Kidneys Cancer

While kidney cancer is not a common type of cancer, one should not underestimate the threat it poses.

Due to the deep location of the kidneys within the human body, early-stage kidney cancer often does not cause any discomfort or symptoms. Therefore, many patients only discover it in the later stages. As the tumour grows or progresses, patients may experience some common symptoms:

• Haematuria (Blood in Urine): One of the most common symptoms is that urine may sometimes contain blood, appearing pink, red, or brown.
• Pain in the Back or Side: A tumour may lead to discomfort or pain in the kidney area, typically felt in the back or side.
• Lump or Mass: A lump or mass may be felt in the abdomen, which could result from a kidney tumour.
• Fatigue: Patients may feel tired or weak, possibly due to the tumour affecting the body's metabolic functions.
• Fever: Sometimes, kidney cancer may cause fever, especially when the tumour becomes infected or invades adjacent tissues.
• High Blood Pressure: Impaired kidney function may lead to high blood pressure.
• Unexplained Weight Loss: Unexplained weight loss could occur, possibly because the tumour causes a loss of appetite or changes in metabolism.

When suspecting kidney cancer, doctors typically start with blood and urine tests. Individuals with early-stage kidney cancer may exhibit a small amount of blood in routine urine tests. For patients with renal pelvis cancer, urine sample examination can reveal actual cancer cells in the urine. Blood tests check for elevated blood calcium levels, perform blood cell analysis, and measure kidney function to determine if the patient has kidney cancer initially.

When doctors suspect that a patient may have kidney cancer, the following further examinations may be conducted:

Doctors will use the above examinations to determine the stage of kidney cancer and decide on the course of treatment. Renal cell carcinoma can be divided into the following four steps:

According to the staging of kidney cancer, doctors will choose the most appropriate treatment for patients. In general, surgical intervention is the primary treatment for most kidney cancers. For patients with stages I to III kidney cancer, doctors will perform surgery based on the location of the tumour to remove either the entire kidney or perform a partial nephrectomy. The surrounding fat tissue, the adrenal gland, and nearby lymph nodes may also be removed depending on the situation. Studies suggest that the effectiveness of total and partial nephrectomy is roughly similar, with the latter helping patients retain more kidney function. In addition to traditional open surgery, many doctors perform minimally invasive partial nephrectomies using laparoscopy or robotic-assisted techniques.

For early-stage kidney cancer, the following invasive treatment options are also available:

• Cryotherapy
    - Uses ultrasound or other imaging methods to guide a special needle through the skin into the kidney tumour.
    - The needle delivers cold gas to freeze and destroy malignant cells.
• Radiofrequency Ablation (RFA)
    - Similar to cryotherapy, it uses ultrasound or other imaging methods to guide a probe through the skin into the kidney tumour.
    - Electric current passes through the probe, heating or burning the cells to cause cell death.
• Embolization
    - Involves blocking the blood supply to cancer cells by embolizing arterial blood vessels to shrink the tumour.

Facing stage IV kidney cancer, where cancer cells have already spread to other parts of the body, doctors will use various methods post-surgery to control or alleviate symptoms of kidney cancer that have spread. Targeted therapy is a primary approach, using drugs to interrupt blood flow and nutrient supply to cancer cells, inhibiting tumour growth and spread. Immunotherapy may also enhance the patient's immune response to cancer cells by using interferon-α and interleukin-2 to resist the cancer cells.

Other methods include radiation therapy, which uses high-energy beams to kill cancer cells and chemotherapy. Although radiation therapy may not significantly cure kidney cancer, it can alleviate symptoms and relieve tumour-induced pain. Chemotherapy involves using drugs to kill cancer cells. Still, it is generally considered less effective for kidney cancer cells, and the associated side effects, such as hair loss, mouth sores, loss of appetite, nausea, and vomiting, can be more pronounced.

The occurrence of kidney cancer is influenced by various risk factors. Here are some factors that may contribute to the development of kidney cancer:

• Smoking: There is an association between smoking and kidney cancer, as the chemicals in tobacco may have harmful effects on the kidneys.
• High Blood Pressure: Long-term hypertension may increase the risk of developing kidney cancer.
• Genetic Factors: Individuals with a family history of kidney cancer may be more susceptible, suggesting a possible role of genetics in the development of kidney cancer.
• Hereditary Kidney Cancer Syndromes: Some rare genetic conditions, such as von Hippel-Lindau (VHL) syndrome and Hereditary Leiomyomatosis, may elevate the risk of kidney cancer.
• Age: Age is a risk factor for kidney cancer, with a higher prevalence typically seen in individuals aged 60 and above.
• Gender: Observations indicate that males are more prone to kidney cancer than females.
• Obesity: Excessive weight is a potential risk factor, and there is some level of association between obesity and the occurrence of kidney cancer.
• Kidney Diseases and Cysts: Certain kidney diseases and cysts may increase the risk of developing kidney cancer.
• Occupational Exposures: Exposure to specific chemicals or substances in certain occupational environments, such as certain organic solvents and heavy metals, may be related to kidney cancer.
• Long-term Kidney Dialysis: Individuals undergoing long-term kidney dialysis treatment may face an increased risk of kidney cancer.