Kidney Cancer

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The kidneys are part of the urinary tract; they remove waste products from the blood and produce urine. As blood flows through them, the kidneys filter waste products, chemicals and unneeded water from the blood. Urine collects in the middle of each kidney in an area called the renal pelvis. Urine then drains from the kidney through a long tube (called the ureter) to the bladder, where it is stored. The kidneys also make substances that help control blood pressure and regulate the formation of red blood cells.

Types of kidney cancer:

In adults, most kidney cancers develop in the tissues that filter blood and produce urine. This type of cancer is called renal cell cancer. Cancer of the renal pelvis is called transitional-cell carcinoma. This disease is very much like the type of cancer that occurs in the bladder and is often treated like bladder cancer.

Kidney cancer accounts for about 2.3 percent of all adult cancers. It mostly occurs in middle-aged adults, and twice as often in men as in women. Smoking cigarettes may put one at greater risk for kidney cancer.

The most common symptom of kidney cancer is blood in the urine. In some cases, a person can actually see the blood, although it may be present one day and not the next. Also, traces of blood may be found during a urinalysis, a urine test done as part of a regular medical checkup.

Another symptom is a lump or mass that can be felt in the kidney area. The tumor may cause a dull ache or pain in the back or side. Less often, signs of a kidney tumor include high blood pressure or an abnormal number of red blood cells. As with other types of cancer, kidney cancer can cause unexplained weight loss, weakness and an overall feeling of poor health.

To diagnose kidney cancer, the doctor asks about the patient's personal and family medical history and does a complete physical exam. In addition to checking temperature, pulse, blood pressure and other general signs of health, the doctor usually orders blood and urine tests and may do one or more of the following exams (if the doctor thinks the patient might have transitional-cell carcinoma, other tests may be performed):

• An IVP (intravenous pyelogram)
• A CT scan
• Ultrasound
• An arteriogram
• MRI (magnetic resonance imaging)
• A nephrotomogram, or a series of X-rays of cross-sections of the kidney

When a diagnosis of kidney cancer is made, the doctor needs to know what stage the disease is in. Because kidney cancer may spread to the bones, lungs, liver or brain, staging procedures may include special X-rays and tests to check these organs.

Treatment depends on the location and size of the tumor and whether the cancer has spread to other organs. The doctor also considers the patient's age and general health in developing a treatment plan.

Kidney cancer is treated with surgery, embolization, radiation therapy, hormone therapy, biological therapy or chemotherapy. The doctor may use just one treatment method or a combination of several.

Surgery - Most kidney cancer patients have an operation called a nephrectomy. In some cases, the surgeon removes just the part of the kidney that contains the tumor. More often, the surgeon removes the whole kidney, along with the adrenal gland and the fat around the kidney. Also, nearby lymph nodes may be removed because they are one of the first places that kidney cancer spreads to. If there are cancer cells in the lymph nodes, there may be cancer elsewhere in the body.

Embolization - In embolization, a substance is injected to clog the renal blood vessels. The tumor shrinks because it does not get the blood supply it needs to grow. In some cases, embolization makes surgery easier. When surgery is not possible, this treatment may help reduce pain and bleeding.

Radiation therapy (radiotherapy) - This procedure employs high-powered rays to damage cancer cells and stop them from growing. Radiation therapy may be used to shrink a tumor before surgery or to kill cancer cells that may remain in the body after surgery.

Biological therapy -Interferon-alpha and Interleukin-2 are sometimes used for advanced kidney cancer, with response rates usually better than those seen for chemotherapy. Monoclonal antibodies, vaccines and other biological therapies hold much promise for the future and are available through clinical trials.

Hormone therapy and chemotherapy - These treatments are also used sometimes but with limited benefits for most patients.

Research suggests that lifestyle modication with regard to patterns of diet, exercise and tobacco use, among other factors, is the best way to prevent any form of cancer, including kidney cancer. It's also good to be aware of the possible symptoms, as described above, and to alert your doctor if you notice them.