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What causes kidney cancer?
- Most kidney cancers are sporadic (no obvious cause) however risks include:
- High blood pressure
- Family history
- Genetic conditions
- Renal cysts acquired from chronic kidney failure
How common is kidney cancer?
- Account for 3% of adult cancers
- Males more commonly affected than females
What are the symptoms of kidney cancer?
- Most kidney cancers these days are detected incidentally on x-rays (ultrasound or CT scan) during investigations of other problems
- Symptoms can include:
- Blood in urine (haematuria)
- Flank pain
- Feeling a mass
- Weight loss
How is kidney cancer diagnosed?
- Kidney cancers are most commonly diagnosed on ultrasound and/or CT scan
- A CT scan is necessary to provide information on size and location prior to determining treatment options
- Routine imaging of the chest is required to ensure no spread (metastasis) of the cancer
What is the role of kidney mass biopsy?
- Biopsy is not indicated in most cases, as approximately 80% of solid lesions in the kidney detected on CT will be kidney cancers
- Biopsy may be indicated if:
- There is a history of previous cancers elsewhere to rule out metastasis
- Lymphoma is suspected
- Tumour is small (<3cm), to help decide if treatment with surgery is required
What are the treatment options for localised kidney cancer?
- Surgery is the most effective treatment option for attempting to cure kidney cancer. See Urological procedures explained for details on each procedure
- If the staging x-rays show no spread beyond the kidney, the potential options include:
- Radical Nephrectomy (removal of the entire kidney & tumour, as well as fat surrounding kidney)
- In most cases this will be performed laparoscopic (key hole)
- Partial Nephrectomy: (surgical removal of just the tumour from the involved kidney, leaving the majority of healthy kidney behind)
- Now considered the gold standard treatment option for smaller kidney tumour (usually <4cm)
- May be performed laparoscopic or open depending on the size and location of the tumour
- Particularly beneficial for patients with impaired baseline kidney function or medical conditions which may impair kidney function in the future (e.g. diabetes)
- RFA (radiofrequency ablation)
- is a relative new treatment option for select patients with small localised kidney tumours not fit for surgery or who don’t want surgery but want some form of treatment
- cancer cure rates are inferior to surgery and longer follow up data is lacking, however offers better results than observation
- May be discussed as an option if:
- The patient is unfit for surgery due to age or other medical conditions
- The tumour is very small and slow growing
- The risk of a small kidney tumour (<3cm) spreading to other organs is very low (1-2%)
What are the treatment options if my kidney cancer has spread (metastasised)?
- TKI’s – Tyrosine Kinase Inhibitors
- Standard chemotherapy agents are not effective at treating kidney cancer
- TKI’s are a relatively new class of drugs that result in a reduction to the blood vessel growth to the cancer
- They can result in significant shrinkage of the tumour
- These agents will be administered under the care of a medical oncologist
- Survival can be improved by several months
- May be used to help control local symptoms from a bleeding kidney cancer if surgery is not possible
- Also can be used to help control the growth of advanced kidney cancers where surgery is not an option