World Kidney Cancer Day reminds us to stay healthy and fit. This is also an appropriate juncture to keep ourselves updated on kidney cancer and the ways to reduce its occurrence and to deal with it in an effective manner. Kidney cancer is a global problem and virtually no country is unaffected by it. With the prevalence gradually increasing over the years, it continues to be a health menace both for patients and clinicians.
It will be prudent to keep ourselves apprised of the real burden. Every year, around 4,30,000 people worldwide will be diagnosed with renal cell carcinoma or kidney cancer as it is more commonly called. Thus, world kidney cancer day reminds and reinforces the very thought of the need to work together to reduce the global burden. Even children are not spared. The overall frequency of new cases is estimated to be around 7 and 3.5 per 1, 00,000 persons per year in men and female, respectively. Thus, one can see that males are twice as likely to be affected as females. Other than this other risk factors being long-standing kidney stones, long term dialysis and chronic kidney dysfunction, high and uncontrolled blood pressure, cystic diseases of the kidney, obesity and occupational exposure to certain chemicals. While all these risk factors are implicated as causal, perhaps the strongest and best-studied relationship is found to be with tobacco (in any form) that increases the risk of acquiring kidney cancer by two folds. So, the point to stress is this cancer is preventable in many people. It may also run in families as most other cancers do. It is the 13th most common cancer worldwide accounting for more than 1,00,000 annual deaths.
The situation is not so gloomy and dismal as there are certain pertinent facts that are positive pointers. Kidney cancer is probably one of the malignancies that enjoy a good survival rate with your probability of still being alive after 5 years of diagnosis being around 93 per cent for early and localized disease. This probability of course decreases as the severity and stage of cancer increases being around 13 per cent for a distant disease which is also a shade better as compared to advanced malignancies of some other organs. So being diagnosed with kidney cancer definitely does not mean the end of life and is certainly not a death sentence. Another important fact that might be of concern to many people is that it enjoys the rare distinction of cancer that does not require chemo or radiotherapy and surgery can cure it completely. So, patients do not have to undergo the arduous journey of bearing the adverse effect of heavy and toxic chemotherapeutic drugs. But the fact that might interest most of you all is the slow growth rate of kidney cancer (0.3 cm per year). It might remain silent and indolent for years altogether before showing up.
Another lesser-known fact is while some cases may be identified early, not all cases are easily detected. Some of these cancers might not show any leading symptoms and are diagnosed incidentally during an unrelated check-up. And the kidneys being located deep inside might make detection of cancer difficult. Some of the people may pass blood in the urine; have abdominal pains or swelling, long term fever not attributable to any other condition, unexplained weight loss, fatigue and easy tiredness, persistent low back pain and a general feeling of ill health.
There are advanced treatment modalities available like laparoscopic /robotic removal of the kidney. This surgery comes in the ambit of minimally invasive surgery which makes sure that hospital stay is minimised, and the recovery is hastened. Do talk to your urologist about partial nephrectomy in which maximum nephrons are spared and the entire kidney need not be removed. This surgery becomes highly important in patients who are diabetic, hypertensive, are suffering from chronic kidney disease, have only a kidney since birth or are left with one kidney due to the other kidney already being damaged for some reason or having been surgically removed. The people who are medically unfit to undergo surgery need not feel left out. They can be offered radiofrequency and cryoablation. Your doctor may also find it suitable to put you on active surveillance for small and seemingly indolent tumours.
World Kidney Cancer Day reinforces that cancer doesn’t have to define you. Don’t give up. Every day is worth it and it’s possible not just to survive, but to thrive and to live a healthy, wonderful life again. The need of the hour is to smell the coffee and to timely consult your urologist. As the lockdown is now gradually lifting up and the covid is ebbing, turning up in hospital might not sound scary now. However, the option of video consultation is also viable and the advice of the surgeon may be availed at the doorstep. As they always say, Cancer Cannot Wait.
The article is authored by Dr. Abhinav Jain, Consultant – Urology & Kidney Transplantation, Dharamshila Narayana Superspeciality Hospital, Delhi