What Are The Types Of Kidney Cancer
Renal Cell Carcinoma is the most common type of kidney cancer, accounting for approximately 85% of all malignant kidney tumors. In RCC, cancerous cells develop in the lining of the kidney tubules and grow into a mass called a tumor. Like many other cancers, the growth begins small and grows larger over time. RCC typically grows as a single mass. However, there are cases where a kidney may contain more than one tumor, or tumors are found in both kidneys at the same time.
There Are Three Ways That Cancer Spreads In The Body
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Clear Cell Sarcoma Of The Kidney
Clear cell sarcoma of the kidney is very rare. This cancer represents less than 3% of pediatric kidney tumors. Only about 20 children are diagnosed with clear cell sarcoma in the United States each year. It is most often found in children ages 1-4 years, and it occurs more often in boys. Younger age and greater extent of disease at diagnosis are associated with less favorable outcome. Compared to other kidney tumors, CCSK is more likely to spread to bone. However, less than 5% of patients show metastases at initial diagnosis. Common sites for spread of disease include lung, bone, brain, and soft tissue.
Treatment of clear cell sarcoma of the kidney includes surgery to remove the kidney . A CCSK diagnosis is made based on histology of the tumor. Multimodal therapy includes surgery, chemotherapy including doxorubin, and radiation after surgery. In the most recent Childrens Oncology Group study, children received combination chemotherapy with vincristine, doxorubicin, cyclophosphamide and etoposide with surgery and radiation.
Patients treated for clear cell sarcoma of the kidney are at risk for late recurrence. The most common sites for recurrence are the brain and lungs. Regular screening including imaging tests are part of follow-up care. Patients should also be monitored for kidney function and late effects of therapy.
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How Common Is Kidney Cancer
Each year an estimated 75,000 patients are found with a kidney tumor. Approximately 65,000 of these are ultimately found to be renal cell carcinoma .
The most common type is clear cell carcinoma. Renal cell cancer is not one disease but rather a collection of 15-20 types of renal tumors that can arise from the kidney. Kidney cancer is among the 10 most common cancers in both men and women, and the risk for developing kidney cancer is higher in men than in women. More information about kidney cancer risk factors >
Looking For More Of An Introduction
If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:
ASCO Answers Fact Sheet:Read a 1-page fact sheet that offers an introduction to kidney cancer. This free fact sheet is available as a PDF, so it is easy to print.
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What Are The Kidneys And What Do They Do
Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine. The urine flows from each kidney to the bladder through a pair of thin tubes called ureters, one on each side of your bladder. Your bladder stores urine. Your kidneys, ureters, and bladder are part of your urinary tract system.
Kidney Tumors & Diagnosis Size Mattersbig Surprise
Kidney cancer is generally a very silent disease. It is sneaky, hides out for years, and is often assumed to be something else. In my case, my doctor essentially decided I was just a menopausal women with the ever-popular stress as a an extra. The stress of carrying about a 10 cm tumor and wasting away was probably part of it.
That slow diagnosis, often delayed for years is far too typical. Only the greater use of CT scans has been significant in finding kidney cancer at an early stage. And just what is early or small? Looking for a cracked rib, or the dislocated shoulder has often revealed kidney cancer, and in the case of the shoulder, lung mets. And then the hunt is on! By the time this diagnosis is made, nearly 30-40% of kidney cancer is already metastatic.
The classic triad of symptoms, are 1) blood in the urine, 2) flank pain, and 3) palpable mass in the abdomen. There are doctors who will consider kidney cancer only when the patient has these three symptoms, but that happens in fewer than 10% of patients. The cancer has to be pretty far along to be found this way. Meeting a pair of new doctors who were aware of my kidney cancer, they were obviously bewildered to hear that I had had none of the these symptoms. But those are the usual symptoms, one said. Maybe classical, but not usual. Unfortunately that expectation is a barrier to good diagnosis.
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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.
What Is A Kidney Mass
A kidney mass is a vague description used to refer to any abnormal growth or area that occurs within or on the kidneys. Various types of tumors can occur within the kidneys, including cancerous and benign growths that may or may not present with any warning signs. Diagnostic and screening procedures will likely be done to determine the best course of treatment for a kidney mass.
The kidneys are a pair of bean-shaped organs located below the ribcage on either side of the spine. These organs are responsible for a number of vital tasks, including filtering blood and producing urine. A kidney mass occurs when mutated cells do not follow the normal patterns of cellular growth and death. Instead of dying, these cells accumulate and form a mass of tissue. These masses are often interchangeably known as kidney tumors and renal lesions.
Although the presence of a kidney mass may be a frightening thought, a mass does not necessarily mean that kidney cancer is present. A benign kidney tumor, such as a simple cyst, could be the problem. A simple kidney cyst is a sac of tissue formed in the kidneys that is usually filled with fluid. These simple cysts are fairly common among older adults and generally do not require treatment.
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How Do We Know When A Tumor Is Cancer
Imaging tests help provide answers. At UP, we review different features of each imaging test to decide if a mass could be cancer. Depending on the original imaging test , additional tests may be recommended to get more information. Some of these tests may include an injection of an enhancera Gadolinium-based contrast agent to help show internal parts of the mass. Following testing, tumors may be referred to as an enhancing or non-enhancing lesion based on whether there was an uptake of the contrast agent in the lesion. Tests may be repeated over time to see if there are changes in the tumor. All kidney tumors are categorized as either cystic masses or solid masses.
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.
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Mass In Kidney May Mean Cancer
Kidney cancer is one of the most aggressive cancers affecting the urinary system. It rarely causes signs or symptoms in its early stages. Most kidney tumors are discovered incidentally when X-ray or MRI is performed to evaluate an unrelated complaint, and 80% of solid kidney masses are cancer, says Vincenzo Galati, DO, FACS, urologist at Saint Francis Medical Center.
Signs and symptoms of kidney cancer may include blood in the urine, back pain below the ribs that does not go away, weight loss, intermittent fever, and fatigue. Some of the risk factors for kidney cancer include smoking, family history of kidney cancer, chronic kidney disease, and obesity.
It is important to realize that with timely diagnosis and treatment, kidney cancer can be cured. The gold standard for treatment of a renal mass is surgery, which can usually be performed with a minimally invasive kidney-sparing approach called a partial nephrectomy. This approach removes the cancer and spares the healthy tissue of the kidney, which leads to better outcomes, notes Galati.
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How Does High Blood Pressure Affect The Kidneys
High blood pressure can constrict and narrow the blood vessels, which eventually damages and weakens them throughout the body, including in the kidneys. The narrowing reduces blood flow.
If your kidneys blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body. Extra fluid in the blood vessels can raise your blood pressure even more, creating a dangerous cycle, and cause more damage leading to kidney failure.
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When To See Your Doctor
If you have any of the symptoms mentioned above, it’s important to see your doctor. Most of the symptoms of kidney cancer have many potential causes, but there are other serious reasons you could be having these symptoms as well.
Kidney Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Symptoms are our body’s way of signaling that something is wrong. Rather than fearing and ignoring them, take action to find out why they’re occurring so that you can obtain appropriate and timely treatment. Talk to your doctor and ask questions. If you still don’t have answers, consider getting a second opinion.
What Are Common Symptoms Of Having A Mass On Your Kidney
Having a mass or tumor on a kidney is often accompanied with other symptoms such as bloody urine, appetite loss, flank pain, weight loss and fatigue, states WebMD.com. It can also cause anemia and swelling in the limbs.
If the mass on the kidney is a malignant tumor and the cancer has spread to other organs, common symptoms include shortness of breath, bone pain and coughing blood, explains WebMD.com. Before a doctor can determine if a kidney mass is cancer, tests must be done to diagnose the disease such as blood and urine tests, a CT scan and MRI, and a renal arteriogram, If the mass is a tumor, the size determines the stage of kidney cancer. For instance, a mass smaller than 3 inches is stage 1 cancer and more treatable than a mass that has spread to the tissue around the kidney.
The mass can be removed depending on the size, states WebMD.com. A patient with a tumor that is smaller than 1 1/2 inches can undergo a partial nephrectomy in which just the mass and some of the surrounding tissue is removed. Larger masses require removal of the entire kidney or even the nearby adrenal gland and lymph nodes. In some cases, the tumor is treated with extreme cold or radio waves.
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What Are The Symptoms Of High Blood Pressure And Kidney Disease
Most people with high blood pressure do not have symptoms. In rare cases, high blood pressure can cause headaches.
Early CKD also may not have symptoms. As kidney disease gets worse, some people may have swelling, called edema. Edema happens when the kidneys cannot get rid of extra fluid and salt. Edema can occur in the legs, feet, ankles, orless oftenin the hands or face.
Symptoms of advanced kidney disease can include
- loss of appetite, nausea, or vomiting
- drowsiness, feeling tired, or sleep problems
- headaches or trouble concentrating
- chest pain or shortness of breath
Infiltrative Renal Cell Carcinoma And Transitional Cell Carcinoma
Radiologically, intrarenal transitional cell carcinoma presents as a centrally invasive renal mass, also referred to as centrally infiltrating or intrarenal TCC. It was first described as a renal pelvic carcinoma in 1841 by French pathologist Rayer. Intrarenal TCC is a close radiologic mimic of other infiltrative renal masses, especially centrally located RCC. Imaging differentiation ofthese two entities is difficult because management strategies differ. Centrally located RCC is surgically treated with nephrectomy, whereas intrarenal TCC requires nephroureterectomy and often wider lymphadenectomy.
On imaging, features suggestive of intrarenal TCC are filling defect in the renal pelvis, irregular, narrowed or amputated collecting system, circumferential urothelial thickening, tumor epicentre within the collecting system, renal shape preservation, absence of cystic or necrotic change, homogeneity of the tumor, and extension into the ureteropelvic junction . On MRI, TCC may be seen as an irregular, enhancing filling defect in the pelvicaliceal system or ureter.
Infiltrative RCC: Axial CECT images showing expansive bean-type renal mass involving the left kidney with retroperitoneal lymphadenopathy
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Challenges In Diagnosis Of Small Renal Masses
Most small renal masses are benign cysts but some are solid and/or cystic that can range from benign AMLs, adenomas, and oncocytomas to RCC. Of the small solid renal masses, only fat-containing AMLcan be confidently diagnosed. Solid renal masse especially less than 1.5 cm in diameter can be problematic and challenging due to varied imaging spectrum of various benign and malignant masses depending on the composition of the renal tumor. Interdepartmental, clinical, and use of multimodality imaging sometimes can be helpful in difficult cases. Observation or watchful waiting is generally recommended for masses that are probably benign a low probability of malignancy exists, hence, the mass can be observed with serial imaging.
Current Role Of Renal Biopsy
At present, percutaneous pretreatment biopsy to identify benign vs. malignant in small solid renal masses is said to be reliable and cost effective. Long-held concerns preventing the incorporation of biopsies into routine patient care, including the perception of poor diagnostic yield and risks of complications such as bleeding or biopsy tract seeding, have largely been disproven. A recent meta-analysis of 5228 biopsies identified less than 1% of patients with complications. As more patients with renal masses are treated with thermal ablation, establishing an upfront cancer diagnosis from renal tumor biopsy is exceptionally important. Biopsy should be performed before the day of treatment so that patients can use the biopsy findings to help make an informed decision prior to treatment. However, one should be aware of biopsy limitations. Pathology from renal mass biopsy may underestimate the nuclear grade or fail to identify aggressive pathologic features in renal cell cancer because of sampling error in heterogeneous tumors. At present, renal biopsy from small solid renal masses may be useful as patients and physicians can use information from biopsy to make more informed decisions among treatments, and the routine use of biopsy decreases overtreatment of incidentally detected benign tumors.
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Ways To Protect Kidney Health
- Drink enough water, about 6-8 cups per day, and avoid dehydration. Be especially careful to stay hydrated when playing sports and in hot weather.
- Limit caffeine intake.
- Be careful with the use of non-steroidal anti-flammatory drugs , as the overuse of these medicines can harm the kidneys when taken in too high of a dose or used too often. Avoid these medicines when possible, and discuss with a doctor before taking.
- Check with a doctor or pharmacist before taking a new medicine. This includes prescription and over-the-counter medications as well as herbal supplements. Make sure that all health care providers and pharmacists know if a patient has only one kidney.
- Avoid constipation by staying hydrated and eating fiber. Take medications to soften stool if they are recommended by a doctor.
- Make sure children are ready before beginning potty training to avoid issues with holding urine.
- Be physically active. Most physical activities and sports pose little to no risk to kidney health. Talk to a health care provider about activities and any concerns.