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Renal cell carcinoma
Definition Renal cell carcinoma is a type of kidney cancer in which the cancerous cells are found in the lining of very small tubes (tubules) in the kidney. Alternative Names Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney Causes, incidence, and risk factors Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in people 50 - 70 years old, and typically affects men. The exact cause is unknown. Risk factors include: - Dialysis treatment
- Family history of the disease
- Genetics
- Smoking
- Von Hippel-Lindau disease (a hereditary disease that affects the capillaries of the brain)
Symptoms - Abdominal pain
- Abnormal urine color (dark, rusty, or brown)
- Back pain
- Blood in the urine
- Emaciated, thin, malnourished appearance
- Enlargement of one testicle
- Flank pain
- Swelling or enlargement of the abdomen
- Unintentional weight loss of more than 5% of body weight
Other symptoms that can occur with this disease: - Constipation
- Cold intolerance
- Excessive hair growth in females
- Paleness
- Vision abnormalities
Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. About one-third of patients have spreading (metastasis) at the time of diagnosis. Signs and tests Palpation of the abdomen may show a mass or organ enlargement, particularly of the kidney or liver. Men may have a varicocele in the testicles. Tests include: - Complete blood count (CBC)
- IVP
- Kidney x-ray
- Liver function tests
- Renal arteriography
- Serum calcium
- SGPT and alkaline phosphatase
- Ultrasound of the abdomen and kidney
- Urine cytology
- Urine test
The following tests may be performed to see if the cancer has spread: - Abdominal CT scan
- Abdominal MRI
- Bone scan
- Chest x-ray
Treatment Surgical removal of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder or surrounding tissues or lymph nodes. Radiation therapy does not usually work for renal cell carcinoma and, therefore, is not often used. Hormone treatments may reduce the growth of the tumor in some cases. Many chemotherapy drugs and other medications have been successful in reducing the growth of some renal cell carcinomas, including cancers that have spread. Current therapies such as interferon and interleukin-2 work by blocking the blood supply of the tumor. Some chemotherapy drugs have been used to treat this and other cancers for many years. A cure is unlikely unless all of the cancer is removed with surgery. Support Groups You can ease the stress of illness by joining a support group whose members share common experiences and problems. See cancer - support group and kidney disease - support group. Expectations (prognosis) The outcome depends on the degree of cancer spread. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower. Complications - Hypertension
- Spread of the cancer
Calling your health care provider Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder. Prevention Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis. References US Food and Drug Administration. FDA Approves New Treatment for Advanced Kidney Cancer. Rockville, MD: National Press Office; December 20, 2005. Press Release P05-107. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Kidney Cancer, v.1.2008. 2007. Review date: 11/12/2007 Reviewed By: Charles Silberberg, D.O., Private Practice specializing in Nephrology, Affiliated with NY Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.
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