Kidney Cancer

It is estimated that approximately 30,000 Americans are diagnosed with kidney cancer each year. The disease is slightly more common in men than women and is usually diagnosed in individuals between the ages of 50 and 70. If kidney cancer is detected early, the survival rate ranges from 79 to 100 percent.

Common risk factors for kidney cancer include:

• Smoking/ Tobacco use
• Chronic kidney failure and/ or dialysis
• Polycystic kidney disease
• von Hippel Lindau disease
• High calorie diet
• Low Vitamin E intake

Common symptoms of kidney cancer may include:

• Blood in the urine (hematuria)
• Abdominal mass or lump
• Fever
• Hypertension
• Pain in the side or lower back
• Persistent fatigue
• Rapid, unexplained weight loss
• Swelling in the legs or ankles

Diagnosis:

If a tumor in the kidney is suspected, radiographic imaging may be recommended. A urologist may order an ultrasound, CT scan or a combination of both to evaluate the tumor. Patients may also undergo an abdominal CT scan, MRI, chest X-ray, blood tests or bone scans to determine if the cancer has spread.

Treatments:

There are several treatment options for patients whose cancer appears to be confined to the kidney.

Surgery
The removal of part of all of the kidney is considered the standard form of treatment for most patients. Radical nephrectomy removes the entire kidney while partial nephrectomy removes just the tumorous area to preserve as much normal tissue as possible. Nephrectomies may be performed through an open or robotic surgical approach.

Tumor Ablation
This procedure utilizes ablative technologies to destroy the tumor without surgically removing it. These technologies can include cryotherapy, interstitial radiofrequency ablation, high-intensity focused ultrasound, microwave thermotherapy and laser coagulation. These procedures may be performed during open surgery, laparoscopic surgery or percutaneously (through the skin). Tumor ablation may be less invasive compared to nephrectomy surgeries, but the long-term results of the procedure are unknown.

Embolization
This treatment is performed under sedation to insert and move a long narrow catheter from a peripheral artery into the artery of the kidney. The catheter then deposits small materials into the kidney vessels to block blood flow to the kidney. With no blood supply, the tumor and entire kidney eventually die. Embolization is typically considered for patients who cannot tolerate more aggressive forms of therapy or as a treatment used in combination with kidney removal.

Treatment options for advanced kidney cancer

Initial Immunotherapy
Immunotherapy agents stimulate the immune system to attack cancer. Common immunotherapy agents are interleukin-2 (IL-2) and interferon. Patients undergoing immunotherapy may experience flu-like side effects, low blood pressure, pulmonary edema, impaired liver function, impaired kidney function, mental status changes, rapid heartbeat or irregular heartbeat. These side effects are usually temporary. Candidates for this procedure must have adequate vital organ function and no metastases (cancer spread) to the brain.

Surgical Therapy
In select patients, surgical therapy (open or robotic) may be useful and beneficial when cancer has spread away from the kidney. Often, surgery is used in combination with other treatments.

Radiation Therapy
This form of treatment will not cure kidney cancer, but is used to alleviate pain from metastases. Depending on the prognosis, radiation therapy may be used alone or with other therapies.

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