Kidney Cancer Treatment in India
Every person has two kidneys, which are located above the waist on both sides of the spine. These reddish-brown, bean-shaped organs are each about the size of a small fist. They are located closer to the back of the body than to the front.
The kidneys filter blood to remove impurities, excess minerals and salts, and extra water. Every day, the kidneys filter about 200 quarts of blood to generate two quarts of urine. The kidneys also produce hormones that help control blood pressure, red blood cell production, and other bodily functions.
Kidney cancer begins when healthy cells in one or both kidneys change and grow uncontrollably, forming a mass called a tumor. A tumor can be malignant, indolent, or benign. A malignant tumor is cancerous, meaning it can grow and spread to other parts of the body. An indolent tumor is also cancerous, but this type of tumor rarely spreads to other parts of the body. A benign tumor means the tumor can grow but will not spread.
Types of Kidney Cancer
There are several types of kidney cancer:
- Renal cell carcinoma. Renal cell carcinoma is the most common type of adult kidney cancer, making up about 85% of diagnoses. This type of cancer develops in the proximal renal tubules that make up the kidney’s filtration system. There are thousands of these tiny filtration units in each kidney.
- Transitional cell carcinoma. This is also called urothelial carcinoma and accounts for 10% to 15% of the kidney cancers diagnosed in adults. Transitional cell carcinoma begins in the area of the kidney where urine collects before moving to the bladder, called the renal pelvis. This type of kidney cancer is similar to bladder cancer and is treated in a similar way.
- Sarcoma of the kidney is rare. This type of cancer develops in the soft tissue of the kidney; the thin layer of connective tissue surrounding the kidney, called the capsule; or surrounding fat. Sarcoma of the kidney is usually treated with surgery. However, sarcoma commonly comes back in the kidney area or spreads to other parts of the body. More surgery or chemotherapy may be recommended after the first surgery.
- Wilms tumor. Wilms tumor is most common in children and is treated differently than kidney cancer in adults. This type of tumor is more likely to be successfully treated with radiation therapy and chemotherapy than the other types of kidney cancer when combined with surgery. This has resulted in a different approach to treatment.
Causes of Kidney Cancer
The following factors may raise a person’s risk of developing kidney cancer:
- Smoking.Smoking tobacco doubles the risk of developing kidney cancer and is believed to cause about 30% of kidney cancers in men and approximately 25% in women.
- Men are two to three times more likely to develop kidney cancer than women.
- Kidney cancer is typically found in adults and is usually diagnosed between the ages of 50 and 70.
- Nutritionand weight. Research has often shown a link between kidney cancer and obesity, which is generally caused by many years of eating a high-fat diet.
- High blood pressure.Men with high blood pressure, also called hypertension, may be more likely to develop kidney cancer.
- Overuse of certain medications.Painkillers containing phenacetin have been banned in the United States since 1983 because of their link to transitional cell carcinoma. Diuretics and analgesic pain pills, such as aspirin, acetaminophen, and ibuprofen, have also been linked to kidney cancer.
- Exposure to cadmium.Some studies have shown a connection between exposure to the metallic element cadmium and kidney cancer. Working with batteries, paints, or welding materials may increase a person’s risk as well. This risk is even higher for smokers who have been exposed to cadmium.
- Long-term dialysis.People having dialysis for a long time may develop cancerous cysts in their kidneys. These growths are usually found early and can often be removed before the cancer spreads.
- Family history of kidney cancer.People who have first-degree relatives, such as parents, brothers, sisters, or children, with kidney cancer have an increased risk of developing the disease
Symptoms of Kidney Cancer
- Blood in the urine
- Pain or pressure in the side or back
- A mass or lump in the side or back
- Swelling of the ankles and legs
- High blood pressure
- Anemia, which is a low red blood cell count
- Loss of appetite
- Unexplained weight loss
- Recurrent fever that is not from cold, flu, or other infection
- For men, a rapid development of a cluster of enlarged veins, known as a varicocele, around a testicle
Stages of Kidney Cancer
Stage I: The tumor is 7 cm or smaller and is only located in the kidney. It has not spread to the lymph nodes or distant organs (T1, N0, M0).
Stage II: The tumor is larger than 7 cm and is only located in the kidney. It has not spread to the lymph nodes or distant organs (T2, N0, M0).
Stage III: Either of these conditions:
- A tumor of any size is located only in the kidney. It has spread to the regional lymph nodes but not to other parts of the body (T1, T2; N1; M0).
- The tumor has grown into major veins or perinephric tissue and may or may not have spread to regional lymph nodes. It has not spread to other parts of the body (T3; any N; M0).
Stage IV: Either of these conditions:
- The tumor has spread to areas beyond Gerota’s fascia and extends into the adrenal gland on the same side of the body as the tumor, possibly to lymph nodes, but not to other parts of the body (T4; any N; M0).
- The tumor has spread to any other organ, such as the lungs, bones, or the brain (any T, any N, M1)
Recurrent: Recurrent cancer is cancer that has come back after treatment. It may be found in the kidney area or in another part of the body.
Diagnosis of Kidney Cancer
n addition to a physical examination, the following tests may be used to diagnose kidney cancer:
- Blood and urine tests. The doctor may recommend having a blood test to check the number of red blood cells and a urine test to find blood, bacteria, or cancer cells. These tests may suggest that kidney cancer is present but cannot make a definite diagnosis.
- Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis
- X-ray. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation.
- Intravenous pyelogram (IVP). A dye is injected into the patient’s bloodstream to highlight the kidney, urethra, and bladder when an x-ray is taken. The picture produced can show changes in these organs and in the nearby lymph nodes.
- Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears gray to the camera, and areas of injury, such as those caused by cancer or a fracture (break), appear dark.
- Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. If a benign angiomyolipoma is suspected, a special dye called a contrast medium is given during the scan to provide better detail on the image. This dye is injected into a patient’s vein.
- Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called gadolinium is given before the scan to create a clearer picture. This dye is injected into a patient’s vein.
- Cystoscopy and nephro-ureteroscopy. Occasionally, special tests called a cystoscopy and nephro-ureteroscopy may be done for renal pelvic cancer. They are not used for renal cell carcinoma. During these procedures, the patient is sedated while a tiny, lighted tube is inserted into the bladder through the urethra and up into the kidney. Sedation is giving medication to become more relaxed, calm, or sleepy. The device can remove samples of cells and, in some cases, small tumors.
Treatment of Kidney Cancer
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. If the cancer has not spread beyond the kidneys, surgery to remove the tumor, part or all of the kidney, and possibly nearby tissue and lymph nodes, may be the only treatment necessary.
The types of surgery used for kidney cancer include the following procedures:
- Radical nephrectomy. Surgery to remove the tumor, the entire kidney, and surrounding tissue is called a radical nephrectomy. If nearby tissue and surrounding lymph nodes are also affected by the disease, a radical nephrectomy and lymph node dissection is performed.. A radical nephrectomy is usually recommended to treat a large tumor when there is little healthy tissue remaining.
- Partial nephrectomy. A partial nephrectomy is the surgical removal of a tumor. This type of surgery preserves kidney function and lowers the risk of developing chronic kidney disease after surgery..
- Laparoscopic and robotic surgery. During laparoscopic surgery, the surgeon makes several small incisions rather than the one larger incision in the abdomen used during a traditional surgical procedure. The surgeon then inserts telescoping equipment into these small, keyhole incisions to remove the kidney completely or perform a partial nephrectomy. Sometimes, the surgeon may use robotic instruments to perform the operation.
Sometimes surgery is not recommended because of characteristics of the tumor or the patient’s overall health. The following procedures may be recommended instead:
- Radiofrequency ablation. Radiofrequency ablation (RFA) is the use of a needle inserted into the tumor to destroy the cancer with an electrical current.
- Cryoablation, also called cryotherapy or cryosurgery, is the freezing of cancer cells with a metal probe inserted through a small incision..
- Immunotherapy: Immunotherapy, also known as biologic therapy, helps in boosting the natural defenses of the body to fight against cancer
These drugs are often used as the first line of treatment against advanced kidney cancers. They can often shrink or slow the growth of the cancer.