cancer info


Thursday, June 28, 2012

Kidney cancer


The kidneys 

Most people have two kidneys. They sit at the back of the body, one on each side, just underneath the ribcage. They filter the blood to remove waste products, which they convert into urine. Urine is carried from each kidney, through a tube called a ureter to the bladder, where it is stored.
When you are ready to pass urine, it leaves the bladder through a tube called the urethra. The urethra opens immediately in front of the vagina in women and at the tip of the penis in men.

What is a kidney tumor?

A kidney tumor is an abnormal growth within the kidney. The terms "mass," "lesion" and "tumor" are often used interchangeably. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common kidney lesion is a fluid-filled area called a cyst. Simple cysts are benign and have a typical appearance on imaging studies. They do not progress to cancer and usually require no follow-up or treatment. Solid kidney tumors can be benign, but are cancerous more than 80 percent of the time.
For more information you can see this video below

The following are also types of kidney cancers:

  • Squamous cell carcinoma
  • Juxtaglomerular cell tumor (reninoma)
  • Angiomyolipoma
  • Renal oncocytoma
  • Bellini duct carcinoma
  • Clear-cell sarcoma of the kidney
  • Mesoblastic nephroma
  • Wilms' tumor (usually diagnosed in children under 5)
  • Mixed epithelial stromal tumor
What are the risk factors for kidney cancer?

Doctors don't know the causes of kidney cancer. 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:
  • Smoking . If you smoke cigarettes, your risk for kidney cancer is twice that of nonsmokers. Smoking cigars may also increase your risk.
  • Being male. Men are about twice as likely as women to get kidney cancer.
  • Being obese. Extra weight may cause changes to hormones that increase your risk.
  • Using certain pain medications for a long time. This includes over-the-counter drugs in addition to prescription drugs.
  • Having advanced kidney disease or being on long-term dialysis, a treatment for people with kidneys that have stopped working.
  • Having certain genetic conditions, such as von Hippel-Lindau (VHL) disease or inherited papillary renal cell carcinoma.
  • Having a family history of kidney cancer. The risk is especially high in siblings.
  • Being exposed to certain chemicals, such as asbestos, cadmium, benzene, organic solvents, or certain herbicides
  • Having high blood pressure. Doctors don't know whether high blood pressure or medication used to treat it is the source of the increased risk.
  • Being black. The risk in blacks is slightly higher than in whites. No one knows why.
  • Having lymphoma. For an unknown reason, there is an increased risk of kidney cancer in patients with lymphoma.
Having these risk factors does not mean you will get kidney cancer. And it's also true that you can have none of them and still get the disease.

Symptoms

Unfortunately, kidney cancer does not have early symptoms but you should see your doctor if you notice the following:3
  • Blood in your urine
  • Lump in your abdomen
  • Unexplained weight loss
  • Pain in your side
  • Loss of appetite
If cancer spreads (metastasizes) beyond the kidney, symptoms depend on the organ involved. Shortness of breath or coughing up blood may occur when cancer is in the lung. Bone pain or fractures may occur when cancer is in the bone. When cancer is in the brain, you may have neurologic symptoms.
In some cases, kidney cancer causes related conditions called paraneoplastic syndromes. These syndromes occur in about 20 percent of kidney cancer patients and can occur in any stage, including cancers confined to the kidney. Symptoms from paraneoplastic syndromes include weight loss, loss of appetite, fever, sweats and high blood pressure. In many cases, the paraneoplastic syndrome improves or disappears after the cancer is removed.

Diagnosis

If a patient has symptoms that suggest kidney cancer, the doctor may perform one or more of the following procedures:
  • Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
  • Urine tests: Urine is checked for blood and other signs of disease.
  • Blood tests: The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
  • Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
  • CT scan (CAT scan): An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. The patient may receive an injection of dye so the kidneys show up clearly in the pictures. A CT scan can show a kidney tumor.
  • Ultrasound test: The ultrasound device uses sound waves that people cannot hear. The waves bounce off the kidneys, and a computer uses the echoes to create a picture called a sonogram. A solid tumor or cyst shows up on a sonogram.
  • Biopsy: In some cases, the doctor may do a biopsy. A biopsy is the removal of tissue to look for cancer cells. The doctor inserts a thin needle through the skin into the kidney to remove a small amount of tissue. The doctor may use ultrasound or x-rays to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.
  • Surgery: In most cases, based on the results of the CT scan, ultrasound, and x-rays, the doctor has enough information to recommend surgery to remove part or all of the kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope
Treatment  for kidney cancer

Surgery
 
Surgery is the initial treatment for the majority of kidney cancers. Surgical procedures used to treat kidney cancer include:
  • Removing the affected kidney (nephrectomy). Radical nephrectomy involves the removal of the kidney, a border of healthy tissue and the adjacent lymph nodes. The adrenal gland also may be removed. Nephrectomy can be an open operation, meaning the surgeon makes one large incision to access your kidney. Or nephrectomy can be done laparoscopically, using several small incisions to insert a video camera and tiny surgical tools. The surgeon watches a video monitor to perform the nephrectomy.
  • Removing the tumor from the kidney (nephron-sparing surgery). During this procedure, also called partial nephrectomy, the surgeon removes the tumor and a small margin of healthy tissue that surrounds it, rather than removing the entire kidney. Nephron-sparing surgery can be an open procedure, or it may be performed laparoscopically. Nephron-sparing surgery may be an option if you have a small kidney cancer or if you only have one kidney. When nephron-sparing surgery is possible, it's generally preferred over radical nephrectomy since retaining as much kidney tissue as possible may reduce your risk of later complications, such as kidney disease and the need for dialysis.
The type of surgery your doctor recommends will be based on your cancer and its stage, as well as your health. Surgery carries a risk of bleeding and infection.

Radiation Therapy (also called radiotherapy)

Radiation therapy uses high-energy x-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.

Biological Therapy (also called immunotherapy)

Biological therapy is a treatment that uses the body's own immune system to fight cancer. It uses materials made by the body or in the laboratory to restore the body's natural defenses against the disease.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or injected by a needle into a vein or muscle.

Hormone Therapy

Hormone therapy uses hormones to stop cancer cells from growing. This type of therapy is used in a small number of patients with advanced kidney cancer.

Arterial Embolization

Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow.

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