20 Jul, 2023
20 Jul, 2023
Renal cell carcinoma is a condition characterized by the development of cancerous cells in the tubular lining inside the kidney. It is a common type of kidney cancer. Diagnosing and treating the disease in its early stages improves the quality of overall outcomes. In most cases, the tumor forms in one kidney only. However, there may be a simultaneous presentation of tumors in both kidneys. The types of renal cell carcinoma include clear cell, papillary, and chromophobe renal cell carcinoma.
Important renal cell carcinoma risk factors include:
Smoking increases the risk of renal cell malignancies. The risk starts reducing as one quits smoking.
Misusing certain analgesics, especially over-the-counter analgesics, for a long period of time increases the risk of this condition.
Compared to healthy people, overweight and obese individuals are at increased risk for renal cell malignancies.
People with high blood pressure (hypertension) are at increased risk of developing renal cell cancer.
People with close family members who have renal cell malignancies are at increased risk of developing this cancer.
Certain genetic conditions, such as von Hippel-Lindau disease, tuberous sclerosis complex, or Birt-Hogg-Dube syndrome, increase the risk of renal cell cancer.
Common renal cell carcinoma symptoms include:
Patients often pass red, pink, or brown-colored urine due to hematuria (the presence of blood in the urine).
The presence of a lump or an abnormal mass in the kidney area is one of the common renal cell carcinoma symptoms.
Patients often experience persistent pain on one side or the back.
Loss of appetite is also one of the renal cell carcinoma symptoms that shouldn’t be ignored.
Patients with renal cell carcinoma also start losing weight while not trying to lose any. In some cases, this weight loss happens rapidly.
Anemia is also one of the renal cell carcinoma symptoms, and patients tend to experience extreme fatigue.
The doctor comprehensively examines the patients overall health, especially in the context of the presented symptoms. Further, a detailed medical history is also evaluated to determine the cause of symptoms.
Ultrasound examination involves using high-energy sound waves to create images of the kidneys to detect any lesions or abnormal tissues.
The patients may also undergo certain blood tests to determine the levels of various substances in the blood. These tests include complete blood cell count (to detect anemia) and levels of uric acid and creatinine in the blood (to determine the health of the kidneys).
The doctors also advise the patients to undergo a complete urine analysis to detect the presence and levels of certain substances in the urine. These include sugar, protein, bacteria, and white blood cells.
Computed tomography (CT) scan provides detailed images of the kidneys from different angles with an X-ray machine linked to a computer. The radiologists may also inject the dye for clearer images. A CT scan helps doctors determine the presence and extent of kidney tumors.
Magnetic resonance imaging (MRI) involves using powerful magnetic fields and radio waves to develop high-quality images of the kidneys. The radiologists deliver a special dye called gadolinium, which is taken up by the abnormal tissues to provide clearer images.
A biopsy is a procedure in which samples of the tumor or abnormal tissues are obtained and sent to the laboratory for microscopic examination. It is generally recommended for a confirmatory diagnosis of cancer. A biopsy will also help with accurate renal cell carcinoma staging. A thin, hollow needle is guided to the abnormal tissues under imaging techniques, such as CT. The procedure is known as a CT-guided biopsy. However, the doctor may not recommend a biopsy in all cases.
There are different types of renal cell carcinoma, and while devising a treatment plan, the doctor will consider the type of RCC, its stage, its grade, and the patient’s overall health status. Several treatment options for renal cell carcinoma are available.
Surgery is one of the main treatments recommended for renal cell malignancies. Renal cell cancer surgery includes partial nephrectomy, simple nephrectomy, and radical nephrectomy. In partial nephrectomy, the surgeon removes only a portion of the affected kidney, while the complete kidney is removed in simple nephrectomy. In advanced stages, the surgeon may recommend radical nephrectomy that includes removing the kidney, adrenal gland, nearby lymph nodes, and healthy tissues. Laparoscopic kidney surgery and robotic kidney surgery are the minimally invasive surgeries available for renal cell malignancies, and they help in preventing a large scar on the abdomen.
Radiation therapy uses high-energy particles to kill cancerous cells. The therapy is used to treat cancer and is also part of palliative therapy to relieve cancer symptoms. Radiation therapy may be external or internal. External radiation therapy delivers radiation from a machine present outside the body. Internal radiation therapy involves delivering radioactive pellets into or near the cancerous tissues. Internal radiation therapy is also called brachytherapy.
Chemotherapy is recommended as a kidney tumor treatment if surgery alone is not able to treat it completely. Chemotherapy uses several drugs to kill or stop the growth of cancer cells. These drugs can be administered either orally or injected into the blood or muscles. Chemotherapy may accompany surgery or radiation therapy.
Immunotherapy for renal cell carcinoma boosts the immune system and makes the cancerous cells more vulnerable to the immune system. The therapy is also known as biological therapy.
Targeted therapy targets proteins and enzymes that are essential for the existence of cancerous cells. Targeted therapy may be used along with antiangiogenic agents to manage advanced cancer. Not all types of renal cancer can be treated with targeted therapy. Therefore, patients are made to undergo a battery of tests before this treatment in order to check if they are the right candidate for this form of kidney tumor treatment.
Renal cell cancer surgery is the first line of treatment, as stage 1 cancers are often localized and can be treated effectively with surgery. It could be done through open surgery or minimally invasive surgeries, such as laparoscopic kidney surgery or robotic kidney surgery.
Ablation therapy is a procedure in which the blood supply to the cancerous tissues is blocked. The blood supply is blocked through tiny gelatin beads or sponges.
In some patients, frequent monitoring is the only intervention required. It includes imaging and blood tests at regular intervals.
Certain patients with advanced cancer, generally not responsive to standard therapy, may enroll in clinical trials related to new treatments for renal cell malignancies.
Renal cell carcinoma surgery is recommended for stage 2 cancers. Early-stage cancers often respond well to surgery.
When administered as a kidney tumor treatment, ablation therapy involves the blocking of arteries supplying the blood to cancerous tissues and results in the shrinking of the tumor.
Certain patients with stage 2 renal cancer undergo routine monitoring, including frequent imaging and blood tests.
Patients with stage 2 renal cell cancer also enroll themselves in clinical trials to benefit from new treatments for renal cell malignancies.
Renal cell cancer surgery is recommended for stage 3 cancers by uro-oncologists. Depending on the severity of the disease, the organ affected may be removed completely, along with nearby lymph nodes.
Radiation therapy uses high-energy radiation to destroy renal cancer cells. The radiation may be delivered from outside, or radioactive beads may be placed in or around the tumor.
Some patients with stage 3 renal cancer may enroll in clinical trials for new therapies that can manage this condition.
Radiation therapy is often administered in combination with systemic therapies and surgery, to reduce the tumor load and improve the quality of life among patients.
Supportive care is recommended for patients with advanced renal cell malignancies to enhance their quality of life. It involves the management of various symptoms, such as fatigue, anemia, pain, anorexia, and venous thromboembolism.
Patients with stage 4 renal cell cancer may enroll themselves in clinical trials related to new treatments for this condition.
The department of uro-oncology at HCG provides comprehensive diagnosis and treatment facilities for several types of renal cancer. HCG offers a patient-centric approach to renal cancer treatment. The center has advanced diagnostic techniques, with all the diagnostic procedures available under a single roof. HCG also offers advanced treatment options for treating early-stage to advanced (metastatic) renal cell cancer. The uro-oncologists providing healthcare services at HCG are extensively experienced in handling simple to complex cases of renal cell malignancies through updated renal cell carcinoma treatment guidelines.
Renal cell malignancies form in the lining of the tubules inside the kidney. Several factors, such as smoking, obesity, family history, and high blood pressure, enhance the risk of renal cell cancer. Diagnostic techniques for renal cell malignancies include blood and urine tests, physical examinations, imaging tests, and biopsy. Renal cancer treatment is customized, based on stage, and includes surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.
The success rate of renal cancer treatment depends upon several factors, such as the age of the patients, renal cell carcinoma staging, underlying medical conditions, response to treatment, and overall health of the patients. Patients with advanced renal cell malignancies have relatively poorer outcomes than patients with early stages.
Stage-4 renal cell malignancies have poor outcomes. Today, we have advanced renal cell carcinoma treatments that are showing promising results. However, survivability depends upon the overall health of the patient, response to treatment, and underlying medical conditions.
Like other surgeries, recovery after renal cell carcinoma surgery depends upon the type of surgery, overall health, and age of the patients. Usually, it takes about 6 to 12 weeks for complete recovery from the surgery.
Complications associated with renal cell carcinoma treatment include weakness, fatigue, skin rashes, nausea, fever, loss of appetite, muscle pain, hair loss, infection, bleeding, weight loss, and altered taste.
Patients with advanced-stage renal cell cancer are at increased risk of cancer recurrence. Renal cell cancer commonly recurs within two years after surgery. Almost 20% of patients with localized renal cell cancer have a recurrence.
Symptoms of renal cell cancer recurrence depend on the site at which the tumor is formed. It may develop in the kidney or other areas of the body (due to metastasis).
There is no method to completely prevent the occurrence of renal cell malignancies. However, certain measures reduce the risk of cancer. These include quitting smoking, managing weight, and controlling high blood pressure.
The choice between radical nephrectomy and partial nephrectomy depends on the extent of the cancer. In cancer limited to a particular region in the kidneys, partial nephrectomy is recommended. However, radical nephrectomy is advised if the cancer spreads to a significant part of the kidney and nearby lymph nodes.
