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What is Kidney Cancer?
Kidney cancer also called renal cancer, or cancer of the kidney, is any type of cancer that has arisen from the kidney. Kidney cancer does not usually include a cancer that arose outside the kidney and metastasized to include metastatic cancer of the kidney.
The most common types of kidney cancer include renal cell carcinoma and urothelial cell carcinoma of the renal pelvis. Almost all kidney cancers first appear in the lining of tiny tubes (tubules) in the kidney. This type of kidney cancer is called renal cell carcinoma. Renal cell carcinoma accounts for approximately 80% of all kidney cancers. Urothelial cell carcinoma is a type of cancer that occurs in the urinary system, specifically the kidney, urinary bladder, ureter, urethra and urachus.
You may not be able to control every situation and its outcome, but you can control your attitude and how you deal with it.
GOD didn't add another day in your life because you needed it, he added it because someone out there needs you.
The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.
Dear GOD, if today I lose my hope please remind me that your plans are better than my Dream.....
Symptoms of Kidney Cancer
Kidney cancer usually shows no symptoms in the early stages. Generally, it is not suspected until symptoms appear; by that point, the tumor may have grown fairly large. As the cancer progresses, symptoms may include some of the following -
Some of these symptoms may be due to other causes, such as an infection.
Risks and causes of kidney cancer
The causes of kidney cancer are unknown. However, there are several factors that may increase your risk including -
Cigarette smoking - around one in three cases may be due to smoking.
Faulty genes - some people inherit a faulty gene, which puts them at a higher risk of developing kidney cancer.
Mild pain-relieving medications - such as overuse of medications containing phenacetin. This chemical is not used in modern pain-relieving medications. However, people who took those containing phenacetin in large quantities before it was banned, may still be affected. There is also early-stage research suggesting that others such as paracetamol, aspirin and 'non steroidal anti-inflammatory drugs' (NSAIDs) such as ibuprofen (Nurofen), may slightly increase the risk of kidney cancer. Researchers say it’s unlikely occasional use or low-dose use would be harmful.
Obesity - having a waist circumference of 100 cm or greater could increase your risk.
Exposure to asbestos or cadmium - this applies to some people who were exposed to these substances in their jobs.
People with kidney disease needing regular dialysis - dialysis is a procedure used on people with kidney failure. Dialysis is a technique that removes extra water and waste products from your body, which is what your kidneys would normally do. The longer you are on dialysis, the greater your risk of getting kidney cancer. The increased risk is most likely due to the kidney disease and not directly due to dialysis.
Types of Kidney Cancer
Kidney cancer can be categorized into different types that includes -
Renal Cell Carcinoma - Renal cell carcinoma (RCC), also known as renal cell cancer or renal cell adenocarcinoma, is by far the most common type of kidney cancer. About 9 out of 10 kidney cancers are renal cell carcinomas.
Clear cell renal cell carcinoma - this is the most common form of renal cell carcinoma. About 7 out of 10 people with renal cell carcinoma have this kind of cancer. When seen under a microscope, the cells that make up clear cell RCC look very pale or clear.
Papillary renal cell carcinoma - these cancers form little finger-like projections (called papillae) in some, if not most, of the tumor. Some doctors call these cancers chromophilic because the cells take in certain dyes and look pink under the microscope.
Transitional Cell Carcinoma - transitional cell carcinoma, also known as Urothelial carcinoma, typically starts in the kidney area where urine gets collected before reaching to the bladder. This is considered and treated like a bladder cancer. People with transitional cell carcinoma often have the same signs and symptoms as patients with renal cell cancer - blood in the urine and, sometimes, back pain.
Wilms Tumor (Nephroblastomas) - Nephroblastomas, more commonly called Wilms tumors, This is seen most commonly in children that can be successfully treated with the help of chemotherapy and radiation therapy.
Renal sarcoma - renal sarcomas are a rare type of kidney cancer (less than 1% of all kidney tumors) that begin in the blood vessels or connective tissue of the kidney.
Chromophobe renal cell carcinoma - the cells of these cancers are also pale, like the clear cells, but are much larger and have certain other features that can be recognized.
Collecting duct renal cell carcinoma - the major feature is that the cancer cells can form irregular tubes.
Unclassified renal cell carcinoma - rarely, renal cell cancers are labeled as unclassified because the way they look doesn't fit into any of the other categories or because there is more than one type of cell present.
Benign (non-cancerous) kidney tumors
Some kidney tumors are benign (non-cancerous) - this means they do not metastasize (spread) to other parts of the body, although they can still grow and cause problems. Benign kidney tumors include renal cell adenomas, renal oncocytomas, and angiomyolipomas. They can be treated by removing or destroying the tumor, using many of the procedures that are also used for kidney cancers, such as radical nephrectomy, partial nephrectomy, radiofrequency ablation, and arterial embolization.
Renal adenoma - renal adenomas are the most common benign kidney tumors. They are small, slow-growing tumors that often show up on imaging tests (such as CT scans) when the doctor is looking for something else. Seen with a microscope, they look a lot like low-grade renal cell carcinomas.
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.
Stage 1 - the first stage is marked by the tumor of about 7 centimeters in diameter. The tumor has not spread and is confined to the kidney.
Stage 2 - the second stage is marked by a larger tumor as compared to the first stage but it is still limited to the kidneys.
Stage 3 - 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
Stage 4 - 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 (including contiguous extension into the ipsilateral adrenal gland).
Diagnosis of Kidney Cancer
Blood Tests - these will be done to rule out any other possible causes of symptoms, such as kidney stones or an infection. These tests help in determining the level of creatinine. The kidneys are not working properly if there are high levels of creatinine.
Ultrasound Test - sound waves are used to create an image of the target area. This scan can help the doctor identify any change in the shape of the kidney which could be caused by a tumor.
Physical Exam - the general health of a patient is checked in order to notice the signs of fever and high blood pressure.
Biopsy - if the doctor suspects the patient has kidney cancer an image-guided biopsy will be performed. A needle is guided through the skin into the kidney - the guidance system is either ultrasound or CT. A small sample of kidney tissue is removed and examined under a microscope to check for the presence of cancer cells.
A biopsy procedure increases the risk of infection and bleeding. There is also a rare chance that a biopsy could help the cancer spread to the area where the needle is inserted. Some doctors may not do a biopsy if they are fairly sure cancer is present, and proceed straight to surgery, thus avoiding the additional risks of a biopsy. Kidney biopsies are more commonly done on patients who are not thought to have cancer, or those who cannot be operated on.
CT scan - this is a medical imaging method that employs tomography. Tomography is the process of generating a two-dimensional image of a slice or section through a 3-dimensional object (a tomogram). Put simply, many pictures are taken and then put together as a 3-D image. Most patients will be given a dye to drink which shows up on the scan.
Urine tests - check for blood in your urine or other signs of problems.
Intravenous pyelogram (IVP) - involves X-raying your kidneys after the doctor injects a dye that travels to your urinary tract, highlighting any tumors.
Magnetic resonance imaging (MRI) - uses strong magnets and radio waves to create detailed images of soft tissues in your body. You may need an injection of a contrast agent to create better pictures.
Renal arteriogram - this test is used to evaluate the blood supply to the tumor. It is not given often but may help diagnose small tumors and has other uses as well.
Treatment of Kidney Cancer
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 is the most common treatment for kidney cancer. It is a type of local therapy. It treats cancer in the kidney and the area close to the tumor.
An operation to remove the kidney is called a nephrectomy. There are several types of nephrectomies. The type depends mainly on the stage of the tumor. The doctor can explain each operation and discuss which is most suitable for the patient -
Radical nephrectomy - kidney cancer is usually treated with radical nephrectomy. The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area also may be removed.
Simple nephrectomy - the surgeon removes only the kidney. Some people with Stage I kidney cancer may have a simple nephrectomy.
Partial nephrectomy - the surgeon removes only the part of the kidney that contains the tumor. This type of surgery may be used when the person has only one kidney, or when the cancer affects both kidneys. Also, a person with a small kidney tumor (less than 4 centimeters) may have this type of surgery.
Chemotherapy - Chemotherapy is also a type of systemic therapy. Anticancer drugs enter the bloodstream and travel throughout the body. Systemic chemotherapy is a procedure where the injection of these drugs is done into vein that then enters the bloodstream and travels in the entire body.
Immunotherapy - immunotherapy, also known as biologic therapy, helps in boosting the natural defenses of the body to fight against cancer. The function of the immune system is improved and restored by using certain materials that can be made in the laboratory or by the body itself.
Radiation Therapy - high-energy radiation beams are used for destroying the cancer cells. External-beam radiation is considered as the most common type of radiation therapy treatment. This treatment is given by using a machine that is placed outside the body. On the other hand, internal radiation therapy (Brachytherapy) provides the radiation treatment by using implants.
Arterial embolisation - this may be used instead of surgery (for example, if you are not well enough for surgery). The aim of this treatment is to block off the blood vessel (artery) which is supplying a kidney tumour with blood. To do this, a catheter is inserted into a blood vessel in the groin. (A catheter is a long thin, flexible, hollow tube.) Using X-ray pictures for guidance, the catheter is pushed up into the blood vessel in the affected kidney. When it is in the correct place, a substance is injected down the catheter into the blood vessel to block the blood vessel. The tumour is then deprived of its blood supply and so dies.
"Happiness is not something ready made. It comes from your own actions".
"The purpose of our lives is to be happy" - Dalai Lama