Renal Cell Cancer Explained
Renal cell cancer (RCC), also called renal cell adenocarcinoma or kidney cancer, is a condition in which malignant (cancer) cells are detected in the lining of the kidney's tubules. RCC accounts for about 2% of cancer diagnoses and deaths around the globe, and is the ninth most common cancer in the U.S.
Basic Anatomy of the Kidneys
The kidneys are positioned above the waist on either side of the backbone. The small tubules of the kidneys filter and cleanse the blood by cleaning up waste and excreting urine. A long tube, called a ureter, transports urine from each kidney to the bladder, where it is held until it flows through the urethra and exits the body.
Symptoms of Renal Cell Cancer
Patients may be symptom-free when RCC is in its early stages, however, as the disease progresses, the following symptoms may appear:
- A lump in the abdomen.
- Blood in the urine.
- Unexplained weight loss.
- Loss of appetite.
- Fatigue.
- Vision problems.
- Persistent pain in the side.
- Excessive hair growth (in women).
- Anemia.
Risk factors for Renal Cell Cancer
Various risk factors for renal cell cancer have been identified, including:
- Male gender (RCC is almost twice as common in men compared to women).
- African American (slightly higher risk of RCC in African Americans compared to Caucasians)
- Smoking.
- Long-term use of various pain relievers (especially over-the-counter pain relievers).
- Excessive obesity.
- High blood pressure.
- Workplace exposure to certain substances (i.e. trichloroethylene).
- Advanced kidney disease, especially if dialysis is needed.
- Family history of renal cell cancer.
- Genetic diseases (i.e. von Hippel-Lindau disease, hereditary papillary renal cell cancer, Birt-Hogg-Dube (BHD) syndrome, Tuberous sclerosis, Hereditary leiomyoma-renal cell carcinoma, Cowden syndrome, familial renal cancer).
Diagnosis of Renal Cell Cancer
A physical exam and health history will first be evaluated. A thorough health history will be taken followed by a physical examination including an inspection of the body to examine evaluate signs of health, including detecting disease-related symptoms, such as abdominal lumps.
Diagnosis of renal cell cancer may also include the following:
- Ultrasound examination.
- Blood chemistry studies.
- Urinalysis.
- Computed tomography scan (CT scan).
- Magnetic resonance imaging (MRI).
- Biopsy.
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Treatment for Renal Cell Cancer
There are five types of standard RCC treatments, including:
- Surgery.
- Radiation therapy.
- Chemotherapy.
- Immunotherapy.
- Targeted therapy.
1. Surgery
Surgery can entail a variety of procedures. A portion of the kidney is removed during a partial nephrectomy. The entire kidney is removed during a simple nephrectomy. Depending on the magnitude of the disease, a more invasive surgery (a radical nephrectomy) may be used to remove surrounding tissue, lymph nodes and adrenal glands. If the cancer cannot be removed with surgery, arterial embolization may be utilized in an effort to shrink the tumor. In some cases, chemotherapy or radiation therapy may be used after surgery in an effort to destroy any cancer cells that may remain after surgery. This is known as adjuvant therapy, and it helps to prevent cancer from recurring.
It’s possible to live a healthy life if only one kidney is removed. However, if both kidneys are removed, dialysis or a kidney transplant is necessary.
2. Radiation
Radiation treatment kills cancer cells by employing high-energy x-rays. Radiation can be delivered by a machine or delivered internally utilizing seeds or wires.
3. Chemotherapy
Chemotherapy involves the use of medications to destroy cancer cells. Depending on the drug, it can be administered either orally or intravenously. This enables the medications to travel through the bloodstream and target cancer cells that have spread to other regions of the body.
4. Immunotherapy
Biologic therapy, often known as immunotherapy, utilizes your immune system to combat cancer. Enzymes or chemicals produced by the body are used to protect your body from cancer.
5. Targeted therapy
Targeted therapy is a relatively new type of cancer treatment. Drugs are used to kill specific cancer cells while causing no harm to healthy cells. Some medications target blood vessels to limit blood flow to the tumor, causing it to starve and shrink.
6. Clinical Trials
In addition to the standard treatment options mentioned above, new therapies are continually be studied in clinical trials. Clinical trials evaluate new medication to determine their efficacy in treating RCC. During a clinical trial, you will be monitored closely and can withdraw from the trial at any point. Consult with your oncologist to determine whether a clinical trial is a realistic choice for you.
In Conclusion
Several factors, including your age, family history, lifestyle, environment, dietary habits and activity level, can influence whether or not you develop cancer. If you have a family history of kidney cancer or are a smoker, consult your doctor if you start experiencing worrying symptoms. Though there are no appropriate screenings for renal cell cancer, discussing your symptoms with your doctor as soon as they develop can improve your chance of an early diagnosis, allowing you to access early treatment and improve your treatment outcomes.