Kidney cancer – symptoms, prognosis, metastasis and cancer treatment

Proven content

Kidney cancer is a very rare neoplasm that usually develops as a result of a suspect mass growth in the area of ​​the kidney parenchyma. As in most other organs, the initial tumor growth is asymptomatic in the kidneys. Cancer usually affects one of the kidneys and is more common in men than in women.

What is kidney cancer?

Kidney cancer is a very rare neoplasm that accounts for only 3% of all malignancies. In Poland, a significant number of cases are reported among men (around 1500) aged 45 years and over, while in women cancer usually occurs after the age of 55 (the risk of developing the disease increases with age). Kidney cancer appears as a result of a suspicious mass growth in the area of ​​the kidney parenchyma, and although it occurs rarely, it is very insidious, as it can develop for a long time without any disturbing symptoms. Preventing early diagnosis and treatment of cancer can lead to metastasis, usually from epithelial cells.

Important! It is distinguished among kidney tumors the so-called malignant nephroblastomawhich only occurs in children. It can be either congenital or acquired. The origin of this cancer is associated with mutations in the child’s genes, namely WT1 and WT2. In addition, some congenital defects as well as diseases of the urinary system and kidneys may contribute to the development of the disease.

The causes of kidney cancer

Kidney cancer causes can be broken down into genetic, hormonal, and environmental factors. Cancer most often attacks people who have acquired cystic kidney disease and are undergoing dialysis. Additionally, the risk of the disease (especially in a woman) is increased by obesity and hypertension.

Other factors contributing to the formation of kidney cancer:

1. habitual smoking (substances in cigarette smoke damage the nephrons that make up the kidney);
2. long-term exposure to chemicals, such as thorium dioxide or asbestos;
3. the use of an excess of painkillers and other preparations;
4. high blood pressure (while resting);
5. a diet high in animal protein;
6. genetic predisposition;
7. drinking too much alcohol.

Histopathological division of kidney cancer

Kidney cancer is a condition that can arise from:

1. The epithelium of the nerve tubules and other components of the nephron. We distinguish cancer here:

1. from eosinophilic or basophilic cells,
2. from chromophobic cells,
3. coming from the collecting tubules,
4. in the form of adenocarcinoma,
5. oncocytoma.

2. Strands – the neoplasm has the following character:

1. benign, usually with: hemangiomas, mixed tumors, fibromas, lipomas,
2. malignant in the form of sarcomas, lymphomas or myelomas.

3. Undifferentiated kidney fetal tissue. In this case, the main role is played by Wilms’ tumor, which occurs mainly in children and is diagnosed during the first three years of life. The tumor is usually located on one side and metastasized in the other kidney or in the lungs. The diagnosis of this neoplasm is confirmed on the basis of computed tomography, echotomography or urography. During treatment, surgery is performed and then chemotherapy or radiation therapy is initiated. The earlier a Wilms tumor is diagnosed, the less likely it is that metastases will occur.

4. Transitional epithelium of the urinary tract.

Types of kidney cancer:

1. papillary,
2. clear cell,
3. sarcomatoidny,
4. collective coil cancer,
5. chromoforbny.

Kidney cancer – symptoms

When the symptoms of kidney cancer are revealed, unbearable pain in the lumbar region (due to nodular enlargement of the kidney) and haematuria usually occur with the naked eye, but sometimes only periodically. Additionally, often an early symptom is a long-lasting fever of unknown origin. It is usually septic in nature, that is, with large fluctuations throughout the day, and does not respond to even intensively applied antibacterial treatments. In addition, anemia is initially observed, and with time it turns into polyglobulia, i.e. hyperemia. Hypertension can also be added.

In addition, many patients have:

1. high OB level,
2. high number of red blood cells (polycythemia)
3. high levels of calcium in the blood,
4. weight loss,
5. in men – varicose veins,
6. excessive sweating at night
7. a tumor in the abdomen palpable when touching,
8. pain in the sacro-lumbar region (occurs when the tumor becomes large),
9. liver dysfunction,
10. swelling of the legs
11. polymyositis,
12. weakness,
13. lack of appetite
14. paraneoplasmic syndromes,
15. a small amount of urine,
16. amyloidosis (amyloidosis).

Benign tumors usually do not give any symptoms, and their detection takes place during the diagnosis of completely different diseases. Kidney cancer metastasizes to other organs in about 30% of cases, which causes elevated ESR levels or hypercalcemia. Metastases usually occur in the liver, lungs, bones and brain.

Diagnosis of kidney cancer

Cancer diagnosis is based on the diagnosis of:

1. a tumor that is sometimes felt around the kidney
2. blood in urine
3. fever
4. pain in the kidney area.

The diagnosis must be confirmed by examination:

1. abdominal ultrasound,
2. kidney echotomographic,
3. urographic,
4. tomographic,
5. urinary system scintigraphy,
6. kidney angiography,
7. magnetic resonance imaging,
8. in the form of an interview with the patient,
9. laboratory,
10. histopathological.

The laboratory test consists of a complete blood count, creatinine clearance, nitrogen, alkaline phosphatase and a general urine test. In turn, thanks to the imaging tests mentioned above, it is possible to determine the stage of the tumor. Thanks to the availability of highly advanced imaging tests, a specialist can detect a tumor even at an early stage of advancement. The detection of a minimally invasive lesion gives a chance that the renal flesh will be preserved during the surgery.

Treatment of kidney cancer

In the treatment of kidney cancer, the most common procedure is surgery in which the entire kidney is removed or only a fragment of it (low stage tumor). Additionally, in some patients metastases are removed. Operational methods are performed in various forms:

1. partial nephrectomy – that is, enucleation of the tumor, partial excision of the kidney with the tumor (performed in many centers using the laparoscopic method),
2. wedge resection – local removal of the tumor or enucleation of the tumor,
3. radical nephrectomy – performed in patients with malignant neoplasm of the kidney. The procedure covers not only the kidney, but also the adrenal glands, Garot’s fascia, and sometimes even the upper ureter. If both kidneys are affected by the tumor, bilateral nephrectomy is performed.

Kidney cancer – prognosis

After kidney tumor removal, patients are prescribed chemotherapy (it is ineffective, therefore it is withdrawn more and more often) or radiotherapy (especially if the tumor had tumor features). In patients after bilateral nephrectomy, it is necessary to initiate renal replacement therapy in the form of dialysis. Currently, new biological preparations are used, but their cost is very high. The prognosis of kidney cancer depends on how soon it is found. Approximately 20-50% of patients who have had their kidneys removed after three years have relapsed (local or generalized).

Kidney cancer prevention

Here are some tips that can help you prevent the disease.

1. You should give up smoking and avoid even passive smoking.

2. Avoid poisoning with heavy metals (they can be found in fruit or vegetables that are grown near roads).

3. Remember to regularly check yourself in order to detect possible neoplasm as early as possible (especially if you know about the family history of the disease).

4. As a prophylaxis, it is worth performing an ultrasound of the abdominal cavity once a year.