What Is Kidney Cancer?

By Chris -

Introduction

Kidney cancer is a type of cancer that originates in the cells of the kidneys. The kidneys are two bean-shaped organs located on either side of the spine, just below the rib cage. Their primary function is to filter blood, remove waste products, and produce urine. Kidney cancer begins when cells in the kidney grow uncontrollably, forming a mass or tumor. This uncontrolled growth can interfere with the kidney’s normal functions and, if left untreated, may spread to other parts of the body. Understanding what kidney cancer is involves exploring its types, symptoms, risk factors, diagnosis, and treatment options.

Kidney cancer is a type of cancer that originates in the cells of the kidneys. Kidney cancer begins when cells in the kidney grow uncontrollably, forming a mass or tumor. This uncontrolled growth can interfere with the kidney’s normal functions and, if left untreated, may spread to other parts of the body. Image Credit: DesignNFMR via Canva.com

Kidney cancer is one of the ten most common cancers in both men and women. Its exact cause is not always known, but several risk factors and genetic components are associated with its development. Early detection is crucial because kidney cancer may not produce noticeable symptoms in its initial stages.

Types of Kidney Cancer

There are several types of kidney cancer, with renal cell carcinoma being the most common. Renal cell carcinoma accounts for approximately 85% of all kidney cancer cases. It begins in the lining of the small tubes in the kidney and has several subtypes. Clear cell renal cell carcinoma is the most common subtype, followed by papillary renal cell carcinoma and chromophobe renal cell carcinoma. Each subtype has distinct characteristics and may respond differently to treatment.

Transitional cell carcinoma is another type of kidney cancer that starts in the renal pelvis, the part of the kidney where urine collects before moving to the bladder. This type of cancer is similar to bladder cancer in terms of its origin and behavior. Wilms tumor is a rare type of kidney cancer that primarily affects children. It is typically diagnosed in children under the age of five and has a high cure rate with appropriate treatment.

Symptoms of Kidney Cancer

In the early stages, kidney cancer may not cause any symptoms. As the disease progresses, however, several signs and symptoms may appear. Blood in the urine, medically known as hematuria, is one of the most common symptoms of kidney cancer. The blood may be visible to the naked eye or detected only through a urine test. Persistent pain in the back or side, usually on one side, is another common symptom. This pain can range from a dull ache to a sharp, stabbing sensation.

Unexplained weight loss and fatigue are also common in individuals with kidney cancer. These symptoms can result from the cancer itself or the body’s response to the disease. A persistent fever that is not caused by an infection may be another indication of kidney cancer. Some people may experience a lump or mass in the abdominal area, which can be felt during a physical examination.

It is important to note that these symptoms are not specific to kidney cancer and can occur with other medical conditions. Therefore, it is essential to seek medical evaluation if any of these symptoms persist.

Risk Factors for Kidney Cancer

Several factors increase the risk of developing kidney cancer. Smoking is one of the most significant risk factors. Smokers are at a higher risk compared to non-smokers because tobacco contains carcinogenic substances that can damage kidney cells. Obesity is another major risk factor. Excess body weight can alter hormone levels and create an environment that promotes the growth of cancer cells.

High blood pressure, or hypertension, has been linked to an increased risk of kidney cancer. The exact reason for this association is not entirely understood, but it may involve changes in kidney function and chronic damage to kidney tissue. Family history also plays a role. Individuals with a first-degree relative who has had kidney cancer are at a higher risk.

Certain inherited genetic conditions significantly increase the risk of kidney cancer. Von Hippel-Lindau disease, caused by mutations in the VHL gene, is a well-known example. This condition predisposes individuals to multiple tumors, including clear cell renal cell carcinoma. Other genetic conditions, such as hereditary papillary renal carcinoma and Birt-Hogg-Dubé syndrome, are also associated with kidney cancer.

Occupational exposure to certain chemicals, such as trichloroethylene, has been linked to kidney cancer. Prolonged exposure to this solvent, used in various industries, increases the risk of developing the disease. Long-term dialysis for kidney failure is another risk factor. People on dialysis for extended periods may develop cysts in the kidneys, which can become cancerous.

Diagnosis of Kidney Cancer

Diagnosing kidney cancer involves a combination of clinical evaluation, imaging studies, and laboratory tests. The process typically begins with a medical history and physical examination. The healthcare provider may inquire about symptoms, risk factors, and family history of kidney cancer.

Imaging studies play a crucial role in detecting and diagnosing kidney cancer. Ultrasound is often the first imaging test used to evaluate the kidneys. It can help identify masses or abnormalities in the kidney. Computed tomography (CT) scans and magnetic resonance imaging (MRI) provide more detailed images and are commonly used to confirm the presence of a tumor and assess its size and spread.

In some cases, a biopsy may be performed to obtain a tissue sample for microscopic examination. This procedure involves inserting a thin needle into the kidney to extract a small piece of tissue. A pathologist then examines the sample to determine whether cancer cells are present and, if so, what type of kidney cancer it is.

Laboratory tests, including blood and urine tests, may be used to assess kidney function and detect any abnormalities. These tests can provide additional information that helps guide diagnosis and treatment planning.

Treatment Options for Kidney Cancer

The treatment of kidney cancer depends on several factors, including the type, size, and stage of the cancer, as well as the patient’s overall health. Surgery is the primary treatment for localized kidney cancer. The goal of surgery is to remove the tumor and preserve as much healthy kidney tissue as possible.

Radical nephrectomy is a surgical procedure that involves removing the entire kidney, along with the surrounding tissue and lymph nodes. This procedure is typically performed when the tumor is large or has spread beyond the kidney. Partial nephrectomy, also known as kidney-sparing surgery, involves removing only the tumor while preserving the remaining healthy kidney tissue. This approach is preferred for smaller tumors and helps maintain kidney function.

For patients who are not candidates for surgery, ablation therapies may be an option. These treatments involve destroying the tumor using extreme temperatures. Cryoablation uses extreme cold, while radiofrequency ablation uses heat to kill cancer cells.

Targeted therapy and immunotherapy are commonly used to treat advanced kidney cancer. Targeted therapies, such as sunitinib (Sutent) and pazopanib (Votrient), work by inhibiting specific molecules involved in cancer cell growth and angiogenesis. Immunotherapy drugs, such as nivolumab (Opdivo) and pembrolizumab (Keytruda), enhance the body’s immune system to recognize and destroy cancer cells.

Radiation therapy may be used to relieve symptoms in patients with advanced kidney cancer. While it is not typically a primary treatment, it can help manage pain and other symptoms caused by the spread of cancer to other parts of the body. Chemotherapy is generally not effective for kidney cancer and is rarely used.

Prognosis and Survival Rates

The prognosis for kidney cancer depends on several factors, including the stage at diagnosis, the type of cancer, and the patient’s overall health. Early-stage kidney cancer has a good prognosis, with high survival rates. When kidney cancer is detected before it spreads beyond the kidney, the five-year survival rate is approximately 93%.

However, the prognosis worsens as the cancer advances. Once kidney cancer spreads to distant organs, the five-year survival rate drops significantly. Advances in treatment, particularly targeted therapies and immunotherapies, have improved outcomes for patients with advanced kidney cancer.

Regular follow-up care is essential for individuals who have been treated for kidney cancer. Follow-up appointments typically involve imaging studies and laboratory tests to monitor for recurrence or the development of new tumors. Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and smoking cessation, can help improve overall health and reduce the risk of recurrence.

Conclusion

Kidney cancer is a serious medical condition that arises from uncontrolled cell growth in the kidneys. Understanding its types, symptoms, risk factors, diagnosis, and treatment options is essential for early detection and effective management. While the exact cause of kidney cancer is not always clear, factors such as smoking, obesity, hypertension, and genetic predisposition play significant roles. Advances in medical research have led to the development of targeted therapies and immunotherapies that improve outcomes for patients with advanced disease. Early detection and prompt treatment are key to achieving the best possible prognosis.

References

  1. Capitanio U, Montorsi F. Renal cancer. Lancet. 2016;387(10021):894-906. https://doi.org/10.1016/S0140-6736(15)00046-X
  2. Jonasch E, Gao J, Rathmell WK. Renal cell carcinoma. BMJ. 2014;349:g4797. https://doi.org/10.1136/bmj.g4797
  3. Linehan WM, Ricketts CJ. The metabolic basis of kidney cancer. Semin Cancer Biol. 2013;23(1):46-55.  https://doi.org/10.1016/j.semcancer.2012.06.002

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