Kidney cancer is the third in frequency among malignant tumors of the uro-genital apparatus, after those of the prostate and bladder. They are, in their great majority, originated in the kidney itself, although exceptionally they can be an extension of tumors from other locations.
If not treated in a timely manner, it can be fatal. If it is diagnosed in a localized stage (before it has expanded outside the kidney), the probability of 10-year survival is greater than 90%, and it decreases depending on the extent of the tumor, says urologist in Dwarka.
What is the cause of this disease?
As in other malignant diseases, it is believed that damage to DNA (the substance within the cell that determines its biological activity) generates a cascade of events that ultimately translate into unregulated and aggressive cell growth and reproduction that make up a tumor.
A type of cancer is the family kidney, which occurs when some mutations (changes in DNA) are passed from one generation to the next. Corresponds to 3-4% of all cases of the disease. If there is a family history of kidney cancer, the person must be strictly controlled.
Another form of cancer is sporadic kidney cancer, which corresponds to the vast majority of cases and is caused by changes in the cells after birth, probably due to external factors that cause DNA damage, explains urologist in Janakpuri. Some of these factors are:
It increases the probability of developing kidney cancer by 40%, making it the highest risk factor for this disease. Many of the chemicals inhaled by smoking are believed to be absorbed into the bloodstream and concentrated in large quantities, where they can cause DNA damage and tumor formation. By quitting smoking the risk decreases, but it can take many years to reach the risk of a non-smoker.
Studies indicate that people exposed to some chemical agents like asbestos, cadmium, some herbicides and organic solvents like trichlorethylene, have a higher risk than people who do not have this contact.
Some scientists believe that it is a factor in 20% of cases. It can alter the balance of hormones in the body, which affects the normal growth of kidney tissue.
Several studies indicate that inactive people are more likely to develop kidney cancer than those who exercise regularly.
Statistics suggest that, added to excess weight, they can triple the risk of kidney cancer.
What are the symptoms of the disease?
According to the best urologist in Janakpuri in its early stages, it is rare to cause symptoms. A significant proportion of cases are detected as a finding in a routine checkup or for an unrelated problem. There is no blood test that allows investigating kidney cancer in its early stages; therefore, it can reach a significant volume before being found. Some of the symptoms that can be experienced are:
- Blood in the urine
- Low back pain
- Mass or bulge in the abdomen
- Lose weight
- Lower limb edema
It should be noted that in the vast majority of cases these symptoms are not caused by cancer, but by benign conditions such as cysts or infections. However, a study is necessary, as tumors diagnosed in a timely manner can be successfully treated, suggests the best urologist in Dwarka.
How do you make the diagnostic?
In addition to the physical exam, one or more of the following studies are done to confirm the diagnosis:
- Urine test
- Blood tests (CBC, plasma creatinine)
- Computed axial tomography (Scanner)
- Magnetic nuclear resonance
- Biopsy puncture
Once the diagnosis of kidney cancer has been established, other laboratory and radiological examinations are used to determine if the tumor is confined to the kidney or presents evidence of local or distant extension. This information is extremely valuable for planning the best kidney cancer treatment.
Kidney cancer treatment will depend on two factors: the degree of extension and the general health condition of the patient. Nephrectomy (surgical removal of the kidney) is the standard therapy for “localized” tumors, that is, confined to the kidney, its adjacent tissue, or peri-renal lymph nodes, says urologist in West Delhi.
It is the most commonly performed surgical procedure for this type of cancer. It consists of the removal of the kidney, adrenal gland, lymph nodes, and perirenal fatty tissue. The remaining kidney allows the patient to lead a normal life.
It is the removal of only the part of the kidney that includes the tumor. It allows preserving a greater reserve of kidney tissue. It has been used more commonly in recent years, especially for small tumors (4 cm or less), in which a radical nephrectomy may be unnecessary. It is the preferred strategy in patients who have only one kidney or, having both kidneys, their overall function is impaired.
Both total and partial removal of the kidney can be performed laparoscopically. The surgery is performed using small instruments and a camera that are inserted through three to four holes of approximately 1 cm. on the abdominal wall. It meets the objectives with the same efficiency as open or traditional surgery, providing the advantages of less pain in the postoperative period and a faster recovery.
Treatment of advanced tumors is gradually improving, but an optimal strategy does not yet exist. Some patients may benefit from kidney removal.
Alternatives include immunotherapy, which is the use of drugs that stimulate the patient’s immune system to try to control the tumor. More recently, other drugs have been incorporated that can attack the tumor, reducing its vascularity and other targets. The latter appear to be more promising, but there are no long-term follow-ups yet.
Chemotherapy and radiotherapy do not play a role in the management of kidney cancer, except in very rare cases.
Like all malignant tumors, even when the tumor has been completely removed, it requires regular monitoring, since malignant cells can appear in other parts of the body. Control includes physical examination, laboratory and radiological examinations. A change in lifestyle is recommended that includes a balanced diet with high fiber intake and low animal fat, regular exercise and smoking cessation.