Kidney Cancer

Kidney Cancer: Understanding the Signs, Diagnosis, and Treatment

Kidney cancer, unfortunately, can be hard to spot in its early stages because there aren't always obvious symptoms. As the cancer progresses, you might notice some changes, such as:

• Blood in your urine: This might be pink, red, or dark brown.
• Back or side pain: Pain that doesn't go away.
• Loss of appetite: Not feeling hungry.
• Unexplained weight loss: Losing weight without trying.
• Feeling tired all the time: Persistent tiredness.
• Fever: A higher body temperature.
• Night sweats: Sweating a lot while you sleep.

If you're concerned about these symptoms, talk to your doctor right away.

How Doctors Diagnose Kidney Cancer

Doctors use several methods to check for kidney tumors:

• Blood and urine tests: These tests can look for substances that might indicate a problem.
• Imaging tests: These tests, such as ultrasounds, X-rays, CT scans, and MRIs, create pictures of the inside of your body, helping doctors see if there's a tumor or other abnormality.
• Biopsy: Sometimes, a small tissue sample is taken from the tumor using a needle. This sample is sent to a lab for further testing.

Staging the Cancer

Once kidney cancer is diagnosed, doctors need to determine how far it has spread. This is called staging.

• Staging tests: These may include more imaging tests, like CT scans.
• Staging results: Doctors assign a number (I through IV) to describe the stage of the cancer. Lower numbers mean the cancer is contained in the kidney. Higher numbers mean it's more advanced and might have spread to other parts of the body, like the lymph nodes or other organs.

Good News About Kidney Cancer

Kidney cancer has a potential advantage over some other cancers. Since we have two kidneys, and most people only need one to function, if the cancer is caught early (localized to the kidney) and hasn't spread, the chances of survival are good, and treatment often won't significantly affect a person's quality of life.

Treatment Options

The best treatment for kidney cancer depends on several factors, including the stage of the cancer, your overall health, and your preferences. Common treatments include:

• Surgery: This is often the first treatment.

  • Nephrectomy: Removing the entire affected kidney.
  • Partial nephrectomy: Removing just the tumor, leaving the healthy part of the kidney.

• Non-surgical methods: These methods destroy the cancer cells without surgery:

  • Cryoablation: Freezing the cancer cells.
  • Radiofrequency ablation (RFA): Heating the cancer cells until they disintegrate.

More About Kidney Cancer

The kidneys are two bean-shaped organs located behind the abdominal organs, one on each side of your spine. They're about the size of your fist.

• Common type: In adults, the most common type of kidney cancer is renal cell carcinoma.
• Other types: There are other, less common types of kidney cancer.
• Wilms tumor: Children are more likely to get a type of kidney cancer called Wilms tumor.
• Increased diagnoses: The number of kidney cancers diagnosed each year seems to be rising. This might be because more imaging tests are being done, leading to more cancers being found, even when they are small and contained to the kidney.

Important Note: This information is for educational purposes only and should not be considered medical advice. If you have concerns about kidney cancer or any other medical condition, please consult with a healthcare professional.

Kidney cancer often has no noticeable symptoms at first. However, as the cancer progresses, some signs might appear. These could include:

• Blood in your urine: This blood can make your urine look pink, red, or even like cola.

• Loss of interest in food (loss of appetite): You might not feel hungry as much as usual.

• Persistent pain in your side or back: This pain doesn't go away and might be a constant ache.

• Feeling unusually tired: You might experience fatigue that doesn't seem to go away, even with rest.

• Unexplained weight loss: You might be losing weight without trying to diet or change your activity level.

If you notice any of these signs or have any other symptoms that worry you, it's important to see a doctor or other healthcare provider right away. Early detection is key to successful treatment.

If you're feeling unwell or have any symptoms that concern you, it's important to schedule a visit with a doctor or other medical professional. This could include a family doctor, a specialist, or a nurse practitioner. Don't hesitate to reach out if you have questions or are worried about your health. Talking to a healthcare provider can help you understand what's going on and get the right care.

Kidney cancer often has no single, identifiable cause.

Kidney cancer starts when cells in the kidneys develop problems with their DNA. DNA is like a set of instructions for a cell, telling it how to behave. In normal cells, the DNA tells the cell how fast to grow and divide, and when to die. But in kidney cancer cells, the DNA instructions change. These altered instructions tell cancer cells to grow and divide much faster than usual, and they don't follow the instructions to die when they should. This leads to an uncontrolled buildup of cancer cells.

These extra cells clump together to form a mass called a tumor. This tumor can get bigger and push into surrounding healthy tissue, damaging it. Sometimes, cancer cells can break off from the main tumor and travel through the bloodstream or lymphatic system to other parts of the body. This spread of cancer cells is called metastasis.

Kidney cancer risk can be higher for some people than others. Several factors can increase the chance of developing this type of cancer.

Age: As you get older, your risk of kidney cancer generally goes up. This is because your body changes over time, and these changes can sometimes increase your risk of developing certain types of cancer.

Smoking: Smoking tobacco significantly raises your chances of getting kidney cancer. Your risk is higher if you smoke compared to people who don't smoke. Importantly, quitting smoking lowers your risk, showing that lifestyle choices can make a difference.

Obesity: Being significantly overweight or obese increases your risk of kidney cancer. Maintaining a healthy weight is important for overall health, and this includes a reduced risk of kidney cancer.

High Blood Pressure (Hypertension): High blood pressure, a condition where the force of blood against your artery walls is consistently too high, also increases your risk of kidney cancer. Managing your blood pressure through healthy habits and, if needed, medication, is crucial for your overall health and can help reduce this risk.

Inherited Conditions: Some people are born with genetic conditions that make them more prone to kidney cancer. These conditions include von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis complex, hereditary papillary renal cell carcinoma, and familial renal cancer. If you have a family history of these conditions, it's important to talk to your doctor about your risk and possible screening options.

Family History: Having a close blood relative (like a parent or sibling) who has had kidney cancer also raises your risk. This suggests a possible genetic predisposition, or that shared lifestyle factors may contribute to the increased risk. If you have a family history of kidney cancer, discussing your risk with a doctor is recommended.

Kidney cancer can't be completely avoided, but there are things you can do to lower your chances.

Healthy Habits to Reduce Kidney Cancer Risk:

• Moderation with Alcohol: If you drink alcohol, limit it. For women, that means no more than one drink per day. For men, it's no more than two. A "drink" is typically a small glass of wine, a can of beer, or a shot of liquor.

• Nourishing Diet: Eat lots of fruits and vegetables. Getting your vitamins and minerals from whole foods is best. Don't take extra vitamins in pill form unless your doctor recommends it, as too much can be harmful.

• Regular Exercise: Aim for at least half an hour of activity most days of the week. If you haven't been active recently, check with your doctor before starting a new exercise routine and begin slowly. Examples of activities include brisk walking, swimming, or cycling.

• Healthy Weight Management: If you have a healthy weight, strive to maintain it. If you need to lose weight, talk to your doctor about safe and effective ways to do so. Gradually reduce your calorie intake and increase your activity level.

• Quitting Smoking: If you smoke, quitting is a crucial step to reduce your cancer risk. Talk to your doctor about strategies to help you quit, such as nicotine replacement patches, medications, or support groups. If you haven't smoked before, don't start.

These healthy lifestyle choices can significantly improve your overall health and reduce your risk of kidney cancer. Always consult with your healthcare provider for personalized advice and guidance.

Understanding Kidney Cancer: Frequently Asked Questions

Dr. Brad Leibovich, a urologic oncologist at Mayo Clinic, answers common questions about kidney cancer.

Can kidney cancer be prevented?

In most cases, kidney cancer isn't related to lifestyle choices. There's usually nothing a person could have done differently to prevent it.

What's the outlook for kidney cancer?

The chances of recovery depend heavily on how early the cancer is found. If discovered early (stage 1), the outlook is very good, and cure is often possible. For later-stage cancers (stages 2-4), while a cure may not be possible, treatment can significantly extend a person's life.

Will I need to have my entire kidney removed?

Sometimes, only the tumor needs to be removed, sparing the entire kidney. In other cases, the entire kidney may be necessary to remove. Most people have a second kidney, and one kidney is usually enough for normal function, so this isn't typically a significant concern.

Do I need to change my lifestyle after treatment?

Generally, no special diet or lifestyle changes are required. Maintaining a healthy overall lifestyle—getting enough sleep, exercising regularly, and eating a balanced diet—is crucial. Your doctor will advise you if any specific changes are needed.

What are the different stages of kidney cancer?

Kidney cancer is staged from 1 to 4, based on how large the tumor is and whether it has spread.

• Stage 1: The tumor is 2 3/4 inches (7 centimeters) or smaller and confined entirely within the kidney.

• Stage 2: The tumor is larger than 2 3/4 inches (7 centimeters) but still only in the kidney.

• Stage 3: The tumor may have grown into surrounding tissues or spread to nearby lymph nodes.

• Stage 4: The tumor has grown beyond the kidney and may have spread to other parts of the body, such as the bones, liver, or lungs.

How is kidney cancer diagnosed?

Diagnosing kidney cancer often starts with a physical exam and a discussion about your health history. Tests may include:

• Blood and urine tests: These can show signs of problems, like blood in the urine or abnormal cell counts.

• Imaging tests: These create pictures of the body, helping pinpoint the location and size of the tumor. Examples include ultrasounds, CT scans (like a CT urogram), and MRIs.

• Biopsy: A small tissue sample may be taken for lab analysis, especially if the images aren't clear enough. A thin needle is inserted into the kidney or nearby lymph nodes to collect the sample.

How is the stage of kidney cancer determined?

Once diagnosed, the extent of the cancer (staging) is determined. This helps create a personalized treatment plan. Additional imaging tests, like CT and MRI scans, may be done to determine the stage.

What can I do to be a good partner in my care?

Learning as much as you can about your diagnosis and treatment options is key. Ask your medical team any questions you have and share any concerns. Being informed and involved in your care is essential for making the best decisions for you.

Treating Kidney Cancer: A Guide for Patients

Kidney cancer treatment often starts with surgery to remove the cancerous part of the kidney. If the cancer is contained within the kidney, this might be the only treatment needed. Sometimes, medicines are used after surgery to reduce the risk of the cancer returning. However, if the cancer has spread beyond the kidney, surgery might not be an option, and other treatments will likely be recommended.

Choosing the Right Treatment

Your healthcare team creates a treatment plan based on many factors, including:

• Your overall health
• The type and stage of your cancer
• Your personal preferences

Different types of surgery are used to treat kidney cancer:

1. Partial Nephrectomy (Kidney-Sparing Surgery): This surgery removes only the cancerous tumor and a small surrounding area of healthy tissue, preserving as much of the healthy kidney as possible. It's a good option for smaller cancers, especially if you only have one kidney, as it helps to keep your kidney function. This procedure can be performed through a large incision (open), or smaller incisions using a laparoscope (a thin tube with a camera) or robotic assistance.

2. Complete Nephrectomy (Radical Nephrectomy): This is a more extensive surgery to remove the entire kidney, along with some surrounding tissues, including lymph nodes and possibly the adrenal gland. This is done when the cancer is too large or has spread. Like partial nephrectomy, this surgery can be performed with open, laparoscopic, or robotic techniques.

Other Treatment Options:

• Cryoablation: This technique uses extremely cold gas to freeze and destroy the cancer cells. A hollow needle is guided into the tumor, and the freezing process can be monitored using imaging tools like ultrasound. This method is suitable for smaller kidney cancers in some cases, particularly when surgery is not an option due to other health concerns.

• Radiofrequency Ablation (RFA): RFA uses heat to destroy cancer cells. A special probe is inserted into the tumor, and an electrical current is used to generate heat and kill the cancer cells. This method is also good for smaller cancers, and is often considered when surgery is risky.

• Radiation Therapy: This treatment uses high-energy beams (like X-rays or protons) to target and kill cancer cells. It can be used to treat kidney cancer directly or to control symptoms if the cancer has spread to other parts of the body (like the bones or brain).

• Targeted Therapy: These medicines specifically target molecules within cancer cells, disrupting their growth and causing them to die.

• Immunotherapy: Immunotherapy helps the body's immune system recognize and attack cancer cells. It may be used after surgery to eliminate any remaining cancer cells or when the cancer is large or has spread.

• Chemotherapy: Chemotherapy uses strong medicines to kill cancer cells. Kidney cancer is often resistant to chemotherapy, but it may be used in some rare situations.

• Palliative Care: Palliative care focuses on improving the quality of life for people with serious illnesses, like cancer. This can involve managing pain, other symptoms, and emotional distress. Palliative care teams work closely with patients, families, and other medical professionals to provide comprehensive support throughout the treatment process, and it can be used alongside other cancer treatments.

Managing Side Effects and Stress:

Cancer treatment and the diagnosis itself can be stressful. Alternative and integrative therapies, such as acupuncture, art therapy, exercise, massage, meditation, and music therapy, may help with managing side effects and overall well-being. It's important to talk to your healthcare team about any concerns or interests in these options.

Support and Information:

Connecting with friends, family, and support groups can be very helpful during this time. Your healthcare team can provide information about local support groups and resources like the National Cancer Institute and the American Cancer Society. Don't hesitate to ask your healthcare team any questions about your cancer, test results, treatment options, and prognosis. This knowledge will help you make informed decisions about your care.

Dealing with a kidney cancer diagnosis can be tough, but you'll learn what works best for you over time. In the meantime, here are some helpful strategies:

Understanding Your Kidney Cancer: Learning about kidney cancer is key to making informed decisions about your care. Talk to your doctor and medical team. Ask them about your test results, the different treatment options, and, if you'd like to know, what your outlook might be. The more you understand, the more comfortable you'll feel making choices about your treatment.

Nurturing Your Support System: Strong relationships with friends and family are incredibly important. They can provide practical help, like managing your household while you're undergoing treatment or in the hospital. They can also offer emotional support when you're feeling overwhelmed by the diagnosis. Having someone to talk to is crucial.

Finding a Supportive Listener: It's important to have someone who can listen to you without judgment. This could be a close friend, family member, or even a mental health professional like a counselor, medical social worker, or clergy member. Support groups can also provide a valuable network of people going through similar experiences. Your healthcare team can help you find support groups in your area.

Reliable Information Sources: For more information about kidney cancer, you can also check out the National Cancer Institute and the American Cancer Society. They offer a wealth of reliable resources.