Health Tips

Kidney Cancer:

Introduction:
Your kidneys are twin organs that play important roles in the urinary system, the production of red blood cells, and the control of blood pressure. Red-brown and approximately the size of a fist, they are located at the back of the abdominal cavity. Their main function is to filter excess fluids, salt and waste products from the body

Kidney Cancer Statistics:

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It makes up three percent of all cancer cases.
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It's the eighth most common malignancy in men.
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It's the tenth most common malignancy in women.

Renal Cell Carcinoma:

This site focuses on renal cell carcinoma (RCC), the most common form of kidney cancer. Renal cell carcinoma accounts for up to 95 percent of all cases. The kidneys contain millions of tiny filters called nephrons. Nephrons in turn contain small tubes called tubules. RCC usually starts in the cells that line the tubules

Risk Factors:

Smoking and Environmental Risk factors
Smoking is one of the key risk factors for malignant renal tumors. Smoking doubles the risk of kidney cancer. The more you smoke, the greater the risk. Quitting smoking decreases risk levels.

In addition to cigarette smoke, a number of occupational and environmental hazards increase the risk of renal tumors. People who work with asbestos or petroleum products increase the possibility that they will contract the disease.
Incidence rates are also higher among steel plant coal oven workers. Exposure to heavy metals such as lead and cadmium may also raise risk levels.

Obesity and Hypertension:

Hypertension, or high blood pressure, has been linked quite convincingly to RCC. Efforts to study the connections among obesity, high fat diets and RCC are inconclusive, but some evidence appears to indicate that a connection may eventually be established.

Gender and Age:

Advancing age appears to be correlated to the chance of developing renal tumors. Most cases of renal cell carcinoma occur between the ages of fifty and seventy, with an average age at diagnosis of 66. Gender also plays a significant role. Men are twice as likely as women to develop kidney cancer.

Hereditary Factors:

A family history of RCC may alert some individuals to the possibility of developing the disease, but heredity does not appear to play a large role. Rare genetic mutations can increase the chance of RCC. People living with tuberous sclerosis and von Hippel Lindau disease may develop it. Von Hippel Lindau disease causes tumors in the kidneys, eyes, spine and brain, and has an incidence rate one in every 36,000 births.

Medical Factors:

The use or, more properly, the over-use of phenacetin or acetaminophen-containing analgesics has been linked to increased chances of developing kidney tumors. Investigations into this claim are ongoing.

The long-term uses of dialysis machines by people with renal failure carries with it a slightly increased chance of developing RCC.

Wilms Tumer :

Wilms Tumor and Children:
Wilms tumor is a form of pediatric kidney cancer. Pediatric treatment options differ from those required for adult RCC.
Common Kidney Cancer Symptoms
Kidney cancer symptoms vary among individuals. Early stages of renal cell carcinoma are usually asymptomatic, meaning that no symptoms are present yet. Kidney cancer symptoms develop as the disease progresses.

Explaining the Classic Triad:

Three conditions make up the "classic triad" of kidney cancer. Hematuria is the most common. Hematuria is the presence of blood in the urine. Often, the blood can be seen with the naked eye (a condition called gross hematuria). Blood may also be present in microscopic amounts, detectable only by urinalysis. Hematuria occurs in sixty percent of patients.

Pain is a symptom in forty percent of cases. The pain is felt in the lower back, just below the ribs, and is constant. Finally, in thirty to forty percent of cases, a palpable mass may be detected during a routine physical examination of the kidneys.

Although the combination of hematuria, pain and a palpable mass is referred to as the classic triad, in reality only ten percent of patients present with all three conditions. The presence of the classic triad usually indicates a well advanced tumor.

Other Symptoms:

Other symptoms of renal cell carcinoma often appear when the disease is more advanced, but no single individual experiences all possible RCC symptoms. Anemia, or a lack of red blood cells, may occur. Weight loss, fatigue, fevers and night sweats are also common. Men may experience varicocele: varicose veins that affect the testes.

RCC may lead to paraneoplastic syndromes. Paraneoplastic complications are hormonal conditions caused by the effects of the tumor on the body. Possible paraneoplastic complications include hypertension (high blood pressure), hypercalcemia and polycythemia.
Erythropoietin and Polycythemia
Some RCC tumors produce excessive amounts of erythropoietin, a hormone that stimulates the production of red blood cells. Excessive amounts of erythropoietin lead to polycythemia, an overabundance of red blood cells. Polycythemia may cause headaches, dizziness, vein inflammation, breathing difficulties, itchiness, and a feeling of abdominal fullness. Patients may also experience unusual redness of the skin, especially in facial skin.

Parathyroid Hormone and Hypercalcemia:

RCC tumors can also produce parathyroid hormone, a hormone usually produced by the parathyroid gland. Too much parathyroid hormone production can lead to hypercalcemia, an excessive amount of calcium in the blood. Hypercalcemia may present asymptomatically. If symptoms do occur, they can include the following:

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tiredness
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a lack of appetite
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pain
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frequent urination
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thirst
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nausea
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vomiting
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difficulty thinking
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constipation.
Methods of Treatment:

Treatment options for kidney cancer depend on how advanced the disease is: thirty percent of cases have metastasized by the time of diagnosis. For localized tumors, surgery is the treatment of choice. Renal cell carcinoma (RCC) is highly resistant to chemotherapy, hormone therapy, and radiation therapy. Immunotherapy medications, which stimulate the immune system, are showing promising results in kidney cancer clinical trials.

Surgical Options:

Surgical removal of renal cell carcinoma offers the best chance of survival. If the cancer is diagnosed at an early stage, surgery can be curative. For over fifty years the surgery of choice has been radical nephrectomy, but developments in cancer research have resulted in other options.

Radical Nephrectomy:

A radical nephrectomy is the complete removal of the affected kidney, the adrenal gland, and surrounding fat. Sometimes, nearby lymph nodes are removed in a procedure called a lymphadenectomy. The patient's other kidney, if healthy, is capable of continuing renal function.

Radical nephrectomy may also be used in palliative care, even if the disease has spread to other organs. Removing the diseased kidney reduces symptoms and can increase survival odds.

Nephron-Sparing Surgery:
If the malignancy is small, removal of the entire kidney may not be necessary. Instead, nephron-sparing surgery attempts to remove only the cancerous tissue, leaving the rest of the organ intact. Investigative clinical trials reveal that, when the tumor is small enough, the technique is just as effective as radical nephrectomy.
Surgical Risks
As with any other surgical procedure, kidney cancer surgery has risks. Bleeding and infection may occur. Damage to surrounding organs is a possibility, including damage to the spleen, lungs, vena cava, pancreas and bowel.

Immunotherapy:
Interferon and Interleukin 2
Immunotherapy is a promising area of kidney cancer research. Immunotherapy stimulates the immune system, helping it to kill the malignant cells. Interferon has displayed some ability to treat RCC, but its results have been limited.

Interleukin 2 appears to be more effective than interferon for RCC treatment. Interleukin 2 stimulates the immune system's lymphoid cells. Due to severe side effects, people treated with Interleukin 2 must be relatively fit: the medication can cause renal failure, gastrointestinal hemorrhage and heart attacks.
Chemotherapy, Tamoxifen and Radiation Therapy:

Chemotherapy and hormone therapy have not proven very effective against renal cancer. Kidney tumors appear to have a high resistance to chemotherapy drugs, although tamoxifen (a drug also used in breast cancer treatment) is used in palliative care to reduce symptoms.

If the disease has spread to other organs, especially to the bones, radiation therapy is often employed. The therapy can reduce painful symptoms in the bones and other metastatic organs.
Cancer Research and Clinical Trials
Advanced stages of RCC are difficult to treat: once the disease has metastasized, surgery no longer offers a cure, and other existing therapies are not very effective. Accordingly, people with advanced stages of the disease are often offered experimental treatments available only through kidney cancer clinical trials