A small tumor in the kidney may be painless and often an accidental finding on sonography. Patients suffering from advanced kidney cancer may usually complain of back pain, which may be described as a dull ache to a sharp stabbing pain below the ribs on the back or one side of the flank. If there is a sudden persistent pain that lasts more than a few days, a doctor visit is recommended to rule out kidney cancer. Side and back pains that are not from an injury may also be symptoms of kidney cancer. Pain is caused by the tumor growing and pushing against nearby organs. It is usually felt on one side only. Larger tumors may cause compression, stretching, or invasion of structures near the kidney, resulting in pain in the flank, abdomen, or back. The mass may be palpable in the abdomen on a physical exam. If the cancer spreads (metastasizes) beyond the kidney, symptoms depend on the organs involved. The other common signs and symptoms of kidney cancer are
- The early symptom of kidney cancer is blood in the urine or hematuria (hematuria makes the urine appear rusty or even dark red)
- A lump or mass in the kidney area or abdomen
- Tiredness
- Recurrent fever
- Loss of appetite
- Weight loss
- Intestinal obstruction
- A general feeling of poor health
- Elevated blood pressure
- Anemia
- Recurrent urine or bladder infections
- For men, swollen veins around the right testicle are seen in patients with kidney cancer
A classic triad of symptoms: flank pain, blood in the urine, and a palpable abdominal kidney may be seen. The above bodily changes may be warning signs of kidney cancer, although they tend not to appear until the disease is advanced. Keep in mind that these symptoms can also result from other conditions, such as a bladder infection or other kidney disease.
What are the causes and risk factors for kidney cancer?
The possible causes and risk factors for kidney cancer may include
- Family history of kidney cancer: Apart from these risk factors, the highest risk is seen in patients who have inherited a disease that increases the risk of kidney cancer or who have parents or siblings who have had kidney cancer. These diseases include
- Von Hippel-Lindau syndrome stems from a genetic mutation that causes kidney tumors.
- Hereditary papillary renal cell carcinoma stems from a genetic mutation in the MET gene that causes kidney tumors.
- Birt-Hogg-Dube syndrome is a skin disease that also causes kidney tumors.
- Older age
- Males are more prone to kidney cancers than females
- Belonging to the African American ethnicity
- Smoking is usually considered the most common risk factor
- Overweight or obesity
- Misuse of certain medicines, such as water pills (diuretics) and over the counter pain relievers
- Contact with certain chemicals, such as metal cadmium, herbicides, and organic solvents. Being exposed to a chemical called trichloroethylene, which is used to remove grease from metal is also considered a risk factor
- High blood pressure
- Advanced or chronic kidney disease
- Having sickle cell trait (symptoms of sickle cell anemia) is associated with a rare form of kidney cancer (renal medullary carcinoma)
- Having a long-lasting infection with hepatitis C
- Having kidney stones
What are the four different stages of kidney cancer?
Kidney cancer stages include
- Stage I: Tumor is confined to the kidney and is up to 2 34 inches (7 cm) in diameter.
- Stage II: Tumor is confined to the kidney but is larger than a stage I tumor.
- Stage III: Tumor extends beyond the kidney into surrounding tissue, major veins, and nearby lymph nodes.
- Stage IV: Cancer has spread outside the kidney to one or more lymph nodes or other organs, such as the bowel, pancreas, or lungs.
The urologist may order additional tests to determine the size of the cancer and whether cancer cells have spread within the body. Tests may include additional computed tomography (CT) scans or other imaging tests.
What are the possible treatment options by stage for kidney cancer?
Treatment for kidney cancer depends on many factors including the stage of cancer and location. Often a combination of therapies will be recommended. They are
- Surgery
- Laparoscopic or robotic nephrectomy (partial or radical) is performed using telescopic instruments inserted in the abdomen through small incisions.
- Partial nephrectomy removes part of the kidney with the tumor.
- Radical nephrectomy removes the whole kidney, sometimes the adrenal gland, tissue around the kidney, and surrounding lymph nodes.
- Open nephrectomy (partial or radical) is performed through a flank or abdominal incision.
- Laparoscopic nephrectomy removes all or part of the kidney through a series of small incisions in the abdomen.
- Robot-assisted laparoscopic nephroureterectomy removes the entire kidney as well as the ureter down to the bladder using telescopic instruments inserted in the abdomen through small incisions.
- Tumor ablation: This destroys the tumor without surgically removing it. Ablative technologies include cryotherapy and radiofrequency ablation.
- Radiation therapy: Radiation cannot cure kidney cancer, but it can alleviate symptoms, such as bone pain. It may be used alone or in combination with other therapies.
- Targeted therapy: Drugs that attack specific cancer cells, slowing down the growth of cancer. Targeted therapy treats advanced kidney cancer.
- Immunotherapy: Immunotherapy or biological therapy uses the body's immune system to fight cancer.
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Medically Reviewed on 6/8/2022
References
WebMD. Understanding Kidney Cancer. https://www.webmd.com/cancer/understanding-kidney-cancer
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