Kidney Cancer

Kidney cancer is a disease where malignant cells form in the tissues of the kidneys. These vital organs, located on either side of the spine, filter waste from the blood and produce urine.

Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults, accounting for about 90% of cases. It occurs when malignant (cancer) cells develop in the tubules of the kidneys.

Understanding the causes, symptoms, diagnostic methods, treatment options, and prevention strategies is crucial for managing and mitigating the impact of this disease.

Common symptoms of kidney cancer

Kidney cancer often goes unnoticed in its early stages because it may not cause any noticeable symptoms. However, as the tumour grows, various signs and symptoms may emerge:

• Blood in the urine (haematuria): This can appear as pink, red, or cola-coloured urine and is often the first indication of kidney cancer.
• A lump or mass in the abdomen: This might be palpable or visible during a physical examination.
• Pain in the side (flank pain): Persistent kidney pain in the side or lower back that doesn’t go away.
• Loss of appetite: A reduced desire to eat, which can lead to other symptoms like weight loss.
• Unexplained weight loss: Significant weight loss without trying.

Severe symptoms or complications

As kidney cancer progresses, it may cause more severe symptoms and complications, such as:

• Chronic fatigue: Persistent tiredness and lack of energy.
• Fever: Intermittent fever not associated with an infection.
• Swelling: Swelling in the legs and ankles due to the build-up of fluid.
• Hypertension: High blood pressure caused by the tumour affecting kidney function.
• Hypercalcemia: Elevated levels of calcium in the blood, which can lead to nausea, vomiting, and confusion.
• Metastasis: If the cancer spreads to other parts of the body, it can cause additional symptoms, depending on the affected area (e.g., bone pain, cough, or shortness of breath).

What causes kidney cancer?

The exact cause of kidney cancer is not fully understood, but several risk factors have been identified:

• Smoking: Cigarette smoking significantly increases the risk of developing RCC.
• Obesity: Excess body weight is linked to an increased risk of kidney cancer.
• Hypertension: High blood pressure has been associated with kidney cancer.
• Misuse of pain medications: Long-term use of certain painkillers, particularly those containing phenacetin, is linked to a higher risk.
• Genetic factors: Inherited conditions like von Hippel-Lindau disease and hereditary papillary renal cell carcinoma can increase risk.
• Occupational exposure: Exposure to certain chemicals, such as asbestos and cadmium, may elevate the risk.

How is kidney cancer diagnosed?

Diagnosing kidney cancer involves a combination of medical history, physical examination, and various tests:

Medical History and Physical Exam

Initial assessment includes reviewing symptoms and risk factors, along with a physical examination to check for lumps or abnormalities.

Urine Tests

Analysis of urine samples to check for blood and other anomalies.

Blood Tests

To assess kidney function and check for signs of anaemia or elevated calcium levels.

Imaging Tests

These include ultrasound, CT scans, MRI scans, and intravenous pyelogram (IVP) to create detailed images of the kidneys and detect any abnormalities.

Biopsy

In some cases, a small sample of kidney tissue may be taken using a needle to confirm the diagnosis.

Treatments for kidney cancer

The treatment approach for kidney cancer depends on the stage and extent of the disease.

Surgery

Surgery is the primary treatment for most kidney cancers. Options include partial nephrectomy (removal of the tumour and part of the kidney) or radical nephrectomy (removal of the entire kidney, and sometimes nearby tissues).

Ablation

Techniques such as cryoablation (freezing cancer cells) and radiofrequency ablation (using heat to destroy cancer cells) for small tumours.

Targeted therapy

Drugs that target specific pathways or abnormalities in cancer cells, such as tyrosine kinase inhibitors.

Immunotherapy

Immunotherapy uses the body’s immune system to fight cancer, including drugs like checkpoint inhibitors.

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells, typically used when surgery is not an option or to relieve symptoms.

Chemotherapy

Chemotherapy is used for RCC but may be considered for other types of kidney cancer.

Can kidney cancer be prevented?

While not all cases of kidney cancer can be prevented, certain lifestyle changes and measures can reduce the risk:

• Quit smoking: Eliminating tobacco use is one of the most effective ways to lower risk.
• Maintain a healthy weight: Regular exercise and a balanced diet can help prevent obesity-related kidney cancer.
• Control blood pressure: Managing hypertension through lifestyle changes and medications can reduce risk.
• Use medications wisely: Avoid the long-term use of painkillers, especially those known to increase risk.
• Occupational safety: Use appropriate protective measures when working with hazardous substances.