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  arrow Common Cancers

 

Kidney Cancer

Kidney cancer, or renal carcinoma, accounts for almost three per cent of adult malignancies. The disease is mainly seen in patients aged between 50 and 70

Among the risk factors involved in developing kidney cancers are cigarette smoking; obesity, especially in women; exposure to working environments in the asbestos and leather industries; dialysis for cystic disease; and end-stage renal disease. There is also a genetic predisposition as demonstrated in a 1/3 of patients with von Hipple-Lindau syndrome who develop kidney cancer.

Renal carcinoma can remain without symptoms for most of its course. However in about 20 per cent of patents, the following symptoms can appear blood-stained urine, abdominal pain and flank mass all of which may also indicate an advanced stage of the disease. About 30 per cent of patients develop metastasis, or a spreading of the disease, at the time of diagnosis, and this is most commonly to the liver, lungs and bones. Other generalised symptoms are prolonged fever, weight loss and anaemia.

Stages Of The Disease

Stage 1: Tumour remains within the kidney.
Stage 2 : Tumour invades the renal capsule.
Stage 3 : Tumour spreads to regional lymph nodes and/or renal vein and Vena Cava.
Stage 4 : Tumor spreads to adjacent organs or beyond

The investigations done to obtain a more definite diagnosis include laboratory and radiological investigations. Ultra sonogram is a simple radiological tool that has been found to be a very useful non-invasive means of diagnosing and staging this disease.

Treatment
Surgery is the standard treatment in the early stage of the disease when the tumour is restricted to the kidney. Radical nephrectomy(total removal of kidney) is carried out here. Radiotherapy plays a role in renal cancer when there is invasion of nearby structures and/or surgery cannot be performed. Radiotherapy is also useful in the palliative treatment of distant spread e.g. bones and lungs.

Renal carcinoma is generally not considered to be chemotherapy sensitive and has only demonstrated a marginal response. Of late, certain biological therapies have been found to be effective in treating metastatic renal carcinoma and these may be employed together with chemotherapy in some situations.

The prognosis depends on the stage of the disease as well as the cellular type. There are three cellular types: clear cell, granular cell and the spindle variant. Amongst the three types, the clear cell variant has been shown to have a better prognosis. Studies have reported better survival for patients whose disease is confined to the kidney than those with metastasis. The five-year survival rate for metastatic disease is zero to 20 per cent, compared to 95 per cent in a local disease.

Therefore early detection and diagnosis contributes to improved survival. Screening for cancer of the kidney is advised for individuals in the high risk groups mentioned earlier, and appropriate investigations for those with abnormal features.


CHINESE VERSION AVAILABLE. Please download here...
 

    arrowDownload full document (Chinese - pdf) File size=96 Kb

  By Dr Jayendran.D and Dr Manoj.S ; Oncology Department, Hospital Pulau Pinang  


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