Kidney cancer, also known as renal cancer, is a form of cancer that starts in the kidneys—two bean-shaped organs on each side of your spine, right below the rib cage. The kidneys filter blood, remove waste, balance fluids, and produce urine. Kidney cancer develops when cells in the kidney grow uncontrolled and create a lump known as a tumor. In recent years, the global incidence of kidney cancer has increased, although diagnostic tools and treatment choices have also improved dramatically.
Types of Kidney Cancer
Kidney cancer may occur in a variety of ways, with the most prevalent ones being:
1. Renal cell carcinoma (RCC).
Renal cell carcinoma is the most common kind of kidney cancer, accounting for over 90% of cases. It usually starts in the lining of the tiny tubes within the kidneys. RCC may be further categorized into subtypes depending on how the cancer cells appear under a microscope.
• Clear cell renal carcinoma is the most prevalent subtype.
• Papillary renal cell carcinoma is the second most prevalent subtype.
• Chromophobe renal cell carcinoma is a less prevalent subtype.
2. Urothelial carcinoma.
This kind of cancer, also known as transitional cell carcinoma, begins in the renal pelvis (the area of the kidney where the ureter attaches). Urothelial carcinoma acts similarly to bladder cancer and is less prevalent than RCC.
3. Wilms' Tumour
Wilms' tumor is an uncommon kind of kidney cancer that primarily affects youngsters. It is often found in children under the age of five and treated differently than adult kidney cancer.
4. Sarcoma & Lymphoma
Sarcomas, however uncommon, may form in the kidneys. Similarly, lymphomas may affect the kidneys. However, this is often part of a more extensive lymphoma rather than independent kidney involvement.
Causes and Risk Factors for Kidney Cancer
The actual etiology of kidney cancer is unclear; however, numerous risk factors have been found that may increase the probability of acquiring the disease:
• Age: Older persons, especially those over 60, are more likely to develop kidney cancer.
• Smoking: Smokers are far more likely to get kidney cancer than nonsmokers.
• Obesity: Being overweight raises the chance of developing kidney cancer owing to hormonal imbalances and increased inflammation.
• High Blood Pressure: Hypertension has been associated with an increased risk of renal cell cancer.
• Family History: A family history of kidney cancer increases your chances of having the illness.
• Certain Inherited Syndromes: Conditions such as von Hippel-Lindau syndrome and hereditary leiomyomatosis may increase the risk of developing kidney cancer.
Symptoms of Kidney Cancer
In the early stages of kidney cancer, symptoms are often absent. However, when the tumor develops, the following signs and symptoms may appear:
• Blood in the urine (haematuria) is the most prevalent sign of kidney cancer. It may emerge occasionally and go ignored.
• Flank pain: Persistent pain or discomfort in the side or back, just below the ribs, may indicate kidney cancer.
• Unexplained weight loss: Sudden and considerable weight loss for no apparent reason is a worrying symptom.
• Fatigue: Constant weariness, even without activity, may indicate kidney cancer.
• Fever: A persistent fever unrelated to an illness may indicate kidney cancer.
Diagnosis for Kidney Cancer
Early detection is essential for the effective treatment of kidney cancer. If a doctor suspects kidney cancer, several diagnostic tests will be conducted to confirm the diagnosis:
• Physical Examination and Medical History: The doctor will review your medical history and conduct a physical exam to search for indicators of kidney cancer.
Imaging tests:
• CT scans: This imaging test visualizes the kidney and surrounding regions to discover abnormalities or tumors.
• MRI: Magnetic resonance imaging offers comprehensive pictures of the kidneys, which may help determine the size and location of the tumor.
• Ultrasound: An ultrasound may help discover tumors or cysts in your kidney.
• Urine and Blood Tests: These tests evaluate overall kidney function and detect the presence of blood or cancer cells in the urine.
• Biopsy: In certain situations, a biopsy may be conducted, which involves removing a tiny tissue sample from the kidney for microscopic inspection to determine the presence of cancer cells.
Staging & Grading
Once identified, kidney cancer is staged according to how far it has gone. Staging is critical in evaluating treatment choices and predicting results. Kidney cancer stages differ from Stage I to Stage IV:
• Stage I: The tumor is limited to the kidney and measures less than 7 centimeters.
• Stage II: The tumor is greater than 7 centimeters but remains localized to the kidney.
• Stage III: The tumor has migrated to neighboring lymph nodes or blood vessels.
• Stage IV: The cancer has spread to distant organs such as the lungs, bones, and liver.
Kidney cancer cells are graded according to how they look under a microscope. The more abnormal cells, the higher the grade and the more aggressive the malignancy.
Treatment Options for Kidney Cancer.
Treatment for kidney cancer is determined by the cancer's stage and kind, as well as the patient's general condition. The primary therapeutic options are:
1. Surgery.
Surgery is the most popular and successful therapy for localized kidney cancer. The following types of surgery may be performed:
• Partial Nephrectomy: This treatment removes just the portion of the kidney containing the tumor, maintaining as much kidney function as feasible.
• Radical Nephrectomy: This procedure removes the whole kidney and any surrounding tissues and lymph nodes.
2. Ablation and Embolisation.
Patients who are not candidates for surgery may benefit from other therapies like ablation and embolization:
• Radiofrequency Ablation (RFA): A treatment that employs heat to kill cancer cells.
• Cryoablation is a method for freezing and killing malignant tissue.
• Arterial Embolisation: This procedure involves cutting off the tumor's blood supply, which causes it to shrink.
3. Targeted therapy
Targeted treatments are medications that inhibit cancer growth and spread by interfering with particular molecules involved in tumor development. These medications are used to treat advanced kidney cancer. Sunitinib, pazopanib, and axitinib are common targeted treatment medicines.
4. Immunotherapy.
Immunotherapy boosts the immune system's ability to recognize and fight cancer cells. Nivolumab and pembrolizumab are often used to treat advanced renal carcinoma.
5. Radiation therapy.
While radiation treatment is seldom used to treat primary kidney tumors, it may be used to reduce symptoms if cancer has spread to other regions of the body.
Prognosis and Follow-Up
The prognosis for kidney cancer varies depending on the stage of the illness upon diagnosis and the efficacy of therapy. When found early, kidney cancer is typically curable, with a five-year survival rate of more than 90% for localized renal carcinoma. The outlook gets worse, though, if the cancer has spread to other parts of the body
Regular follow-up treatment is critical for detecting recurrence or metastases. Follow-up appointments usually include physical examinations, imaging studies, and blood testing to confirm that the cancer has not returned.
Prevention of Kidney Cancer
While there is no sure method to avoid kidney cancer, several lifestyle modifications might lower your risk:
• Stop Smoking: Quitting smoking is one of the most effective strategies to reduce the risk of kidney cancer.
• Maintain a good Weight: Obesity is a recognized risk factor for kidney cancer, so a good diet and exercise routine may help.
• Manage Blood Pressure: Regularly monitoring and controlling blood pressure lowers the chance of getting kidney cancer.
• Minimise Prolonged Exposure to Harmful Chemicals: Limiting exposure to occupational toxins like asbestos and cadmium may help lessen risk.
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