Renal Cell Carcinoma (Cancer of Kidney): Causes, Risk Factors, Symptoms, Stages, Treatment

Cancer originating in the kidneys is known as kidney cancer. The shape of our kidneys resembles the beans and each kidney is about the size of our fist. They are present behind the abdominal organs. Each kidney is located on the side your spine. Renal cell carcinoma is the most common type of kidney cancer occurring in adults. Wilms’ tumor is a type of kidney cancer which often affects young children. Treatment includes surgery, cryoablation, radiofrequency ablation, immunotherapy, targeted therapy and radiation therapy.

The cause for renal cell carcinoma is not clear. Doctors believe that cancer occurs when there are some DNA mutations in the kidney cells. This result in rapid division and growth of the cells and these cells accumulate and form a tumor, which can also metastasize from the kidney to the distant regions of the body.

• The risk for Renal Cell Carcinoma (Cancer of Kidney) is more in old age or as a person ages.
• Individuals who smoke are at a higher risk for developing it. This risk can be cut down by quitting smoking.
• Individuals who are obese or overweight are at a higher risk for having Renal Cell Carcinoma.
• High blood pressure or hypertension increases the risk for developing it.
• People who get treatment for chronic kidney failure, such as long-term dialysis, are at a higher risk for developing Renal Cell Carcinoma.
• Individuals who have hereditary papillary renal cell carcinoma, which is an inherited condition, are more likely to develop Renal Cell Carcinoma (Cancer of Kidney).
• Individuals who have Von Hippel-Lindau disease, which is also an inherited disorder, are at an increased risk for developing various tumors, including Renal Cell Carcinoma.

Symptoms of Renal Cell Carcinoma (Cancer of Kidney) usually start to appear in its later stages and include:

• Hematuria or blood in the urine, which makes the urine red, pink or cola colored.
• Persistent pain in the back, just below the ribs.
• Unintentional weight loss.
• Tiredness.
• Recurrent fever.

• Blood tests.
• Urine tests.
• Ultrasound of the kidney.
• Computerized Tomography (CT) Scan.
• Magnetic Resonance Imaging (MRI).
• Biopsy where a sample of kidney tissue is taken from a suspicious region in the kidney and sent for cancer testing.

• Stage I: In this stage, the tumor is limited to the kidney and may be up to 7 centimeters in diameter.
• Stage II: In this stage, the tumor size is increased; however, it is still limited to the kidney.
• Stage III: In this stage, the tumor has spread beyond the kidney to the adjacent tissues and can also metastasize to the adjacent lymph nodes.
• Stage IV: In this stage, the cancer has metastasized to distant parts of the body, such as the liver, lungs, bones etc. and also to lymph nodes.

Treatment options include surgery, cryoablation, radiofrequency ablation, biological therapy/immunotherapy, targeted therapy and radiation therapy. Treatment depends on the stage of the cancer, patient’s overall health and patient’s treatment preferences.

Surgery is the main line of treatment for most of the kidney cancers and it includes:

• Nephrectomy where the affected part of the kidney is removed along with a margin of healthy tissue and nearby lymph nodes. The adrenal gland could also be removed. In radical nephrectomy, the entire kidney is removed. Nephrectomy can be done laparoscopically or as an open operation.
• Nephron-sparing surgery, also known as partial nephrectomy, where the tumor is removed along with a small border of the surrounding healthy tissue. This surgery is commonly done for small kidney cancers. Nephron-sparing surgery can also be done laparoscopically or as an open operation.

• Cryoablation where the cancer cells are frozen via a special needle which is inserted into the kidney tumor with the help of x-ray for guidance. Gas present in the needle cools or freezes the cancer cells. Cryoablation is done for those patients whose kidney tumors are small and who cannot undergo surgery.
• Radiofrequency ablation where the cancer cells are heated by inserting a special needle into the kidney tumor. Electrical current is then passed through the needle into the cancer cells resulting in heating or burning of the cancer cells. Radiofrequency ablation is done for those patients whose kidney tumors are small and who cannot undergo surgery.

• Surgery is done to remove kidney tumor as much as possible and also to remove the metastasized cancer from other areas of the body.
• Biological therapy, also known as immunotherapy, is a treatment where drugs, which use our immune system to fight the cancer, are used. Drugs which are used are aldesleukin and interferon. Side effects include fever, chills, nausea, vomiting and appetite loss.
• Targeted therapy is a treatment which targets only the precise features of the cancer by blocking certain abnormal signals which are present in the cancer cells. Targeted therapy also helps in treating kidney cancer which has metastasized to other regions of the body. Targeted therapy drugs include bevacizumab, axitinib, sorafenib, pazopanib and sunitinib. Side effects include rash, fatigue and diarrhea.
• Radiation therapy is a treatment which involves the use of high-powered energy beams like x-rays, which are directed at specific points on the body and destroy the cancer cells. Radiation therapy also helps in managing and alleviating cancer symptoms, especially if the cancer has spread to other parts of the body.

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