor needs to know if youve been exposed to secondhand smoke or environmental chemicals.
The first step of the process is examining the size and shape of the nodule. The bigger the nodule, and the more irregular the shape, the greater the risk of it being cancerous.
A CT scan can provide a clear image of the nodule and give more information about the shape, size, and location. If the results from a CT scan reveal that a nodule is small and smooth, your doctor may monitor the nodule over time to see if it changes in size or shape.
Youll have to repeat the CT scan a few times at regular intervals. If the nodule doesnt grow larger or change over a 2-year period, its unlikely to be cancer.
They may also request that your blood be drawn for additional tests to rule out other causes such as local fungal infections. These may include coccidioidomycosis in the southwestern states like California and Arizona or histoplasmosis in the central and eastern states, especially in areas around the Ohio and Mississippi river valleys.
What Causes Kidney Cysts
If your kidney cysts are caused by PKD, then they are inherited. This means you have them because they run in your family. For most people, though, this is not the case. Doctors arent sure why kidney cysts form for them. It could be that the kidney surface weakens over time. This could explain why kidney cysts are most common in people who are age 50 and older.
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Symptoms Of A Pulmonary Nodule
Pulmonary nodules dont cause symptoms. You may have a nodule on your lungs for years and never know it.
If a spot on your lungs is cancerous, you may have symptoms related to the specific type of cancer. For example, growths caused by lung cancer may cause a persistent cough or breathing difficulties.
What Are The Types Of Kidney Cancer
The information in this document refers to renal cell carcinoma the most common form of kidney cancer. However, there are different types of kidney cancer, including:
- Renal cell carcinoma : This is the most common form of kidney cancer in adults and accounts for 85% of all kidney cancers. Renal cell carcinoma usually develops as a single tumor in one kidney, but it can affect both kidneys. Renal cell carcinoma begins in the cells that line the small tubes that are part of the nephrons within the kidneys. .
- Transitional cell carcinoma: Transitional cell carcinoma accounts for 6% to 7% of all kidney cancers. This cancer usually begins in the area where the ureter connects to the main part of the kidney. This area is called the renal pelvis. Transitional cell carcinoma also can occur in the ureters or bladder.
- Renal sarcoma: This is the least common form of kidney cancer, accounting for only 1% of kidney cancer cases. It begins in the connective tissues of the kidneys and, if not treated, can spread to nearby organs and bones.
- Wilms’ tumor: This is the most common type of kidney cancer in children. It accounts for about 5% of kidney cancers.
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Should I Get A Biopsy
A question that we hear all the time. There is a theoretical risk of bleeding or spreading the cancer with a biopsy, but this not why they are not widely used.
Unlike prostate, breast, or colon biopsies it turns out that biopsies of small kidney tumors are not as accurate as we would like.
As many as 20% of the biopsies are “false negatives”- in other words the biopsy says there is no cancer when indeed there is a cancer.
We still use them sometimes but it has to be in the right patient. Recent innovations in how we do the biopsies has allowed us to get more information than ever before. It remains, however, that a biopsy should only be obtained after a discussion with an expert on this disease!
Treatment options for patients with a small kidney tumor including active surveillance, ablation, partial nephrectomy, and total nephrectomy. In the vast majority of patients treatment of a small kidney tumor should result in saving the kidney. A quick decision to remove the kidney may not be the best treatment. Experience is critical in being able to save the kidney. In our section regarding treatment one can find details regarding these options.
At Johns Hopkins our surgeons are experts on all approaches and will help tailor the treatment to the patient. One size does NOT fit all.
What Are The Symptoms And Complications Of Simple Kidney Cysts
As people age, simple kidney cysts tend to grow bigger and grow in number. However, simple kidney cysts usually dont cause symptoms or additional health problems.
In rare cases, simple kidney cysts can become large enough to
- press on your bones or other organs, causing pain or discomfort
- block blood or urine flow through the kidneys or the ureters
- become infected, causing fever, pain, and tenderness
- burst, causing pain or blood in the urine, also called hematuria
Talk with your health care professional if you have any of these symptoms. Health care professionals can treat simple kidney cysts that cause symptoms or other health problems.
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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.
Diagnosis For Lung Cancer
If your doctor believes a pulmonary nodule is cancerous, they may order more tests. Diagnostic testing used to confirm or rule out cancer includes:
- Positron emission tomography scan:These imaging tests use radioactive glucose molecules to determine if the cells that make up the nodule are dividing rapidly.
- Biopsy: Your doctor may order a biopsy, especially if the results of the PET scan are inconclusive. During this procedure, a tissue sample is removed from the nodule. Its then examined for cancer cells using a microscope.
Sometimes this is done by a needle biopsy thats inserted near the edge of your lung through the chest wall. Another option is a bronchoscopy where your doctor inserts a scope through the mouth or nose and passes it through your large airways to collect cells.
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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.
- A tumor 7 centimeters or smaller that is only in the kidney
- A tumor larger than 7 centimeters that is only in the kidney
- 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
- 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
Cancer has spread beyond Gerota’s fascia
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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The Most Common Kidney Cancer Symptoms
Kidney cancer, also called renal cell carcinoma , accounts for nearly four percent of all cancers in the United States. Each year, more than 62,000 Americans are diagnosed with the disease. The risk of kidney cancer increases with age, but in general, it is more common in men than in women.
Most people have two kidneys. They are located below the ribcage near the middle of your back on each side of your spine. The kidneys work to:
- Filter waste from your blood
- Produce urine
- Control blood pressure
- Create red blood cells
Your body can function normally with one kidney. But if a tumor develops and grows in a kidney, its normal functions may be disrupted.
What Do White Spots On The Kidneys Mean
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What You Need To Know
About Kidney Masses
- Many masses may never need to be removed though evaluation by a qualified physician is the only way to determine this
- Complex cysts may require further testing
- Solid masses, especially those that pick up blood are considered malignant until otherwise proven
- Typically, we follow masses under 2.5cm for further growth before treating
- The causes of kidney masses are many and varied
- Hand assisted laparoscopic radical nephrectomy
- Hand assisted laparoscopic partial nephrectomy
- Robotic partial nephrectomy