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All you need to know about Renal Cancer

(Symptoms, Prevention and Treatment)

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1.What is Kidney/Renal cancer?

Kidneys are one of the vital organs of the human body which help purify the blood by removing waste from the bloodstream and passing them as urine. The presence of cancerous cells in the kidney is called kidney cancer or renal cancer. This condition is caused when kidney cells begin to grow rapidly to form a tumour. This tumour turns out to be cancerous (malignant). Most often, kidney cancer affects the lining of tubules ( the tiny tubes of the kidney responsible for absorption and water regulation). This is called renal cell carcinoma. Kidney cancer is usually diagnosed at an early stage which helps in quick and easy treatment. However, if left unnoticed, it multiplies and spreads to different organs.

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2.Symptoms and Causes of Kidney Cancer

Renal cancer symptoms are not evident in the early stages; however, it becomes very evident as the tumour grows bigger. Some of the common symptoms of renal cancer are-

  • Constant pain in your back pain, particularly below the ribs
  • Presence of blood in the urine
  • Abdominal pain caused due to swelling in the abdomen.
  • A lump found in the abdomen
  • Sharp pain in the abdomen that fails to go away
  • Feeling of tiredness
  • Sudden loss of weight
  • A sudden fever that stays for weeks
  • Reduced appetite
  • Swelling in ankles and legs
  • Deficiency of blood

The moment cancer spreads to the other parts of the body it shows symptoms such as -

  • Bone pain
  • Shortage of breath
  • Coughing up blood

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3.Causes

There are no strong points found to define kidney cancer causes. Doctors believe that renal cancer is caused due to changes in DNA that allow the cells to proliferate, which leads to an accumulation of abnormal cells that form a lump or a tumour. There are certain risk factors that increase the chances of renal cancer. Some of them are -

  • Gender (Men are 2 - 3 times more likely to develop kidney cancer compared to women)
  • Drug Abuse
  • Smoking
  • Genetic Mutation
  • Obesity
  • Exposure to Toxic Chemicals
  • Pre-existing Kidney Diseases
  • High Blood Pressure
  • Family History
  • Lymphoma

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4.Types of Kidney Cancer

There are many types of kidney cancer. Some of the most significant ones are -

Adenocarcinoma - This cancer is most often found in adults and is also called renal cell carcinoma. Adenocarcinoma is a specific type of kidney cancer that begins in the part of the kidney where the blood is purified.

Renal pelvis carcinoma - This type of cancer is formed in the part of the kidney where urine is collected.

Wilms' tumour - This rare form of cancer occurs in children below the age of 5.

Besides the above, there are other types of kidney cancer, but they occur very rarely.

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5.Risk factors associated with Kidney Cancer

The various risk factors associated with kidney cancer include -

Gender - Kidney cancer occurs more in men when compared to women.

Drug Abuse - Intake of excessive painkillers for a long time increases the risk of being affected by kidney cancer.

Smoking - Smoking increases the chances of renal cancer by 50% when compared to non-smokers.

Genetic Mutation - An inherited condition such as Von Hippel-Lindau (VHL) disease or papillary renal cell carcinoma increases the chances of renal cancer.

Obesity - Excessive weight gain leads to hormonal changes which raise the risk of renal cancer.

Exposure to Toxic Chemicals - Constant exposure to chemicals such as cadmium, organic solvents, asbestos, benzene and certain herbicides increase the risk of kidney cancer.

Pre-existing Kidney Diseases - If you are suffering from a long term kidney disease or undergoing kidney dialysis for a long time, you are at a higher risk to get infected by kidney cancer.

High blood pressure- The actual reason behind how blood pressure is related to kidney cancer is still unknown; however, individuals suffering from high blood pressure are at an increased risk of being affected by kidney cancer. Doctors say that the medication prescribed for high blood pressure can increase the risk.

Family History - If family members, particularly siblings, are affected by kidney cancer, then one has to be extra cautious as there is an increased risk.

Lymphoma - Patients suffering from lymphoma are at a higher risk of being infected with kidney cancer.

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6.Diagnosis and Treatment of Kidney Cancer

Diagnosis of kidney cancer

Once renal cancer symptoms are noticed, it is recommended to consult with a doctor who would perform specific checks to diagnose the problem further. Firstly, the doctor would suggest a complete physical check-up and will look into the details of the patient's medical history. Some of the common methods that are involved in kidney cancer diagnosis are-

Urine Test - A sample of urine is submitted to check for symptoms that confirm the presence of renal cancer.

Blood Count Analysis - Kidneys are responsible for producing erythropoietin hormones which regulate the production of red blood cells. A complete blood count analysis will help to identify the increase of red blood cell count which leads to polycythemia.

Blood Chemistry Test - The blood test is done to check the performance of the kidneys based on chemical levels present in the blood.

Intravenous pyelogram (IVP) - An X-ray of the kidneys are taken to identify the location of the tumour. This is done by injecting a dye of a contrasting colour into the urinary tract.

Ultrasound - Images obtained during an abdominal ultrasound scan can also reveal the presence of tumours that cause kidney cancer.

CT scan - This test allows doctors to take cross-sectional pictures of the body. This is done to get more exposure on size, location and other details about the tumour present. This scan is done by injecting dye into the urinary tract.

Magnetic resonance imaging (MRI) - MRI scan is done with the help of strong magnetic and radio waves. It is done to obtain detailed images of the soft tissues present in the lungs. A contrast dye is injected into the veins to get clear pictures.

Renal arteriogram - This test is performed to diagnose small tumours. This test helps in calculating blood supply to the tumour. The test is performed by inserting a catheter up a large artery in legs or groin to reach the renal artery. A special dye is injected into the artery to find the blood supply levels to the kidney. This test is performed with the help of X-ray images.

Biopsy - Biopsy is recommended very rarely for kidney cancer. Doctors recommend a biopsy to confirm the analysis. A biopsy is done to remove a small piece of tissue from the infected area through a needle biopsy. The sample is further investigated under a microscope to know the severity of the cancer present. Doctors usually prefer removing the tumour first and then take a sample tissue to investigate further and suggest treatments based on the research.

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7.Treatment

Kidney cancer treatment options vary depending on the severity of cancer present. Most often, cancer is treated through surgery where the doctors eradicate the tumour from the body. The surgery done could be simple or moderate, depending on the size and location of the tumour. Some of the treatment options for kidney cancer are-

Radical Nephrectomy - It is a surgery performed to remove the infected kidney entirely along with healthy tissues and lymph nodes surrounding it. This procedure is conducted by an incision or through laparoscopy, which involves the insertion of a thin tube with a camera attached to it.

Conservative Nephrectomy - During this surgery, the doctor targets to remove only the infected part of the kidney along with a small portion of healthy tissues and lymph nodes. The remaining part of the healthy kidney is left behind to heal itself. This process is also known as nephron-sparing nephrectomy.

Non-surgical treatments - Kidney cancer can be cured without surgery. The non-surgical treatment methods are-

Cryoablation - This process is done by freezing the cancer-causing cells with the help of liquid nitrogen. This procedure is carried out by injecting special needles into the kidney tumour with the help of ultrasound scan images. The liquid nitrogen is passed through the hollow needle to freeze the infected cells, which destroy them eventually.

Radiofrequency Ablation - During this process, a particular probe is passed through the skin to reach the kidney tumour with the help of ultrasound images. Once the probe is placed in the targeted location, an electric current is passed through the probe and then into the tumour cells to burn them.

Immunotherapy - The body loses the capability to fight against the cancer cells as proteins produced by the cancer cells blind the immune system cells present in the body. This process can be reversed with the help of drugs like Interferon and Aldesleukin (Proleukin), which are synthetic versions of chemicals present in the body.

Targeted Therapy - Targeted therapy helps in blocking particular unusual signals present in kidney cancer cells and prevents them from multiplying. Some of the drugs involved in targeted therapy are Sorafenib (Nexavar), Bevacizumab (Avastin), Axitinib (Inlyta), Pazopanib (Votrient), Sunitinib (Sutent) and Cabozantinib (CaboMetyx). These play a vital role in blocking blood vessels that help in treating the cancerous cells. The other drugs such as Temsirolimus (Torisel) and Everolimus (Afinitor) are targeted to block signals that help in the multiplication of cancer cells.

Radiation Therapy - Radiation therapy is usually used to kill cancer cells that have spread to other parts of the body such as nearby organs, bones and brain. This therapy is done with the help of high -powered X-ray beams which bring the symptoms of kidney cancer under control. All treatments have their own set of side effects. Before undergoing these, it is recommended to clear all doubts about the treatment with the respective oncologist. Also, feel free to mention about discomforts caused during the treatment. This will help the doctor offer better treatments accordingly.

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8.Steps to Prevent Kidney Cancer

The causes of kidney cancer are not known yet; hence, its prevention is not certain. Depending on the risk factors associated with kidney cancer, here are a few steps to maintain healthy kidneys and prevent the occurrence of kidney cancer.

Quit Smoking - There is a proven record that smoking doubles the chances of kidney cancer by 30% in men and 25 % in women.

Stay active and maintain a healthy weight- Obesity increases the chances of kidney cancer due to hormonal changes. It is important to exercise for at least 30 mins a day.

Eat nutritious food- A balanced diet with all nutrients helps build a stronger immune system in the body. Meals should ideally include fresh fruits and vegetables. Junk food intake must be kept to a minimum. Obese men and women can reach out to a nutritionist to plan a suitable healthy diet.

Avoid exposure to toxic chemicals- Those working in hazardous chemical environments should follow all safety measures before beginning work. Get a complete body checkup done once a year to know the condition of your internal organs. Inhalation of toxic chemicals leads to many diseases, and kidney cancer is one of them.

Control Blood Sugar Levels and Blood Pressure- Both increased rate of blood sugar and high blood pressure affect the kidney in a big way which leads to several issues that damage the entire organ. This leads to kidney cancer.

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9.Stages of Kidney Cancer

Kidney cancer stages are defined by the severity of the disease. This entirely depends on the size of the tumour, the location, and whether the cancer has spread to other parts of the body. Kidney cancer is divided into four stages which are -

Stage I - This is the beginning stage of cancer where the cancer is limited only to the kidney. The size of the tumour present at this stage is roughly 7 centimetres.

Stage II - At this stage, the tumour found in the kidney has grown more than 7 centimetres and is still limited to the kidney.

Stage III - At this stage, cancer has begun to spread to parts around the fatty areas of the kidney, lymph nodes and surrounding tissues. It also spreads to major veins and perinephric tissues.

Stage IV - Cancer is at its last stage where cancer cells have vigorously grown beyond the fatty layer of tissue present around the kidney. Nearby lymph nodes, organs such as bowel, pancreas, liver and lungs are infected too. This leads to the bones and brain being infected at the final stage.

The treatment for kidney cancer gets difficult if not diagnosed at early stages. The survival rate also decreases drastically at later stages in spite of various treatment methods available.

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10. Road to Recovery and Aftercare (Diet and Nutrition)

Sticking to healthy habits is very important to lead a healthy life. Eating a balanced diet, getting good sleep, moderate drinking habits, no smoking, regular exercise, hygiene and cleanliness, etc are signs of healthy habits. It is important to follow all these habits to avoid major health consequences.

Living with kidney cancer makes life difficult and reduces appetite, so it is very important to watch one's daily eating habits. The diet during the treatment for kidney cancer should help the body cope up with treatments and stress. Here is the list of food items that can benefit the body during treatments of cancer.

Whole Grains and Starches - Food products which are high in iron, vitamin B and fibre such as whole wheat pasta, whole bread and wild rice increases energy levels in the body. Few whole grain products contain a good source of Potassium and Phosphorus in them. This helps in the functionality of the kidney. However, these food products need to be limited to a certain amount as they might increase the stress on the kidney's work process. Always consult an expert before consuming these products.

Fruits and Vegetables - Including fresh fruits and vegetables in your daily diet helps build a strong immune system. Fruits and vegetables are known for containing soluble fibres which help in maintaining healthy blood sugar and cholesterol levels. They also contain a high source of essential minerals and vitamins in them.

Proteins - Proteins are vital nutrients required to develop and maintain muscle mass in the body and need to be part of one's daily diet. Those suffering from kidney problems need to control the intake of proteins as they increase the stress on the kidneys' functionality. People diagnosed with kidney cancer should limit their protein intake to fewer portions as the waste produced from the food gets piled up in the bloodstream and causes severe problems.

Avoid food with high salt content - High intake of salt leads to high blood pressure which is caused due to imbalance in body fluid levels. This imbalance increases stress levels on the kidney and leads to kidney damage. Avoid food that contains high sodium such as canned food, deli meats, fast food and salty snacks. Instead, try replacing salt with spices and herbs to enhance the flavours and taste of food.

Avoid Food High in Phosphorus - Phosphorus is abundant in food items such as nuts, seeds, beans and processed bran cereals. It is an important nutrient that helps in maintaining bone strength. However, excessive intake of phosphorus while one has kidney cancer increases stress on the kidney. Phosphorus piles up in the bloodstream and reacts severely to cause symptoms such as joint pain and itchiness.

Avoid Overhydration - Drinking 8 to 10 glasses of water every day is healthy and ideal for everyone. Overhydrating yourself by drinking too much water can cause unnecessary stress to kidneys. It is important to monitor the amount of water consumed every day to avoid complications. It is recommended that kidney patients drink less water when compared to others as their kidneys are already under stress.

Diet During Treatment - Appetite is greatly reduced in patients diagnosed with cancer. It is important to eat a balanced diet with all nutrients that can help in quick recovery. Most often, cancer patients feel nauseous and lose interest in eating as their palettes have failed to identify the taste. These shouldn't be a reason to stop healthy eating habits. Here are a few tips that can help with eating better during cancer treatment.

  • Eat small portions of food in small intervals. This will maintain energy levels at all times.
  • Do not wait to be hungry. Have meals on time.
  • Cancer treatments weaken the immune system. Always rinse all fruits and vegetables before cooking or eating raw.
  • Stay cautious while eating outside. Avoid street food.
  • Ensure meat products are cooked well before eating.
  • Do not eat raw foods like shellfish, sushi and vegetable sprouts.
  • Do not drink unpasteurised juice or milk. Remember to boil milk before drinking.

Eating healthy food is the key to well being. It is important to watch what you eat and avoid edibles that do not suit the body. Consult a dietician and nutrition to suggest foods that suit your body.

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11. Kidney Cancer FAQs: All your concerns addressed

Q. Is kidney cancer curable?

  1. Kidney cancer can be cured in a patient where the cancer is confined only to the kidneys and has not spread to other organs of the body. Most often, primary kidney cancer can be treated by removing the tumour from the kidney to avoid the recurrence of cancer. However, patients exhibiting growth that has spread beyond the kidney are less likely to do well. If the disease has spread to one or more organs, it is vital to have access to treatments that can stabilise or even eliminate secondary tumours. Some patients with secondary tumours respond well to further treatment (which is usually in the form of targeted therapy) and others do not respond or respond only temporarily.

Q. What are the symptoms of kidney cancer?

  1. Symptoms of kidney cancer are not very evident in their early stages. The most common symptom is blood in the urine. Sometimes it won't be visible to the naked eye, but it can still be detected by a urine test. Most people who find blood in their urine do not have kidney cancer. This is mostly a sign of prostate problems, urinary infection, kidney stones or bladder cancer. However, it is always crucial to find out what has caused it. Most kidney cancers are too small to feel, but if you feel a lump or mass in the area of your kidneys, you should tell your doctor straight away. The sooner kidney cancer is detected, the easier it is to treat. Here are a few symptoms of kidney cancer-
  • Haematuria - Indicating blood in the urine
  • Persistent low back pain or pain in the side between the ribs and hip bone
  • A lump or mass in the kidney-region
  • High blood pressure or hypertension
  • Tiredness
  • Weight loss and/or loss of appetite
  • Persistent high fever and heavy sweating, especially at night.

Q. What are the causes of kidney cancer?

  1. With most cancers, there is no direct cause and kidney cancer is no exception. For many people, the cause of cancer is never found. However, certain lifestyle factors can increase the risk of developing the disease:
  1. Age - The risk of developing kidney cancer is highest in people aged 45-75
  2. Diet and obesity - An unhealthy diet and being overweight (obesity) increases the risk of developing kidney cancer.
  3. moking - Smoking increases the risk of kidney cancer. The longer a person smokes, and the more cigarettes they smoke, the greater the risk.
  4. Family History -People with siblings or parents suffering from kidney cancer are at higher risk of developing kidney cancer themselves.
  5. An associated medical history - Certain medical conditions, such as high blood pressure (hypertension) and chronic kidney disease, especially people on long-term kidney dialysis, have a higher risk of kidney cancer.
  6. Long-term regular use of painkillers - Frequent and long-term addiction to painkillers such as ibuprofen, naproxen, phenacetin is linked to kidney cancer.

Q. What is Wilms' tumour?

  1. Wilms' tumour is a kind of kidney cancer which is found in children below the age of five. Wilms' tumour accounts for up to 95% of childhood kidney cancers.

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