Kidney Cancer - Symptoms and Treatment

About 85% of kidney cancers - also called nephrocarcinoma, renal carcinoma, hypernephroma, and grawitz's tumor - originate in the kidneys. Others are metastases from various primary-site carcinomas.

Most kidney tumors are large, firm, nodular, encapsulated, unilateral, and solitary. They may affect either kidney; occasionally they're bilateral or multifocal.

Kidney cancer is twice as common in men as in women; it typically strikes after age 40. Renal pelvic tumors and Wilms' tumor occur most commonly in children.

Kidney cancer can be separated histologically into clear cell, granular cell, and spindle cell types. Sometimes the prognosis is considered better for the clear cell type than for the other types; in general, however, the prognosis depends more on the cancer's stage than on its type.

Causes

Although the cause of kidney cancer is unknown, some studies implicate particular factors, including heavy cigarette smoking. Patients who receive regular hemodialysis also may be at increased risk.

Signs and Symptoms

The following are the most common symptoms of renal cell cancer. However, each individual may experience symptoms differently. Symptoms may include:

• Abdominal mass or lump
• blood in the urine
• rapid, unexplained weight loss
• low back pain (not caused by an injury)
• loss of appetite
• mass or lump in the belly
• Persistent fatigue
• recurrent fever (not caused by a cold or the flu)
• high blood pressure (less frequently)
• anemia (less frequently)
• unrelieved pain in the side
• Swelling (edema) in the legs and ankles

The symptoms of renal cell cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Diagnostic tests 

Renal ultrasonography and a computed tomography scan can distinguish between simple cysts and renal cancer. In many cases, these tests eliminate the need for renal angiography. Other tests that aid diagnosis and help in staging include excretory urography, nephrotomography, and kidney-ureter-bladder radiography.

Additional relevant tests include liver function studies, which show increased alkaline phosphatase, bilirubin, and transaminase levels and prolonged prothrombin time. Such results may point to liver metastasis. If the tumor hasn't metastasized, these abnormal values reverse after tumor resection.

Treatment

Radical nephrectomy, with or without regional lymph node dissection, offers the only chance of cure. It's the treatment of choice in localized cancer or with tumor extension into the renal vein and vena cava. Nephrectomy doesn't help in disseminated disease.

Because this disease resists radiation, this treatment is used only when the cancer has spread into the perinephric region or the lymph nodes or when the primary tumor or metastatic sites can't be completely excised. In this case the patient usually needs high doses of radiation.

Chemotherapy is erratically effective against kidney cancer, and hormonal therapy has no proven results. Biotherapy with lymphokine-activated killer cells plus recombinant interleukin-2 shows promise but is expensive and causes many adverse reactions. Interferon is somewhat effective in treating advanced disease.

Prevention

Although the following steps may not prevent kidney cancer, they can help reduce your cancer risk and keep you healthier overall:

• Eat more fruits and vegetables
• Stay physically active
• Quit smoking
• Reduce high blood pressure
• Maintain a healthy weight