Kidney cancer, also known as renal cancer, is a type of cancer that begins in the kidneys. The kidneys are two organs located in the abdomen that filter waste from the blood and remove excess water through urine, helping keep the body’s chemical balance in check.
Dr. Fernando Bolio Laviada, urologist with a subspecialty in urologic oncology at ABC Medical Center, explains that up to 90% of kidney cancers are diagnosed incidentally. This happens because a patient undergoes an imaging test for an unrelated reason, and a kidney tumor is discovered in the process.
Based on these imaging results, the doctor begins to assess the type of tumor, its characteristics and size, and determine the best course of action.
There are two possible ways kidney tumors can present. The first is the synchronous type, involving a single tumor in one kidney, which is the more common presentation. The second is the metachronous type, in which both kidneys develop two or more tumors, often as a result of hereditary syndromes.
Since kidney cancer is asymptomatic in its early stages, it’s often only detected once other symptoms appear, such as blood in the urine, fever, or loss of appetite, symptoms that are nonspecific and common to many other conditions. By the time a patient develops these symptoms, the disease is often already advanced.
One of the most important things to know about kidney cancer, notes Dr. Bolio, is that it’s the most lethal cancer within the genitourinary system, the organs involved in urination. If not caught and controlled in time, this cancer has the potential to metastasize over the medium to long term, and depending on its aggressiveness, it can spread to the brain or other less common sites, which is why, left untreated, kidney cancer can ultimately be fatal.
“The American Cancer Society estimates that around 14,890 people (9,920 men and 4,970 women) will die from this disease. In addition, approximately 81,800 new cases of kidney cancer are expected to be diagnosed each year.”
To help prevent this outcome, when a doctor detects a tumor in one kidney, the standard treatment is to remove the affected organ. This is because these tumors have a high likelihood of spreading to other organs, making them particularly dangerous. Additionally, kidney tumors often develop many abnormal blood vessels, which can easily lead to dangerous bleeding.
While biopsies are sometimes performed, this is more common in patients who only have one remaining kidney and can no longer have it removed. In these cases, doctors will consider adjuvant treatment with medications to control the disease.
Once the tumor has been removed and its histology is known, systemic treatment may be recommended, such as immunotherapy or tyrosine kinase inhibitors, which block the activity of a specific protein and prevent it from promoting tumor growth. Chemotherapy isn’t used for this type of cancer, notes Dr. Bolio.
For patients with tumors in both kidneys, the doctor must take a much more detailed approach to treatment, since a patient with two similarly sized tumors in both kidneys requires a very different plan than someone with a small tumor in one kidney and a large tumor in the other.
Once a patient has had a kidney removed, and depending on any additional treatment needed, as long as the cancer hasn’t spread to other organs, the patient can live a normal life, following a supervised, but not overly restrictive, diet, and staying mindful of keeping their remaining kidney as healthy as possible. A nephrologist will continue monitoring the patient to help maintain good kidney health over time.
Dr. Bolio recommends getting preventive checkups before any symptoms appear, to catch this type of condition while it can still be treated in a straightforward way. For kidney cancer specifically, getting a baseline CT scan starting at age 40 and following any further guidance from a nephrologist is a valuable tool for catching this cancer at an early stage.
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