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Renal Cancer and Chronic Kidney Disease

September 5, 2023

Similar to other vital organs in the body, your kidneys can occasionally develop cancer. The most prevalent form of kidney cancer in adults is renal cell carcinoma (also known as renal adenocarcinoma), which originates in the cells lining the small tubes within the kidneys.

Kidney cancer typically remains inconspicuous in its initial stages. However, as a tumor grows, you may observe certain indicators such as blood in your urine, unexplained weight loss, or persistent back pain. Additionally, kidney cancer cells can potentially metastasize, spreading to neighboring organs and even distant parts of the body.

A Brief Overview of Kidney Cancer:

Renal cancer was first reported in 1826, and its precise cause remains unknown. Although kidney cancer is most commonly diagnosed in individuals over the age of 40, it can affect even very young children, as early as six months of age. While renal cell carcinoma is the primary type of kidney cancer in adults, children are more likely to be diagnosed with Wilms’ tumor, which is a less common form. A rare kidney cancer called renal sarcomas, originating in the kidney’s connective tissue, accounts for less than one percent of all kidney cancers. Despite the potential for rapid spread, the prognosis for a full recovery is generally favorable when kidney cancer is detected and treated early.

Does CKD or ESRD Lead to Kidney Cancer?

A 2005 study conducted by the United States Renal Data System (USRDS) established a connection between kidney cancer and end-stage renal disease (ESRD). The study’s findings indicated that an increased number of kidney cancer patients subsequently developed ESRD during their treatment. Similarly, patients with chronic kidney disease (CKD) or ESRD showed an elevated incidence of renal cancer following long-term hemodialysis. The prolonged use of kidney dialysis has been associated with a heightened risk of kidney cysts, which, in turn, increases the risk of kidney cancer. Experts believe this risk is primarily linked to kidney disease rather than dialysis itself, as there is no direct relationship between dialysis and cancer risk.

Risk Factors for Kidney Cancer:

The exact triggers of kidney cell malignancy remain unclear. The risk of kidney cancer rises with age, primarily affecting individuals between 50 and 70 years old. Kidney cancer is almost twice as common in men as in women and appears to be somewhat more prevalent in African American men compared to white men. Researchers have identified several other factors that may elevate the risk of both renal and transitional cell kidney cancers. These factors include:

  • Smoking.
  • Obesity.
  • Certain occupational exposures, such as those experienced by coke-oven workers in steel plants or individuals exposed to asbestos in the workplace.
  • Specific radiation treatments, such as those used for uterine disorders.
  • Prolonged and heavy use of phenacetin, a pain-relieving drug no longer available in the U.S.
  • An inherited condition known as Von Hippel Lindau Disease.

Awareness of these risk factors plays a crucial role in prevention and successful treatment.

Symptoms of Renal Cancer:

Kidney cancer rarely exhibits noticeable symptoms during its early stages, often being incidentally discovered during routine examinations or while investigating unrelated health concerns. As the disease progresses, certain symptoms may surface, including the presence of blood in the urine. Other potential symptoms may encompass:

  • Back pain, typically below the ribs and persistent.
  • The detection of a mass in the kidney area during a medical examination.
  • Unexplained weight loss.
  • Fatigue.
  • Intermittent fever.
  • Pain in other parts of the body if cancer spreads.
  • High blood pressure.
  • Anemia (a reduction in red blood cell count).

Wilms’ tumor, in contrast, typically manifests no symptoms, and healthcare providers typically identify this condition during abdominal examinations. Keep in mind that these symptoms can also result from less severe conditions like cysts or infections. If you experience any of these symptoms, it’s advisable to consult your physician, who can perform necessary tests to determine the underlying cause.

Methods of Kidney Cancer Detection:

If kidney cancer is suspected, your healthcare provider will assess your overall health and perform blood and urine analyses. This assessment may also involve an abdominal examination to identify lumps or masses. Further diagnostic tests that may be ordered include:

  • CT scan, Magnetic Resonance Imaging (MRI), or ultrasound, which can detect the presence of a tumor and determine its nature (benign or malignant).
  • Intravenous pyelogram (IVP), a series of x-rays conducted after injecting a contrast dye.

If doubts persist after these initial tests, a biopsy may be recommended to examine a tissue sample under a microscope for signs of cancer cells. If kidney cancer is confirmed, the healthcare provider will determine the disease’s stage to develop an appropriate treatment plan. This could involve additional MRI and x-ray assessments of kidney tissues and blood vessels. Arteriography, a series of x-rays of blood vessels, may be conducted to ascertain whether it’s feasible to remove only part of the kidney or if the entire kidney needs removal. Chest x-rays can also help determine if the cancer has spread to the lungs, while bone scans can reveal bone involvement.

Treatment Options for Kidney Cancer:

The choice of treatment method depends on factors such as the disease stage, overall health, age, and other considerations. A multidisciplinary team, including urologists, oncologists (cancer specialists), and radiation oncologists, may be involved in the treatment of kidney cancer. The typical treatment options for kidney cancer include:

  • Surgery: The most common approach for kidney cancer treatment, often involving the removal of the entire kidney along with the adrenal gland and surrounding tissue. Occasionally, a portion of the kidney containing the tumor may be excised.
  • Arterial Embolization: A procedure sometimes performed prior to surgery to facilitate the operation. It involves injecting a specialized gelatin sponge material through a plastic tube to block the primary kidney blood vessel, which reduces the tumor’s oxygen and nutrient supply, leading to its shrinkage.
  • Radiation Therapy: Utilizes high-energy rays to target and destroy cancer cells. This therapy may be employed to alleviate pain when kidney cancer metastasizes to the bone. Typically administered on an outpatient basis over several weeks in a hospital or clinic.
  • Biologic Therapy: Also known as immunotherapy, this treatment harnesses the body’s immune system to combat cancer naturally. Interleukin-2 and interferon are examples of therapies used for advanced kidney cancer. Many individuals undergoing biologic therapy are closely monitored in a hospital during treatment to manage potential side effects.
  • Chemotherapy: Involves the use of drugs to kill cancer cells. While chemotherapy is effective against many types of cancer, its effectiveness in treating kidney cancer is limited.
  • Hormone Therapy: Employed in a small number of patients with advanced kidney cancer. Hormone treatment may be used to control cancer cell growth in some cases.

Conclusion:

A cancer diagnosis is a daunting experience, and kidney cancer can pose additional challenges when complicated by kidney disease and dialysis treatment. In many instances, early detection and treatment offer a promising prognosis for renal cancer. If you have concerns or questions about the risk of kidney cancer, it’s advisable to consult your physician for guidance.

Learn More about Kidney Cancer:

To acquire further knowledge about kidney cancer, including the relationship between kidney cancer and kidney disease or hemodialysis, you can explore the following websites:

Cancer Organizations:

  • Kidney Cancer Association: Offers publications, patient meetings, annual patient conferences, online support (chat, message boards), videos, and a newsletter called “Kidney Cancer News.” Contact at 1-800-850-9132.
  • American Cancer Society: Provides educational programs and information on support groups through a network of local offices. Offers materials such as booklets, videos, and audiotapes, many of which are available in Spanish. Contact at 1-800-ACS-2345.
  • National Coalition for Cancer Survivorship: Offers publications including “Teamwork: The Cancer Patient’s Guide to Talking with Your Doctor” and an audio program for patient empowerment known as “Cancer Survival Toolbox.” Contact at 1-877-622-7937.
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