Kidney cancer or renal cell cancer, occurs when cells in the kidneys develop abnormally and become cancerous. The kidneys are organs located on either side of the spine, they clear toxins produced by the body by forming urine that drains into the bladder and is then passed out of the body.
Kidney cancer commonly affects the elderly, with most being diagnosed over the age of 65. It also affects more men than women. In Singapore, kidney cancer is the 7th most common cancer among men.
A link has been discovered between kidney cancer and kidney disease, where individuals with chronic kidney disease have been found to have an increased risk of developing kidney cancer after long-term haemodialysis. This is probably due to the increased risk of developing kidney cysts for individuals on long-term kidney dialysis, which increases the risk of kidney cancer.
Surgery
Targeted ablation therapy
Active surveillance
Radiation therapy
Radiation therapy or radiotherapy uses high-energy beams to kill cancer cells. It is also sometimes used to relieve pain when kidney cancer has spread to the bone.
Systemic therapy
For some patients who present late with kidney cancer that has spread to other parts of the body, surgery to remove the kidney in combination with systemic therapy has shown to be effective.
Systemic treatment for this group of patients includes:
If a patient is not fit for surgery, immunotherapy or targeted therapy may be given to control the disease (with or without surgery), depending on the patient’s response to treatment.
Arterial embolisation
Arterial embolisation is a procedure where a special material is injected through a catheter to clog the main renal blood vessel. This deprives the cancer tumour of oxygen-carrying blood and other substances it needs to grow, and therefore causes the tumour to shrink. Arterial embolisation may be used before surgery or in some cases may be used to provide pain relief when it is not possible to surgically remove the tumour.
Palliative treatment
Palliative treatment is a specialised type of medical care that can help patients with advanced stage disease by providing pain relief and helping with other symptoms they may experience. This is done when the cancer is advanced, and it is not possible to completely remove the cancer. The goal of palliative treatment is to improve the quality of life of the patient and their family. Palliative treatment for kidney cancer may include surgery or other treatments that can help relieve symptoms from the cancer such as pain or bleeding.
Not all lesions in the kidney are cancerous. Some kidney lesions are benign, such as renal cell adenoma, renal oncocytoma and angiomyolipoma. While these are not cancerous, they can impair kidney function and cause pain or other symptoms. It is important to consult a doctor who will evaluate if the tumour is cancerous or benign (not cancer) and advise you if any treatment is needed.
Kidney cancer can be successfully treated especially when detected early. The likelihood of a cure depends on several factors, including the stage of the cancer, how aggressive the cancer is, how far it has spread, and the patient’s overall health and response to treatment.
There are usually no signs or symptoms in the early stages of kidney cancer. The disease is often diagnosed during an ultrasound or CT scan when patients are being investigated for other health complaints. Symptoms may include blood in the urine, an abdominal mass, persistent pain in the lower back or side, loss of appetite, sudden and unexplained weight loss or anaemia. While the symptoms may be caused by a number of other reasons, they should not be ignored. You should make an appointment with your doctor if you experience any signs or symptoms that worry you.
The most common type of kidney cancer which occurs in 9 out of 10 kidney cancer cases is renal cell carcinoma (RCC). There are several different types of RCC - clear cell RCC (the most common), papillary RCC (the 2nd most common) and chromophobe RCC (a rare form). Each of the RCCs is different in how they develop and change over time or how aggressive they are. It is important to get the right diagnosis from your doctor to ensure that you get the right treatment needed for the type of kidney cancer you have.
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