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Where Does Kidney Cancer Spread To First

What Medical Therapies And Medications Treat Renal Cell Carcinoma

Ask Mayo Clinic: Kidney Cancer

Treatment of renal cell cancer depends on the stage of the disease and the personâs 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

There Are Different Types Of Treatment For Patients With Renal Cell Cancer

Different types of treatments are available for patients with renal cell cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

The Following Stages Are Used For Renal Cell Cancer:

Stage I

In stage I, the tumor is 7 centimeters or smaller and is found in the kidney only.

Stage II

In stage II, the tumor is larger than 7 centimeters and is found in the kidney only.

Stage III

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.

Stage IV

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.

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What Are Your Kidney Cancer Metastasis Treatment Options

Surgery is not always an option for kidney cancer that has metastasized. Kidney cancer metastasis treatment is focused on slowing down the spread of the disease and alleviating symptoms of kidney cancer metastasis.

Surgical removal of the cancer is an option where the kidney tumor and any metastases are isolated.

Surgery may involve removal of as much of the tumor as possible or removal of the entire kidney. Alternatively, the entire kidney attached adrenal gland and nearby lymph nodes and other surrounding tissues may be removed.

Your doctor is in the best position to determine whether you are a candidate for surgery. Moreover, even if surgery is not an option, you still have other options.

Biological Therapy

Biological cancer therapies interfere with the way cells work. They also boost the bodys immune system response to fight off and destroy cancer cells and block the signals that promote cancer cell growth.

These medications are known for their ability to shrink or control advanced kidney cancer.

The goal of biological therapy is to help you live longer. With biological therapy, cancer cell growth is slowed or stopped, for months or even years.

Targeted Therapy

There are several targeted therapy drug options, including Sorafenib and Sunitinib , that target molecular and genetic changes responsible for causing cancer. These medicines are used when traditional chemotherapy has not worked or isnt an option.

Embolization

What Are The Chances Of Kidney Cancer Spreading

Kidney Cancer Surgery

The chances of spreading kidney cancer vary based on several factors. These factors include your age and overall health. If your cancer is fast-growing, your chances of spreading may be higher. If your cancer is slow-growing, your chances of spreading will be less. Cancer cells that grow at a fast rate tend to invade the lymph nodes, which filter bodily fluids and help fight infections. If they invade these lymph nodes, cancer cells will circulate and eventually accumulate.

If you have cancerous cells outside your kidney, there are many options available to treat the cancer. Radiation is one option that can reduce symptoms. Radiation is used in cases where the cancer has spread to the brain or bones. The treatment may cause skin burn, nausea, fatigue, and diarrhea. The surgical removal of your kidney is another option. This surgery may prolong your life.

Once your cancer has spread outside the kidney, it can spread to distant organs, such as the lymph nodes and the adrenal gland. The size and location of your tumor also affects the chances of its spread to other organs. Your healthcare provider will use these details to guide your treatment.

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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.

Direct invasion

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.

Hematogenous spread

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

Bone Cells And Immune System

A complex system of interaction exists between bone and body immune system at molecular level. This includes RANK, RANKL and natural decoy receptor osteoprotegerin . Higher serum ratio of RANKL/OPG promotes osteoclastogensis . Mikami at el . stated that expression of RANKL and RANK is directly related to stage of primary lesion and metastasis to bone and other organ.

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Risk Of Recurrence In The Opposite Kidney

This is a very common question asked by patients. Sometimes tumours can be seen in both kidneys at the same time and they are detected at the time of first assessment. Some tumours may appear in the opposite kidney after a period of time. This could be a spread from the kidney that was removed previously or a new tumour in the otherwise normal kidney.

Metastatic RCC

Although the majority of patients present with a localised tumour, in almost half of these patients the disease may spread. In nearly a third of patients, spreading is evident at the initial assessment. When cancer cells spread outside the kidney, treating the local tumour by removing the kidney is not usually effective. The only way of reaching dispersed cancer cells is by chemotherapy or by sensitising the body against the RCC . Traditional chemotherapy has shown negligible response rates. However, a number of new drugs have shown promising results.

Immunotherapy

Surveillance after Surgery

Bone Cells And Renal Cell Carcinoma

Mayo Clinic Explains Kidney Cancer

The pathogenesis of skeletal metastasis in RCC is same as for breast cancer. A vicious cycle exists between tumor cells and bone. Osteoclast activation due to presence of malignant cells lead to bone destruction with secretion of different bone-derived growth factors and cytokines which facilitate cancer cell proliferation and enhance tumor growth. These include transforming growth factor-beta , fibroblast growth factors , insulin like growth factors and bone morphogenic protein and many more. These factors not only stimulate the local growth of RCC cells but also circulate and stimulate remote metastatic growth . Tumor cells are responsible for release of prostaglandins, activated vitamin D, tumor necrosis factor , para-thyroid hormone and its related peptide, these activates osteoblast and stromal cells on bone marrow by interacting through RANKL system and ultimately stimulates osteoclast activity.

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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.

Metastatic Kidney Cancer In The Lymph Nodes

Cancer cells can travel to other parts of the body through the lymphatic system, a part of your bodys immune system. Lymph nodes are small glands that help your immune system filter harmful substances. You have hundreds of lymph nodes in your body. Kidney cancer typically spreads to lymph nodes closest to the diseased kidney.

Top five signs of lymph node metastases :

  • swollen lymph nodes in the neck, armpits, or groin

  • chronic fatigue

  • From the community: 3 years ago I had partial kidney removal due to cancer. So far have been clear, but when doing a routine scans they found nodules on my left kidney, lung and two on my adrenal gland. That being said Im scared and was wondering if anyone has gone through this themselves, and what was the outcome. – Inspire member

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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.

    Radiation Treatments For Kidney Cancer

    Kidney Cancer

    Radiation uses high-energy rays to kill cancer cells. Its sometimes used to treat kidney cancer in patients who cant have surgery, but other treatments might be tried first.

    Radiation is aimed at the kidney from a machine outside the body. This is called external beam radiation.

    Side effects of radiation treatments

    If your doctor suggests radiation treatment, talk about what side effects might happen. Side effects depend on the type of radiation thats used. The most common side effects of radiation are:

    • Skin changes where the radiation is given
    • Feeling very tired

    Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect.

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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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    New Ultrasound Treatment Controls Pain From Kidney Cancer Bone Mets

    How frequently do you hear about kidney cancer? Chances are, not very often. Yet kidney cancer is one of the 10 most common cancers. While more men than women are diagnosed with kidney cancer, nearly 64,000 new cases occur in the U.S. annually.

    When kidney cancer is diagnosed early, 5-year survival rates are high. According to the Integrated Staging System developed by UCLA:

    • For patients with localized kidney cancer , 5-year survival rates were 97% for the low-risk group, 81% for intermediate-risk group, and 62% for the high-risk group.
    • For patients with kidney cancer that had spread to the lymph nodes or distant organs when it was first found, 5-year survival rates were 41% for the low-risk group, 18% for intermediate-risk group, and 8% for the high-risk group.

    It is estimated that at the time of diagnosis, 20-50% of patients will be found to have kidney cancer that has begun to grow beyond the organ, or has already spread to distant locations.i

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    Prognosis And Survival Rates For Kidney Cancer

    When someone is diagnosed with kidney cancer, their doctor will give them a prognosis. A prognosis is the doctors opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the persons age and general health.

    In most cases, the earlier that kidney cancer is diagnosed, the better the chance of successful treatment.

    If you have kidney cancer, your doctor will talk to you about your individual situation when working out your prognosis. Every persons experience is different, and there is support available to you.

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    Treating Kidney Cancer

    Most kidney tumors and kidney cancer are cured with surgery. Surgery involves removing the entire tumor in the safest manner for each patient, and can be performed through a variety of approaches including a more traditional open incision, laparoscopic surgery or robot-assisted laparoscopic surgery.

    is 12 percent

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    Immunotherapy For Kidney Cancer

    Immunotherapy is treatment that boosts your own immune system or uses man-made parts of the immune system to help attack kidney cancer cells. Many types of immunotherapy are used to treat kidney cancer. These drugs are given into a vein.

    Side effects of immunotherapy

    Immunotherapy can cause many different side effects depending on which drug is used. These drugs can make you feel tired, sick to your stomach, or cause fever, chills, and rashes. Most of these problems go away after treatment ends.

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

    Where Does Kidney Cancer Usually Spread To

    Where does kidney cancer usually spread to? The cancer cells can break away from the original site and travel anywhere in the body which then may form a new cancerous growth called secondary cancer. For kidney cancer, there are particular areas in the body where it usually metastasizes. The stage of when the cancer has spread is called metastatic stage .

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