Advanced Urology Associates specializes in kidney cancer treatment for men and women, we offer the most state-of-the-art treatments and cancer care available.
The kidneys are two bean-shaped organs, each about the size of a fist. They are located behind the abdominal organs with one on each side of the spine, above the waist. The kidneys do most of the work in the urinary tract, which is a filtering system. A person cannot control what the kidneys do. They filter approximately 20% of our total blood volume each minute, taking waste by-products from digestion and other body functions out of the blood. The kidneys take the waste out of the blood and make urine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about one to two quarts of urine. The urine collects and is stored in the central part of the kidney called the renal pelvis, the area at the center of the kidney. At regular intervals, the renal pelvis contracts and pushes the urine through the ureters, into the bladder, and out of the body.
Normal, functioning kidneys:
- Prevent the buildup of wastes and extra fluid in the body
- Keep levels of electrolytes, such as sodium, potassium and phosphate, stable
- Make hormones that help regulate blood pressure
- Make hormones that help produce red blood cells
- Keep bones strong
What is Kidney Cancer?
Kidney cancer means cancer cells form in the tissues of the kidneys. Our body is composed of billions of cells that function for a while and then die, being replaced in an organized manner. Sometimes there can be an uncontrolled replacement of the cells, leaving them unorganized. This abnormal growth of cells and disorder is cancer. The cancer cells can grow without the normal control and limits. Cancer can spread locally into surrounding tissues or break away from the tumor and enter body fluids, such as blood and lymph and spread to other parts of the body, called metastasis.
There are three main types of kidney cancer.
- In adults, renal cell cancer is the most common type and accounts for about 90% of cancerous tumors.
- Transitional cell cancer forms in the renal pelvis and ureter in adults.
- Wilms tumors are the most common in children.
What is Kidney Cancer Caused By?
It is not clear what causes renal cancer, though there are several risk factors:
- Smoking: Smokers have a greater risk of kidney cancer than non-smokers. The risk decreases after you quit.
- Older age.
- Hypertension (high blood pressure).
- Treatment for kidney failure: People who receive long-term dialysis to treat chronic kidney failure have a greater risk of developing kidney cancer.
- Certain inherited syndromes: People who are born with some inherited syndromes may have an increased risk of kidney cancer, such as von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis complex, hereditary papillary renal cell carcinoma or familial renal cancer.
- Family history of kidney cancer: People who have a strong family history of renal cell cancer have a greater risk of kidney cancer.
- Exposure to certain substances in the workplace: May include exposure to cadmium or specific herbicides.
What Are the Signs and Symptoms of Kidney Cancer?
Kidney cancer rarely causes signs or symptoms in its early stages. There are no screening tests in the absence of symptoms. In the later stages, signs and symptoms may include:
- Blood in your urine, which may appear pink, red, or cola colored.
- Pain in your back or side that does not go away.
- Loss of appetite.
- Unexplained weight loss.
- Fever, which usually comes and goes.
How is Kidney Cancer Diagnosed?
- Urine tests, including urinalysis and urine cytology.
- Imaging studies to visualize the kidney, related structures, and any tumor or abnormality, such as ultrasound, computerized tomography (CT) scan, and magnetic resonance imaging (MRI).
- Tissue biopsy may be used in rare cases to obtain a small sample of cells from a suspicious area in the kidney. The tissue is then checked under a microscope for signs of disease.
- Ureteroscopy is a procedure to look inside the ureter and renal pelvis to check for abnormal areas. A ureteroscope is a thin, tube-like instrument with a light and a lens for viewing. The ureteroscope is inserted through the urethra into the bladder, ureter, and renal pelvis. A tool may be inserted through the ureteroscope to take tissue samples to be checked under a microscope for signs of disease.
What is the Staging of Kidney Cancer?
Once a kidney lesion is identified, staging is used to determine the extent of the cancer. Tests to help stage include imaging studies as listed above.
- Stage I-the tumor can be up to 2 ¾ inches (7centimeters) in diameter. The tumor is confined to the kidney.
- Stage II-the tumor is larger than a stage I tumor, but it is still confined to the kidney.
- Stage III-at this stage, the tumor extends beyond the kidney to the surrounding tissue and may also have spread to nearby lymph nodes.
- Stage IV-cancer spreads outside the kidney to multiple lymph nodes or to distant parts of the body, such as the bones, liver, or lungs.
How is Kidney Cancer Treated?
Treatment options for kidney cancer depend on a number of factors, including your general health, the kind of kidney cancer you have, whether the cancer has spread and your preferences for treatment.
Surgical Treatments for Kidney Cancer
Surgery is the main treatment for the majority of kidney cancer, with the goal of removing the tumor and preserving normal kidney function. When the cancer is confined to the kidney, surgery is usually the only treatment needed. Routine follow up is all that is needed. Surgical procedures may include:
- Removing the affected kidney (nephrectomy): A complete (radical) nephrectomy involves removing the entire kidney, a border of healthy tissue, and occasionally additional nearby tissues such as the lymph nodes, adrenal gland, or other structures. The surgeon may perform a nephrectomy through a single incision in the abdomen or side (open nephrectomy) or through a series of small incisions in the abdomen (laparoscopic or robot-assisted laparoscopic nephrectomy).
- Removing the tumor from the kidney (partial nephrectomy): Also called kidney-sparing or nephron-sparing surgery, the surgeon removes the tumor and a small margin of healthy tissue that surrounds it rather than the entire kidney. It can be done as an open procedure or laparoscopically or with robotic assistance. Kidney-sparing surgery is a common treatment for small kidney cancer and it may be an option if you have only one kidney. When possible, this surgery is generally preferred over a complete nephrectomy to preserve kidney function and reduce the risk of later complications, such as kidney disease and the need for dialysis.
- Nephroureterectomy: Surgery to remove the entire kidney, ureter, and the bladder cuff (tissue that connects the ureter to the bladder).
- Segmental resection of the ureter: Removes the part of the ureter that contains cancer and some of the healthy tissue around it. The ends of the ureter are then reattached. This treatment is used when the cancer is superficial and in the lower third of the ureter only, near the bladder.
Non-surgical treatments may be used to destroy small tumors without surgery:
- Treatment to freeze cancer cells (cryoablation): A special hollow needle is inserted through your skin and into the kidney tumor using ultrasound and other image guidance. Cold gas in the needle is used to cool down or freeze the cancer cells.
- Treatment to heat cancer cells (radiofrequency ablation): A special probe is inserted through your skin and into the kidney tumor using ultrasound or other imaging to guide placement of the probe. An electrical current is run through the needle and into the cancer cells, causing the cells to heat up or burn.
Treatments for Advanced Kidney Cancer
Treatments for advanced (cancer that spreads to other parts of the body) kidney cancer and recurrent kidney cancer, may not be curable, but may be controlled with treatment, which include:
- Surgery to remove as much of the kidney tumor as possible.
- Drugs that use your immune system to fight cancer (biological therapy or immunotherapy): Uses your body’s immune system to fight cancer. Drugs in this category include interferon and aldesleukin (Proleukin), which are synthetic versions of chemicals made in your body. Nivolumab (Opdivo) is an immunotherapy sometimes used to treat advanced renal cell carcinoma.
- Targeted therapy: Block specific abnormal signals present in kidney cancer cells that allow them to multiply. The drugs cabozantinib (CaboMetyx), axitinib (Inlyta), bevacizumab (Avastin), pazopanib (Votrient), sorafenib (Nexavar), and sunitinib (Sutent) block signals that play a role in the growth of blood vessels that nourish cancer cells and allow them to spread. Temsirolimus (Torisel) and everolimus (Afinitor) are targeted drugs that block a signal that allows cancer cells to grow and survive.
- Radiation therapy: Uses high-powered energy beams to kill cancer cells. It is sometimes used to control or reduce symptoms of kidney cancer that has spread to other areas of the body, such as the bones and brain.
- Clinical trials: Assess the safety and effectiveness of potential treatments and try to find new ways to prevent or detect disease.
How Can I Prevent Kidney Cancer?
- Quit smoking: There are many options to help quit, including support groups, medications, nicotine replacement products, and hypnosis.
- Maintain a healthy weight: Reduce the number of calories you consume each day and try to be physically active most days of the week.
- Control high blood pressure: Lifestyle measures such as exercise, weight loss, and diet changes can help; in addition to medications.
Questions About Kidney Cancer or Treatments?
Advanced Urology Associates specializes in kidney cancer treatment for men and women. Request an appointment or contact us today at 815.409.4930.