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The most common type of kidney cancer is called renal cell carcinoma, or RCC (renal is the Latin word for "kidney"). The information in these pages will refer to renal cell carcinoma. The kidneys are two large bean-shaped organs fixed to the upper back wall of the abdominal cavity, protected by the lower ribcage. The kidneys' main function is filtering blood to rid the body of excess water, salt, and waste products. Although kidneys are important organs, we actually need less than one complete kidney to perform all of their important functions. Tens of thousands of people in the United States are living normal healthy lives with just one kidney. Kidney cancer can exist in four variations: clear cell type, granular cell type, mixed clear and granular cell type, and spindle cell type. The clear cell type is made up of cells that contain a lot of fat and sugar. When these cells are prepared for examination under a microscope, the sugar and fat are washed out, leaving the cells almost invisible, or clear. Granular cell types are full of small pink granules, which are mitochondria (the part of the cell that supplies its energy). Mixed clear and granular cell type contain both clear cells and granular cells. Spindle cell type tumors contain long cells with pointed ends. The prognosis (outlook) of kidney cancer can depend in part on the type of cells the tumor is made of. Clear cell renal cancer has a slightly better prognosis than the other cell types, and spindle cell type often grows and spreads more quickly than the others. However, prognosis is based much more on the stage of the cancer (how far it has spread beyond the original site) than the cell type.
Renal cell carcinoma can be difficult to detect physically. Tumors can become quite large without causing any pain or discomfort. Because the kidney is located deep within the body, small tumors cannot be detected with a physical exam. Most cases of kidney cancer are discovered "incidentally," meaning that they are discovered while a patient is being examined for some other reason (i.e. tests for illnesses such as gallbladder disease). The survival rates for incidental kidney cancer are quite high when treated appropriately, since these cancers are usually found in early stages. These symptoms might be caused by kidney cancer:
It is important to note, however, that many of these symptoms are more often caused by other medical conditions. It is important to consult a physician to find out what is causing symptoms. If a doctor suspects kidney cancer, there are a number of tests to help determine if cancer is present. A medical history evaluates a patient’s risk factors and symptoms. Doctors may perform laboratory tests such as blood and urine analyses, and cytoscopy. Cytoscopy is the use of a slender tube with a lens and a light that is inserted in the urethra so the doctor can check the bladder and urethra for possible cancers. The doctor can also take small tissues samples for examination during this procedure. A patient may receive local or general anesthetic during cytoscopy. A doctor may also use imaging tests, which produce pictures of the kidney area to determine if cancer may be present. Some imaging tests include
Risk Factors Risk factors are conditions that increase a person’s chance of getting a type of cancer. Risk factors vary depending on the type of cancer. Doctors have determined several risk factors for kidney cancer:
Prevention Researchers don’t know enough about the causes of kidney cancer to say for certain how people can prevent it. Taking preventative measures in light of your risk factors can obviously lower kidney cancer risk, but it cannot guarantee protection. However, researchers have estimated that 25% to 30% of kidney cancer cases are the direct result of tobacco abuse. Avoiding tobacco is the best and way to decrease the risk of developing renal cell carcinoma. Also, being aware of job-related risks for kidney cancer and following workplace precautions to avoid exposure to asbestos and cadmium can help prevent some kidney cancers.
Doctors may use surgery, chemotherapy, immunotherapy, and/or radiation therapy to treat kidney cancer. They may combine one or more of these therapies in order to treat the cancer most effectively. Surgery is the most common means of treatment for kidney cancer. Survival chances are poor for kidney cancer patients that don’t undergo surgery for treatment. The type of surgery performed depends on the stage of the disease (how far the cancer has spread beyond the original site). Radical nephrectomy is the most often performed surgery for kidney cancer. It involves the removal of the entire kidney, the attached adrenal gland and the fatty tissue immediately surrounding the kidney. Often, a regional lymphadenectomy – the removal of nearby lymph nodes – is performed with radical nephrectomy. Partial nephrectomy involves removing only the part of the kidney that contains cancer. This procedure is sometimes performed if there is only one small RCC on the kidney, or if there is RCC on both kidneys. The results of this procedure have been promising, but there is a small risk of cancer being left behind. If the cancer has spread beyond the kidney area, doctors may or may not remove metastases (cancers that have spread beyond the original site). Removal may temporarily relieve pain or other symptoms, but the surgery usually does not help the patient survive longer. This type of surgery is generally not performed if a patient has many metastases, but may be recommended if the patient has a few, easily accessible ones that can be easily removed without causing serious side effects. The side effects of kidney surgery depend on the type of operation, the patient's general health, and other factors. Nephrectomy is major surgery, and after the operation most people experience pain and discomfort. Patients may find it difficult to breathe deeply due to discomfort from surgery, and they may have to do special coughing and breathing exercises to help keep their lungs clear. It is also common for patients who have had surgery to feel tired or weak for a period of time. In addition, patients may need intravenous (IV) feeding and fluids for several days before and after the operation. When a kidney is removed, the one remaining kidney takes over the work that both did previously. Nurses will monitor the amount of fluid a person takes in and the amount of urine produced. Doctors have not had great success treating renal cell carcinoma with chemotherapy or radiation therapy; consequently, a lot of attention is now focused on the use of immunotherapy to treat kidney cancer. The goal of immunotherapy is to boost the body’s immune system to help destroy cancer cells. Doctors inject patients with cytokines, which are proteins that encourage the immune system. This has become a standard treatment for metastatic kidney cancer (cancer that has spread beyond the kidneys). Side effects of immunotherapy include low blood pressure, fluid accumulation in the lungs, kidney damage, heart attacks, intestinal bleeding, high fever, and chills. These side effects are often severe and, rarely, can be fatal. For this reason, immunotherapy should be given only by doctors experienced with this approach to kidney cancer treatment. Renal cell carcinoma is very resistant to chemotherapy and there is no standard way to treat RCC with present-day chemotherapy drugs. Depending on the type and stage of kidney cancer, chemotherapy may be given as an adjuvant (addition) to surgery. Chemotherapy is the use of anti-cancer drugs given intravenously or taken by mouth. Chemotherapy is a systemic therapy, meaning it travels through the blood stream, reaching all parts of the body. The drugs affect rapidly dividing cells – like cancer cells. But since the medication travels throughout the body, other cells of the body that divide rapidly – like blood cells, cells in hair roots and cells that line the digestive tract – are affected as well. As a result, patients receiving chemotherapy may have an increased chance of infection, bruise or bleed easily, have less energy (caused by affected blood cells), loose their hair (caused by affected hair root cells), and suffer from nausea, vomiting, loss of appetite, diarrhea, or mouth sores (caused by affected digestive tract cells). Kidney cancer is not very sensitive to radiation therapy either, though it is sometimes used for patients whose general health is too poor to undergo surgery. It may also be used to palliate, or ease, symptoms related to kidney cancer. Also called radiotherapy, radiation therapy is the use of high-energy rays to damage cancer cells and stop them from growing and dividing. Like surgery, radiation therapy is local therapy, meaning the radiation affects cancer cells only in the treated area. The radiation comes from a machine that aims the rays from radioactive material at a specific area of the body. It is common to lose hair in the treated area and for the skin to become red, tender, and itchy; doctors instruct patients how to take care of the treated area. Nausea, vomiting and tiredness are also common side effects. Radiotherapy aimed at the chest may cause lung damage and lead to breathing difficulty and shortness of breath.
Kidney cancer can exist in four variations: clear cell type, granular cell type, mixed clear and granular cell type, and spindle cell type. The clear cell type is made up of cells that contain a lot of fat and sugar. When these cells are prepared for examination under a microscope, the sugar and fat are washed out, leaving the cells almost invisible, or clear. Granular cell types are full of small pink granules, which are mitochondria (the part of the cell that supplies its energy). Mixed clear and granular cell type contain both clear cells and granular cells. Spindle cell type tumors contains long cells with pointed ends. The prognosis (outlook) of kidney cancer can depend in part on the type of cells the tumor is made of. Clear cell renal cancer has a slightly better prognosis than the other cell types, and spindle cell type often grows and spreads more quickly than the others. However, prognosis is based much more on the stage of the cancer (how far it has spread beyond the original site) than the cell type.
It is difficult to discover what actually causes cancer from one person to another, but researchers have found several specific factors that increase a person’s likelihood of developing kidney cancer. Some risk factors for kidney cancer include:
Renal cell carcinoma can be difficult to detect physically. Tumors can become quite large without causing any pain or discomfort. Because the kidney is located deep within the body, small tumors cannot be detected with a physical exam. Most cases of kidney cancer are discovered "incidentally," meaning that they are discovered while a patient is being examined for some other reason( i.e. tests for illnesses such as gallbladder disease). The survival rates for incidental kidney cancer are quite high when treated appropriately, since these cancers are usually found in early stages. These symptoms might be caused by kidney cancer:
It is important to note, however, that many of these symptoms are more often caused by other medical conditions. It is important to consult a physician to find out what is causing symptoms.
If a doctor suspects kidney cancer, there are a number of tests to help determine if cancer is present. A medical history evaluates a patient’s risk factors and symptoms. Doctors may perform laboratory tests such as blood and urine analyses, and cytoscopy. Cytoscopy is the use of a slender tube with a lens and a light that is inserted in the urethra so the doctor can check the bladder and urethra for possible cancers. The doctor can also take small tissues samples for examination during this procedure. A patient may receive local or general anesthetic during cytoscopy. Your doctor will let you know what to expect before and after the procedure. A doctor may also use imaging tests, which produce pictures of the kidney area to determine if cancer may be present. Some imaging tests include CT scanning, MRI, ultrasonography, intravenous pyelogram (IVP) and arteriography, chest x-ray, and bone scan. For explanations of these terms, see Detection.
Three kinds of treatment are used to treat pancreatic cancer:
A doctor may use just one method or combine methods to treat the cancer most effectively. These are some questions a person may want to ask his/her doctor before treatment begins:
It is hard to limit the effects of therapy so that only cancer cells are destroyed. Because treatment often damages healthy cells and tissues, it can cause unpleasant side effects. The side effects of cancer treatment vary, depending on the type of treatment. Also, each patient reacts differently. Doctors try to keep side effects to a minimum, but problems may occur. Surgery is the most common treatment for kidney cancer. The side effects of kidney surgery depend on the type of operation, the patient's general health, and other factors. Nephrectomy is major surgery, and after the operation most people experience pain and discomfort. Patients may find it difficult to breathe deeply due to discomfort from surgery, and they may have to do special coughing and breathing exercises to help keep their lungs clear. It is also common for patients who have had surgery to feel tired or weak for a period of time. Doctors also use immunotherapy to fight kidney cancer. Side effects of immunotherapy include low blood pressure, fluid accumulation in the lungs, kidney damage, heart attacks, intestinal bleeding, high fever, and chills. These side effects are often severe and, rarely, can be fatal. For this reason, immunotherapy should be given only by doctors experienced with this approach to kidney cancer treatment. Chemotherapy and radiation therapy have not been as successful in treating kidney cancer, but they are still given to patients, perhaps if a patient’s overall health wouldn’t allow him or her to undergo surgery. Chemotherapy drugs affect rapidly dividing cells – like cancer cells. But since the medication travels throughout the body, other cells of the body that divide rapidly – like blood cells, cells in hair roots and cells that line the digestive tract – are affected as well. As a result, patients receiving chemotherapy may have an increased chance of infection, bruise or bleed easily, have less energy (caused by affected blood cells), loose their hair (caused by affected hair root cells), and suffer from nausea, vomiting, loss of appetite, diarrhea, or mouth sores (caused by affected digestive tract cells). With radiation therapy, it is common to lose hair in the treated area and for the skin to become red, tender, and itchy; doctors instruct patients how to take care of the treated area. Nausea, vomiting and tiredness are also common side effects. Radiotherapy aimed at the chest may cause lung damage and lead to breathing difficulty and shortness of breath.
Each cancer survivor’s recovery is different, and a person’s adjustment after cancer treatment depends on a number of factors. The body can function with one or even part of one kidney, so if treatment is successful, the removal of part of the kidney will not really affect the survivor negatively. It is important for people to seek support during and after cancer treatment. Taking advantage of a social support system, such as a cancer support group, helps patients by providing a forum of information and experiences. Maintain an open dialogue with your cancer care team to address any concerns you have.
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