RCC-Renal cell carcinoma is the most common type of kidney cancer. The disease occurs when a tumor grows in the lining of the tubules (tiny tubes) in the kidney.
Other kinds of kidney cancer include renal sarcomas, transitional cell carcinomas, Wilms tumors, and lymphomas.
Kidney cancer at its early stage usually does not cause any signs or symptoms. A possible sign of later-stage kidney cancer includes blood in the urine (hematuria) that causes the urine to change color. Other signs and symptoms include (among others) low back pain, loss of appetite, unexplained weight loss, fever that comes and goes, fatigue, and anemia.
To diagnose kidney cancer, patients usually undergo a series of tests and procedures:
- Urine tests-the first step is checking for blood in the urine.
- Blood tests- such as a full blood count, and kidney functions.
- Intravenous pyelogram (IVP)-during the procedures, the specialist injects dye into the patient’s bloodstream and uses X-rays to study the color as it passes through the urinary tract.
- Imaging tests- creating detailed images of the kidney to detect a tumor or any abnormalities. The tests might include an ultrasound, a CT, or an MRI.
- A biopsy- the surgeon performs a biopsy, and the pathologist checks the tissue sample for cancerous cells. The pathologist generates a report detailing the type of cells in the tumor and the cancer aggressiveness. Special lab tests might also specify whether the tumor cells have specific mutations, such as mutations of the VHL gene. This information assists the medical team to plan the appropriate treatment.
A kidney tumor can spread locally within the kidney, regionally to the other kidney or nearby lymph nodes, and systemically to other organs. Common spreading might occur to the lungs and bones. It can also spread to the brain, liver, and other tissues. To learn whether cancer has spread, the doctor might recommend imaging tests. They may include CT, MRI, bone scan, chest X-ray, or a PET CT scan.
Most patients diagnosed with kidney cancer will need to undergo surgery. The surgeon may perform a partial nephrectomy (PN), which involves removing the tumor and some surrounding tissue. The surgeon can perform PN as an open surgery or a laparoscopic procedure that can be robot-assisted. When necessary, the surgeon will remove the entire kidney, the adrenal gland, and the surrounding tissue in a procedure called a radical nephrectomy (RN).
For people who cannot undergo surgery, the medical team might consider another treatment approach to destroy small tumors. The procedure is called ablation therapy: either freezing the tumor (cryoablation-CA), heating the cancer cells (RFA-radiofrequency ablation), or microwave ablation (MWA). Some patients might benefit from specific targeted therapy, such as tyrosine kinase inhibitors (TKI). Examples include sunitinib and pazopanib. The medical team might recommend chemotherapy or radiation therapy. For some patients with metastatic or advanced kidney cancer, there is also the option of immunotherapy drugs and clinical trials with new medications and combo treatments.
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