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Kidney also called renal cancer is a disease in which kidney cells become malignant (cancerous) and grow out of control, forming a tumour. Almost all kidney cancers first appear in the lining of tiny tubes (tubules) in the kidney. This type of kidney cancer is called renal cell carcinoma. The good news is that most of kidney cancers are found before they spread (metastasize) to distant organs. And cancers caught early are easier to treat successfully. However, these tumours can grow to be quite large before they are detected.
The kidneys are two bean-shaped organs, each about the size of a fist. They lie in your lower abdomen on each side of your spine. Their main job is to clean your blood, removing waste products and making urine.
The cause of kidney cancer remains unclear. But certain factors appear to increase the risk of getting kidney cancer. For example, kidney cancer occurs most often in people older than age 40. These are some other risk factors for kidney cancer:
Having these risk factors do not mean you will get kidney cancer. It is also true that you can have none ofthem and still get the disease.
In many cases, people may have no early symptoms of kidney cancer. As the tumour grows larger, symptoms may appear. You may have one or more of these kidney cancer symptoms:
Kidney cancer that spreads to other parts of your body may cause other symptoms, such as:
Maybe you have kidney cancer symptoms such as pain in your side, weight loss, or extreme fatigue. Or maybe your doctor has found a lump in your side during a routine exam or a sign of kidney cancer during a test for another disease. Regardless, to confirm a diagnosis of kidney cancer, you will need a thorough physical examination, health history, and tests.
Your doctor will feel your abdomen and side for lumps and check for fever and high blood pressure, amongst other things. You will also answer questions about your health habits, any past illnesses, and types of treatment. To make a diagnosis of kidney cancer, your doctor will also order one or more tests like these:
Unlike many other cancers, your doctor may be pretty certain about a diagnosis of kidney cancer without a biopsy. Sometimes, a biopsy will be done to confirm the diagnosis. A doctor may use a needle biopsy to remove a sample of tissue, which is then examined under a microscope for cancer cells. The biopsy may also tell the grade of the cancer - how aggressive the cancer is likely to be. Often the surgeon will simply remove the entire tumour and then have a sample of tissue examined.
Once your doctor makes a diagnosis of kidney cancer, you may need other tests to tell if the cancer has spread within your kidney, to the other kidney, or to other parts of your body. When cancer spreads from the place where it first started, it has metastasized. You might need a CT scan or MRI. A chest X-ray can show whether the cancer has spread to your lungs. A bone scan can see if it is in your bones. These tests will help your doctor determine the stage of kidney cancer.
These are four stages of kidney cancer. The higher the stage, the more advanced the cancer.
Generally, when the cancer is localised, and not invading into surrounding tissue, surgery would offer the best chance of cure. In stage IV kidney cancer, where surrounding and distant spread are present, the treatment aim is more control and palliation, with systemic treatment options of targeted therapy, immunotherapy or chemotherapy.
Surgery involves the removal of tissues that contain the tumour and nearby tissues/lymph nodes. This may be done via laparoscopy or open surgery. These are the main types of surgery for kidney cancer. Which type you require depends on how advanced your cancer is.
If surgery cannot remove your kidney cancer, your doctor may suggest another option to help control the tumour locally.
Chemotherapy uses anticancer drugs to shrink/kill cancer cells. The drugs enter the bloodstream and can affect cancer cells all over the body.
Some people with kidney cancer that has spread receive targeted therapy. Targeted therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules involved in tumour growth and spread. They have proven to be effective in controlling kidney cancer.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area.
This therapy uses your immune system to fight cancer by boosting, directing, or restoring your body's natural defences. Examples of biologic therapy used in the past for metastatic kidney cancer include interferon alpha or interleukin-2. There are currently approved new immunotherapies which have shown good activity and control in advanced kidney cancer.
Because doctors do not know the causes of kidney cancer, it is not clear how to prevent the disease. However, certain factors are linked to kidney cancer, so you can take certain steps to lower your risk - quit smoking, maintain a healthy weight, manage your blood pressure, and avoid being exposed to harmful chemicals.
CanHOPE is a non-profit cancer counselling and support service provided by Parkway Cancer Centre, Singapore. CanHOPE consists of an experienced, knowledgeable and caring support team with access to comprehensive information on a wide range of topics in education and guidelines in cancer treatment.
The CanHOPE team will journey with patients to provide support and personalised care, as they strive to share a little hope with every person encountered.