Kidney cancer

Symptoms Of Kidney Cancer 

A person with kidney cancer may or may not have one or more of the symptoms in the early stages. With time, signs and symptoms may develop which include:

• Loss of appetite

• Blood in urine (hematuria)

• Lower back pain 

• A general feeling of poor health

• A mass (lump) on the side or lower back

• Fever that keeps coming and going 

• Feeling tired all the time

Causes Of Kidney Cancer 

• Cancer occurs due to changes in DNA, which contains genes that control cell growth and division. 

• Oncogenes promote cell growth, while tumor suppressor genes regulate it or cause cells to die at the right time.

• DNA mutations can activate oncogenes or deactivate tumor suppressor genes, leading to uncontrolled cell growth.

• Certain factors can increase the likelihood of these mutations leading to kidney cancer.

Types Of Kidney Cancer 

Kidney cancer can be classified into different types based on the cells where it originates and how it grows. It includes:

1. Renal cell carcinoma

• This is the most common type of kidney cancer in adults which often stays confined to the linings of tiny tubes in the kidney called renal tubules. 

• Sometimes cancer can spread to other parts of the body, most often the bones, lungs, or brain.
  
  

2. Clear cell renal cell carcinoma

• This is also called conventional renal cell carcinoma and is named after how the tumor looks under the microscope.

•  The cells in the tumor look clear, like bubbles.

• In adults, renal clear cell carcinoma makes up 80% of the cases while 2% to 6% of childhood and young adult kidney cancer cases.
  
  

3. Rare type of kidney cancer 

1. Papillary renal cell carcinoma (PRCC): The tumor in the kidney tubes is found in 15% of all renal cell carcinomas. 

2. Translocation renal cell carcinoma (TRCC): It is a slow-growing tumor in the kidney. This accounts for 1% to 5% of all renal cell carcinomas and 20% of childhood cases. 

Risk Factors Of Kidney Cancer

A risk factor is anything that increases your chance of getting a disease. Risk factors for kidney cancer can include:

1. Non-modifiable factors

• Age: The incidence of kidney cancer increases with age, with a peak of incidence at approximately 75 years of age.

• Sex: The incidence of kidney cancer is two-fold higher in men compared with women. 

• Genetic risk factors: Certain rare inherited conditions may increase the risk of kidney cancer.

• Family history of kidney cancer. The risk of kidney cancer increases if first-line relatives or close family members have the condition.

2. Modifiable factors

• Obesity

• Tobacco smoking
  
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• Environmental and occupational exposure ( such as pesticides, arsenic, cadmium, lead, etc)

3. Certain Medical Conditions

• High blood pressure (Hypertension)

• Chronic kidney disease 

• Kidney stones

• Diabetes

Diagnosis Of Kidney Cancer 

Understanding the staging of kidney cancer is crucial before diagnosis.

The staging system used for kidney cancer is based on the TNM system

• The size and extent of the main tumor (T): Is it confined to the same area or it has grown into nearby areas?

• The spread to nearby lymph nodes (N)

• The spread (metastasis) to distant sites (M): It has spread to nearby organs such as the brain, bones, or lungs.
  
  

Note: Higher stage numbers indicate more advanced cancer. T, N, and M categories are combined through stage grouping to determine the overall stage, which helps diagnose kidney cancer. 

Diagnosis consists of:

1. Medical history or physical exam 

• If kidney cancer is suspected, the doctor will review your medical history, ask about symptoms, and check for risk factors.

• They may conduct a physical exam, check for lumps or swelling, and order blood tests to identify potential kidney issues.
  
  

2. Blood tests 

• Urine tests: Urine tests can detect hidden blood or cancer cells, which may indicate kidney or bladder cancer.

• Complete blood count: This test measures the number of different cells in the blood. This test result is often abnormal in people with kidney cancer.   

• Kidney Function Test:  It assesses how well the kidneys are working and help detect abnormalities linked to kidney cancer.
  
  

3. Imaging tests 

• Magnetic Resonance Imagining (MRI) scan: A scan that uses strong magnetic fields and radio waves to produce a detailed image of your kidneys.

• Positron Emission Tomography (PET) scan: A detailed body scan that can be helpful for investigating confirmed cases of kidney cancer to see if cancer has spread and how well it's responding to treatment.

• Ultrasound scan: It can be helpful in finding a kidney mass and showing if it is solid or filled with fluid. 

• Computed tomography (CT) scan: The CT scan uses X-rays to make detailed cross-sectional images of your body. It can provide precise information about the size, shape, and location of a tumor.

• Angiography: It is an x-ray test that looks at blood vessels. It can also diagnose renal cancers since the blood vessels usually have a special appearance with this test.

• Bone scan: This test is helpful to check if cancer has spread to the bones.

• Cystoscopy: Where a thin tube is passed up your urethra (the tube that carries urine out of your body) so that problems in the bladder can be detected.

• Chest x-ray: An x-ray may be done after kidney cancer has been diagnosed to check if the cancer has spread to the lungs. 
  
  

4. Biopsy

• A biopsy might be done to get a small sample of tissue from an area that may be cancer when the imaging tests are not clear enough to permit surgery. 

• Fine needle aspiration cytology (FNAC) and needle core biopsy are 2 types of kidney biopsies that may be done. 

• In cases where the doctors think kidney cancer might have spread to other sites, they may take a biopsy of the metastatic site instead of the kidney.

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Prevention Of Kidney Cancer

While kidney cancer can't always be prevented, maintaining a healthy lifestyle can significantly reduce your risk. These include:

1. Identify and Avoid Risk Factors

• Quit smoking to lower your risk of kidney cancer

• Obesity is a risk factor; aim for a balanced diet and regular exercise

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2. Stay Hydrated

• Drinking plenty of water may help flush out toxins from your kidneys

• Aim for at least 7-8 glasses of water throughout the day.
  
  

3. Limit Painkiller Use

• Avoid long-term use of over-the-counter pain medications like NSAIDs unless prescribed

• Eat a Healthy Diet: Focus on fruits, vegetables, and whole grains while reducing salt and processed foods.
  
  

4. Avoid Occupational Exposure

• Limit exposure to harmful chemicals such as asbestos and cadmium at workplaces.

5. Manage Underlying Conditions

• Control diabetes or other chronic illnesses that may increase kidney cancer risk

• Managing hypertension can help reduce your risk

6. Know Your Family History

• Be aware of any genetic predispositions and seek regular check-ups.

• If you're at higher risk, consider regular kidney function tests and imaging as advised by your doctor.

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Specialist To Visit

Diagnosis and treatment of kidney cancer requires a comprehensive approach like any other cancer. These include:

• General physician

• Urologist

• Genitourinary (GU) medical oncologist

• Nephrologist

A general physician can evaluate the symptoms, and start the treatment. He can further refer to other doctors for assessment depending upon the organ affected. 

A urologist specializes in diseases of the urinary tract and plays a vital role in diagnosing and treating kidney cancer.

A genitourinary (GU) medical oncologist helps in the treatment, research, and prevention of genitourinary cancers of the prostate, bladder,and  kidney.

A nephrologist specializes in kidney health and helps manage kidney function and complications during kidney cancer treatment.

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Treatment Of Kidney Cancer 

The treatment for kidney cancer depends on the size of the cancer and whether it has spread to other parts of the body (metastatic).  The treatment consists of:

1. Surgery

• Partial nephrectomy: Removes only the tumor, preserving kidney function.

• Radical nephrectomy: Removes the entire kidney, nearby tissues, and sometimes lymph nodes.
  
  

2. Targeted therapies 

It is a cancer treatment that uses drugs to specifically target and block cancer-causing genes, proteins, or tissues while minimizing damage to healthy cells. The medicines included in the targeted therapies include: 

• Everolimus
• Bevacizumab 
• Nivolumab
• Tivozanib
• Sunitinib 
• Pazopanib
• Cabozantinib
• Axitinib
  
  

3. Ablation therapies 

These treatments destroy cancer cells by either:

• Freezing cancer cells (Cryotherapy): It is done by inserting needles into the tumor. This can be done through a small cut (laparoscopic cryotherapy).
• Heating cancer cells (radiofrequency ablation): It is done by inserting a needle-like probe through your skin, so no large cuts are needed.

4. Radiotherapy 

• It is a treatment where radiation is used to target or destroy cancerous cells.

• It is advised in advanced kidney cancer that has spread to other parts of the body, such as your bones or brain, radiotherapy 

•  It cannot usually cure kidney cancer, but it can slow down its spread and help control your symptoms. 
  
  

5. Embolization 

• Embolization is a procedure to block the blood supply to the tumor, causing it to shrink. D

• During embolization, a small tube called a catheter is inserted into a blood vessel in your groin and then guided to the blood vessel supplying the tumor.

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Home-care For Kidney Cancer

Home remedies that can help with kidney cancer include:

1. Echinacea: The echinacea plant has anti-inflammatory effects on the body and is considered an effective herb against cancer. 

2. Astragalus: It is one of the best herbs known as a kidney restorer but also one of the best anti-cancer immune-building herbs.

3. Korean Ginseng: The roots of this plant have been used for health and longevity for thousands of years in Traditional Chinese Medicine. Ginseng reduces the risk of multiple types of cancer. 

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Diet for individuals with kidney cancer individuals

A kidney cancer diet should include many of the same things found in any healthy diet, with some nutritional add-ons to combat the specific effects of cancer treatment. Daily nutrition should include

• A lot of whole grains: Whole grains may reduce cancer risk because of their high amounts of fiber, antioxidants, and minerals like vitamin E and selenium. 

• Fruits and vegetables: Research suggests that fruits and fiber-rich vegetables may have a protective effect against cancer and its recurrence. 

• High caloric intake: During cancer treatment, including high-calorie foods like butter, milkshakes, meats, etc can help counter weight loss and maintain strength.

Complications Of Kidney Cancer 

Kidney cancer can cause several complications, including impacts on mental health, especially when diagnosed at advanced stages, leading to challenges in coping with the disease. Some of the other complications can include:

• High blood pressure: Kidney cancer may disrupt the kidney's ability to regulate blood pressure, leading to persistent or difficult-to-control hypertension.
  
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• Liver insufficiency: Cancer spreading to the liver can cause toxin build-up in the blood, resulting in confusion, personality changes, and mood swings.

• Pleural effusion: Fluid build-up in the pleural cavity ( thin space between the lungs and the chest wall due to cancer spread to the lungs can cause significant shortness of breath and require drainage.

• Kidney failure: Removal of a kidney or part of it can strain the remaining kidney, which can lead to kidney failure requiring dialysis or transplant.

Alternative Therapies For Kidney Cancer 

Complementary or alternative therapies refer to a range of treatments that can help cope with cancer treatments' side effects. Some of them include:

1. Mind therapies 

• Meditation: Helps reduce stress and improve emotional well-being, supporting overall health during cancer treatment.

• Yoga: Enhances flexibility, reduces fatigue, and promotes relaxation, aiding recovery and mental resilience.
  
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• Tai Chi: Improves balance, reduces anxiety, and boosts energy, supporting holistic cancer care.

2. Body-based practices 

• Massage: Alleviates pain, reduces stress, and improves overall relaxation, supporting cancer patients’ physical and emotional well-being.

• Chiropractic therapy: Helps manage pain and improve mobility, offering non-invasive relief for cancer-related discomfort.

3. Acupuncture 

• It is a common practice in Chinese medicine that involves stimulating certain points in the body to promote health or to lessen disease symptoms and treatment side effects

Living With Kidney Cancer 

A cancer diagnosis can be overwhelming, affecting not just your body but also your mind. Here are some steps you or your caregivers can take to help:

1. Monitoring for cancer recurrence

• Follow-up care includes regular tests and health checkups to detect if cancer has returned.

• Testing is personalized based on the type, stage of cancer, and treatments received.

2. Managing long-term side effects

• Side effects may persist after treatment or appear months to years later, affecting both physical and emotional health.

• Emotional support and mental health care are vital for coping with stress, anxiety, or depression.

3. Keeping health records

• Maintain a detailed record of your treatment history, including medications and procedures.

• A well-documented history helps doctors manage future health needs and emergencies.

4. Focusing on diet and nutrition

• A balanced diet helps maintain strength, prevent infections, and support tissue repair during and after treatment.

• Avoid excessive sugar, maintain a healthy weight, and prioritize nutrient-rich foods.

5. Being physically active

• Regular exercise can improve strength, muscle tone, and overall well-being.

• Activities should be tailored to your fitness level and recovery needs.