- What are the risk factors for Renal Cancer?
- What are the symptoms of Renal Cancer?
- How is Renal Cancer diagnosed?
- How is Renal Cancer staged?
- What is the treatment of Renal Cancer?
- Is there need for follow-up after the completion of Renal Cancer therapy?
'Renal Cancer' or 'Renal Cell Carcinoma' (RCC) is the third most common malignancy of the urinary tract. It occurs more frequently in males in the 6th and 7th decade of their life.
What are the risk factors for Renal Cancer?
According to studies, it seems that factors increasing the risk for the development of renal cancer are:
- Smoking - Smokers run higer risk for developing renal cancer compared to non-smokers. This risk increases depending on the number of cigarettes smoked and the duration one has been smoking.
- Obesity - Obesity also increases the risk for renal cancer, even more in the female population.
- High blood pressure - According to several studies, uncontrolled high blood pressure has been correlated with renal cancer development
- Nutrition - Excessive consumption of red meat, animal fat and fried food increases the risk for renal cancer. On the contrary, high consumption of fruit and vegetables has a protective action.
- Family history of renal cancer - Individuals who have at least one family member with renal cancer have a slightly higher risk for developing the disease
- Hemodialysis - Patients who have been under hemodialysis for many years due to renal failure, are also a high risk group for renal cancer
However, it should be clarified that many people developing renal cancer may not have any of the above risk factors. Also, if one has the above risk factors, it does not necessarily mean that they will develop the disease.
What are the symptoms of Renal Cancer?
In early stages, there are rarely any noticeable symptoms and, if any, they still may not be properly evaluated, e.g. an episode of hematuria or a feeling of heaviness on the right or left of the waist. As the tissue increases in its dimensions and depending on its location in the kidney, the most common symptoms occurring are:
- Hematuria (presence of blood in the urine, either visible with naked eye or traced in the laboratory)
- Pain in the flank (side or back above the waist), that is around the kidneys area
- Palpable mass in the abdomen
- Unjustified body weight loss
- Unjustified weakness, fatigue, malaise and fever
The above symptoms may be due to other causes besides renal cancer. In case any one of them arises, you should inform your doctor so that -whatever the problem- it is diagnosed and treated as early as possible.
How is Renald Cancer diagnosed?
If you manifest any of the above symptoms and are clinically examined, your physician may probably ask for some further laboratory testing:
- General urine test (Urinalysis): Hematuria ocurs in 40-60% of cancer cases.
- General blood test:: Eryhtrocyte Sedimentation Rate (ESR) is usually high in patients with renal cancer, while the general blood test may diagnose some degree of anemia.
- UltraSound screening: A simple, painless and safe imaging screening method that can provide important information about the presence of renal cancer.
- CT scan of the abdomen and retroperitoneal region: This is the screening test of choice for the diagnosis of the disease. It is also used for the staging of the disease to indicate whether there is expansion to lymphnodes or other abdominal organs.
- MRI of the abdomen and retroperitoneal region: It is equally helpful as CTscan, but in some cases it is even more useful with regard to staging of the disease.
- Biopsy: In some cases, when imaging scanning is ambiguous, the physician may recommend biopsy. A small specimen is obtained with a fine needle transcutaneously and is sent for biopsy. Biopsy is performed with the use of ultrasound (U/S) or, more frequently, with CT scan.
How is Renal Cancer staged?
As long as renal cancer is diagnosed, the physician will ask for some further screening tests to identify whether the tumour has expanded to other sites of the body. The abcominal CTscan will check whether there is extrarenal expansion and whether lymphnodes or other abdominal organs have been afflicted, such as the liver. The abdominal MRI may demonstrated even further expansion and potential infiltration of some large abdominal vessels. Radiography or Chest CT scan will trace any potential ocurring metastases to the chest, while Bone Scintigram will demonstrate any potential bone metastases.
How is Renal Cancer treated?
Treatment recommended depends on the size of the patient's tumor, stage of the disease, age and general health condition. Therapeutic options that are available today are mentioned below.
- Surgical treatment is considered to be the treatment of choice for localized renal cancer. The surgical procedure may involve full removal of the kidney (Radical Nephrectomy) or in some cases removal only of the tumor (Partial Nephrectomy)
- Molecularly Targeted Therapy has been more and more widely used during the last years. Pharmaceutical agents used in this therapy aim at cancer cells at a molecular level and prevent their growth. Results are encouraging.
- Immune Therapy with the use of various drugs has been applied, but with very low response rates.
- Chemotherapy. Even though applied in metastatic disease, it does not seem to give good results.
- Radiotherapy. Even though not playing a therapeutic role, it can be provided as palliative care in patients with metastases.
Is there need for follow-up after the completion of Renal Cancer therapy?
Given that the disease may recur, your physician will recommend you to undergo screening on a regular basis. This screening includes clinical examination, blood testing, chest X-rays, CT scan and ultrasound.