Kidney cancer is one of the rare diseases. Only between three to four percent of all cancer patients suffer from malignant tumors on the kidney. Most often, kidney cancer occurs in the form of hypernephroma or renal cell carcinoma.
What is kidney cancer?
Schematic diagram showing the anatomy and structure of the kidney in kidney cancer. Click to enlarge. The term kidney cancer includes all malignant tumor tissues that affect the kidney. In adult patients, renal cancer usually presents as renal cell carcinoma. In rare cases, Wilms tumors, lymphomas or sarcomas occur in this organ of the body. Furthermore, usually only one kidney develops cancer, very rarely both organs of the urinary system suffer from malignant tumors. Regarding the gender distribution, it should be noted that more men than women suffer from kidney cancer. Noticeable physical symptoms of this cancer usually appear only at a very late stage of the disease. Thus, patients often complain of loss of appetite, fever, fatigue and unexplained back pain. Therefore, kidney cancer is usually detected by chance during an ultrasound examination of the abdomen, which the doctor has performed on the patient for another reason.
Causes
Kidney cancer, like many other cancers, has no specific causes. However, there are some factors that promote it. These include heavy nicotine use, some painkillers, chronic diseases of the kidneys, severe obesity, and frequent contact with certain risky substances, such as asbestos, some dry cleaning agents, and fuel, among others. Genetic predispositions also seem to play a role. It is estimated that about one percent of all cases of kidney cancer are due to mutated genes. The altered genetic material probably lacks certain substances that inhibit the development of cancer. This abnormality makes it harder for the body to defend itself against tumors, so that cancers can develop more easily. Among other things, kidney cancer can develop in this way.
Typical symptoms and signs
Kidney cancer can go for weeks, months, or even years without symptoms. The first symptoms that indicate serious disease are increasing pain in the area of the flank or back. The urine may be reddish to brown in color, and urinary retention and occasionally incontinence may also occur. Accompanying general symptoms include fatigue and exhaustion and a general decrease in physical and mental performance. In addition, fever and night sweats occur. Due to the disturbed digestion and the persistent feeling of illness, a loss of appetite also sets in. Then the patient loses weight and suffers various deficiency symptoms, for example, dullness, dizziness and irritability. Finally, a palpable lump forms in the abdomen. In men, a varicocele of the testicular varicose vein may develop. If the cancer spreads to surrounding regions, other symptoms occur, such as headaches, stomach pain, and movement disorders. Eventually, the infestation leads to the patient being unable to eat sensibly and eventually becoming bedridden. If it progresses negatively, kidney cancer leads to the patient’s death. If the carcinomas can be completely removed, the organ usually recovers fully.
Diagnosis and progression
To diagnose kidney cancer, the use of imaging is crucial. A physical examination, blood tests, and analyses of the urine do not lead to a definite diagnosis. For this reason, ultrasound examinations, magnetic resonance imaging, and computed tomography are used. These procedures have the ability to differentiate between tumors and other kidney diseases. In addition, an X-ray examination with contrast medium can provide information about a possible cancer of the kidney. Since kidney cancer can lead to life-threatening complications, timely detection and treatment are important. In the early stages, the chances of cure are up to 90 percent. However, if the cancer has already spread to other organs with metastases, the chances of survival from kidney cancer decrease, sometimes drastically, depending on the type of infestation.
Complications
Kidney cancer often causes serious complications.Malignant kidney tumors, for example, have the ability to spread through the organism via blood and lymph vessels and to affect other regions of the body. A frequent consequence of kidney cancer is the occurrence of metastases (daughter tumors). They primarily affect the lymph nodes, bones and lungs. In rare cases, they also affect the liver or brain of the patient. This in turn can lead to life-threatening complications. These include blood clots that block blood vessels or inflammation of the lungs (pneumonia). Blood clots in the heart, brain and lungs are considered particularly dangerous. To counteract such sequelae, rapid treatment of renal carcinoma is extremely important. In most cases, surgical intervention is performed. In the case of larger kidney tumors, obstruction of the outflow of urine from the body is possible. This in turn results in a buildup of urine. The urine stagnation becomes noticeable through pain and infections. In the worst case, organ failure occurs. Complications can also occur with kidney cancer during surgical therapies. For example, there is a risk that adjacent organs or body structures may suffer damage as a result of the operation. Sometimes this occurs in the intestine. There is a risk of life-threatening effects such as peritonitis (inflammation of the peritoneum). If vessels are affected, this can cause bleeding, secondary bleeding or hematomas (bruises). In turn, if nerves are injured, numbness or paralysis are possible.
When should you see a doctor?
Kidney cancer is a serious disease that, without treatment, first severely damages the kidneys, then spreads to other organs and becomes fatal. The sooner the patient contacts a doctor with suspected kidney cancer, the sooner the diagnosis can be confirmed and treatment appropriate to the severity of the disease can be initiated. As with all types of cancer, the prognosis for kidney cancer is best the earlier it is detected. In the early stages of the disease, a cure is still possible if the diagnosis is made in time. Late stages, on the other hand, are more difficult to treat, and there is also a risk that the kidney cancer has already spread, requiring treatment for other types of tumors. The difficulty with kidney cancer, as with very many tumors, is that symptoms often do not become apparent until the advanced stages of the disease and initial signs are not recognized as indications of kidney cancer, if any occur at all. One of the first signs is a small amount of blood in the urine, which has no apparent cause and is not necessarily accompanied by pain. Since it can take a long time for kidney cancer to develop further characteristic symptoms such as pressure pain or palpable induration, a doctor should be consulted for clarification as soon as possible even if there is blood in the urine.
Treatment and therapy
If kidney cancer is diagnosed, surgical intervention is performed. Often, the surgery involves removal of the diseased kidney. This is the only way to be certain that no tumors remain. Since the human body has two kidneys, the healthy kidney takes over the functions of the kidney that was cut out. If the tumor has already spread to other organs, radiation therapy is then recommended. This therapy destroys any metastases in the body and thus slows down the cancer from continuing to grow. Furthermore, radiation therapy as part of kidney cancer treatment can alleviate typical bone pain. Furthermore, there is the possibility of immunotherapy with a protein that regulates cell growth. This activates the immune system to defend itself against the tumors in the body. However, the efficacy of this immunotherapy in kidney cancer is questionable, and further clinical studies are needed. Chemotherapy is not used. The reason for this is the lack of effect of the drugs used in chemotherapy for kidney cancer.
Prospect and prognosis
The prognosis for kidney cancer is based on the severity of the cancer. If the tumor is confined to the kidney, about 70 percent of patients survive five or more years. The prospects of recovery are even better for small tumors. Recovery is possible in 90 percent of cases. If cancer screening is used regularly, tumors can be detected and treated at an early stage.Older patients over 40 in particular should take advantage of routine annual check-ups. In general, early-stage kidney cancer can be treated well. Stage III or IV kidney cancer offers a poor prognosis. In the third stage, the 5-year survival rate is only 50 percent. If metastases have already formed in a lymph node, the prognosis is even worse. In stage IV, the probability of cure is five to ten percent. In addition, the probability of a relapse increases with the stage. The prognosis is determined by the specialist physician in charge, taking into account the severity of the disease and the patient’s willingness to undergo aggressive therapy measures. In addition, social and financial factors also play a role. The quality of life is not necessarily limited in the case of kidney cancer. Pain medications and comprehensive adjunctive treatment aim to improve the patient’s well-being.
Prevention
No specific preventive measures exist for kidney cancer. However, a healthy lifestyle and careful observation of certain body signals offer protection against kidney cancer. For example, high-fat foods and smoking should be avoided. Painkillers should only be taken in exceptional situations. In case of unexplained back pain or bloody urine, it is advisable to consult a doctor at an early stage to clarify a possible kidney cancer disease.
Follow-up
In most cases, the physician and patient discuss follow-up care before the initial therapy ends. This involves determining the location and rhythm of the examinations. In principle, appointments take place at least quarterly during the first year. After that, the intervals are extended. After years of freedom from symptoms, annual check-ups are sufficient. An important topic of the aftercare is the integration into everyday life. A rehabilitation measure, in which specialists from different disciplines are available, facilitates the way back to the original life. Patients can, for example, also be given medication there to enable them to live pain-free. As part of the aftercare, doctors check whether the kidney cancer has recurred. This is a not unlikely consequence. By diagnosing at an early stage, doctors hope to have the best treatment options. A follow-up examination consists of a discussion about existing complaints. This is followed by a physical examination. The physician also arranges for imaging procedures as well as urine and blood analyses. This form of aftercare is extended if further secondary diseases have developed as a result of an intervention. Constantly high blood pressure, for example, can be lowered with medication. If mental stress arises from the kidney cancer, psychotherapy, for example, can provide support.
What you can do yourself
In most cases, patients who receive a cancer diagnosis have to deal with the initial shock of the disease. Often, they are unable to think clearly in the first few days after being diagnosed with the disease. It is important to have an open and honest exchange with the attending physician. Questions should be noted and discussed at the next visit to the doctor. It is advisable to follow the therapy and treatment instructions. Physical exertion should be avoided to prevent further strain. Cancer patients can try a special diet. It promotes healthy food intake and is based on cancer research findings. In addition, mental techniques help to experience cognitive relief. Through meditation, yoga or autogenic training, an inner balance can be established and stress reduced. Exchanging ideas with other sufferers via self-help groups or on Internet forums can provide helpful tips and advice on how to deal with the disease. Communication about existing fears, concerns or consequences of kidney cancer can be important for psychological balance. Conversations with trusted people are recommended. The intake of harmful and toxic substances should be refrained from. The consumption of alcohol, nicotine or drugs has a negative effect on general health and further weakens the immune system. Good sleep hygiene, sufficient exercise and oxygen, on the other hand, support the immune system.
