About Kidney Cancer
Kidney cancer – also known as renal cancer – is among the top 10 most common cancers for men and women. The rate of new kidney cancer diagnosis has risen as it is being detected more frequently through CT scans. When caught early, it is treatable and the number of survivors in remission has grown.
The disease starts when the cells of the kidneys mutate and form a tumor. Sometimes multiple tumors can form, break off and move into different parts of the body.
There are two main types of kidney cancer:
- Renal cell carcinoma is the most common type of kidney cancer and accounts for about 90 percent of cancerous tumors. It starts in the lining of very small tubes in the kidney.
- Wilms’ tumor may develop in young children but is rare.
Kidney cancer does not usually cause signs or symptoms in the early stages, and there are currently no routine screening tests. In the later stages, kidney cancer signs and symptoms could include blood in the urine, back pain that won’t go away, loss of appetite, unexplained weight loss, chronic fatigue and intermittent fevers.
Prevention
Researchers aren’t sure exactly what causes kidney cancer, but there are things that can increase your risk. These are known as risk factors and include:
- Older age
- Smoking
- Obesity
- High blood pressure / hypertension
- Kidney failure treatment / dialysis
- Inherited syndromes like von Hippel-Lindau, Birt-Hogg-Dube syndrome, and tuberous sclerosis
- Family history of kidney cancer
- Frequent exposure to cadmium or specific herbicides
There best preventative measures include taking steps to improve your current health:
- Quit smoking
- Maintain a healthy weight
- Control high blood pressure
Detection and Diagnosis
Kidney cancer is usually detected at more advanced stages because it can grow quite large before causing discomfort or pain. Tumors are also difficult to detect in a standard physical because the kidneys are deep inside the body. The majority of cases where kidney cancer is caught early on scans, the patient was being tested because they were suffering from symptoms of other kidney issues. If you are not at increased risk, then putting yourself through frequent CT scans or MRIs is not recommended.
Treatment
If you find that you have kidney cancer, rest assured you have some of central Maine’s best experts by your side. Our dedicated team—including board-certified urologic surgeons, medical and radiation oncologists and more specialists—works closely with you to create a personalized treatment plan.
Surgery
Surgery to remove of all or part of the kidney is the main treatment for most kidney cancers and may include removing the surrounding tissues or lymph nodes. Until recently, kidney removal could only be accomplished through a surgical procedure called open or partial nephrectomies. This procedure requires a large, muscle-cutting abdominal incision, removal of a rib and a relatively longer hospital stay and recovery period.
Fortunately, new minimally invasive techniques now make the procedure much easier for patients. At Central Maine Comprehensive Cancer Center, we offer laparoscopic surgery, which allows your surgeon to perform an operation that results in significantly less pain and a faster recovery.
Chemotherapy & Radiation Therapy
Chemotherapy and radiation therapy are generally not effective for treating kidney cancer, but immunotherapy may help some patients by increasing their body’s immune response in the setting of metastatic disease.
Genetic Counseling
If you have a family history of kidney or renal cancer, it is possible to test for hereditary cancer syndromes. The Cancer Care Center’s genetic counselors can work with you and your providers to determine if you are at risk for certain cancers and steps that should be taken to prevent cancer cells and tumors.
Support
Throughout your journey, you’ll find a variety of cancer support services to meet your physical, emotional, spiritual and financial needs. That includes your very own nurse navigator to coordinate all of your care, answer any questions and provide extra comfort and support every step of the way.
Screening and Diagnosis
If you’re worried you might have kidney cancer, we know it can be upsetting and distracting. At Central Maine Health, we understand not knowing can be the most difficult experience. That’s why we’re focused on providing the expert medical attention you need to get a diagnosis as quickly and accurately as possible.
Screening for Kidney Cancer
A screening test is used to find cancer before symptoms appear. While there are no recommended screening tests for kidney cancer in people who are at average risk, there are symptoms you should be aware of. And even though these symptoms are more often caused by conditions that are not cancer, you should still see your provider.
Symptoms that may indicate kidney cancer include:
- Blood in your urine, which may appear pink, red or cola colored
- Low back pain on one side (not caused by injury)
- Loss of appetite
- Weight loss not caused by dieting
- Tiredness
- Fever, which usually comes and goes (intermittent)
- Anemia (low red blood cell counts)
Screening for People at Higher Risk for Kidney Cancer
Some people inherit from their parents conditions that put them at higher risk for the disease. If you’re at a higher risk, your provider may recommend regular imaging tests like MRI, CT or ultrasound scans to look for kidney tumors. When these are found early, kidney cancer can often be cured.
Talk to your provider if anyone in your family (blood relatives) currently has kidney cancer or had it in the past, especially at a younger age. Also, you may be advised to have genetic testing done if you have a family history of inherited conditions linked to this cancer. These conditions include von Hippel-Lindau disease, hereditary papillary renal cell carcinoma, and Birt-Hogg-Dube (BHD) syndrome.
Genetic testing cannot detect kidney cancer. It can only tell you if you’re at a higher risk for the disease. If you are at higher risk, your provider may recommend regular testing. It’s important to note that a genetic test that shows you may be at higher risk does not mean you will get cancer. If genetic testing is recommended by your provider, our genetic counselors will help you understand what the test means for you.
Diagnosis of Kidney Cancer
If your provider suspects you may have kidney cancer, they will want to get more information. First, they will want to ask questions about your symptoms and learn more about your medical history. They will also want to give you a physical exam to see if anything feels abnormal in your abdomen and to check for other signs of cancer or other health problems. They may also order one or more of the following tests:
Blood and/or Urine Tests
A sample of your blood or urine is examined to show if there may be any problems with your kidneys. The tests cannot show whether or not you have cancer for certain, but they do provide your provider the information they need to determine next steps in your diagnosis.
Imaging Tests
There are many varieties of imaging tests, but all use either x-rays, sound waves, radioactive substances or magnetic fields to create pictures of the inside of the body. They help your provider look at areas they suspect may be cancer, to see how far cancer has spread, and/or to help find out if treatment is working. Examples of these tests include computed tomography (CT) scans, magnetic resonance imaging (MRI) scan, ultrasound, chest x-rays and bone scans.
Biopsies
If imaging tests are not clear enough, a biopsy can help your provider determine if an area may be cancerous. In this case, he’ll remove a small sample of tissue, often with a needle. This sample is sent to a pathologist, who will look for any signs of cancer.
Guiding You Every Step of the Way
If you are diagnosed with kidney cancer, Central Maine Healthcare is here to support you and your family. Our nurse navigators work with you from your first appointment, helping you through your journey. They can provide or connect you with a wide variety of support services, including financial counseling, shuttle services, free lodging for family members at Arbor House, nutritional support and educational resources.
Treatment
Taking on cancer isn’t easy for anyone. At Central Maine Healthcare, we want to help you in your fight. We provide the highest-quality kidney cancer care, from advanced imaging, to a full range of treatment options and support services.
After your diagnosis, the first step in creating your treatment plan will be to determine what stage your cancer is. Stage 1 is least severe and stage 4 is most. Understanding the size of the tumor and how far the cancer has spread helps your provider understand how to treat the cancer and how successful that treatment may be.
Surgery for Kidney Cancer
Usually surgery will be the first step and is frequently the only intervention needed. Because we have two kidneys, it’s possible to live a full and healthy life with only one. Your provider may remove some or all of a kidney to treat your cancer.
Total Nephrectomy is the most common surgery done for kidney cancer. It removes the entire kidney, and occasionally the adrenal gland and surrounding tissue. A total nephrectomy can be done with a hand-assisted laparoscopic approach, which involves a few small incisions.
Partial Nephrectomy is removal of just the tumor, leaving as much normal kidney tissue as possible. This is done in some cases when the patient has a smaller tumor and it is in a favorable location within the kidney.
If both kidneys must be removed, or if neither of them is working, you may need dialysis. Dialysis is using a machine to clean your blood the way a healthy kidney normally would. Or if your cancer has not spread outside your kidneys, you may be able to have a kidney transplant, if a donated kidney is available.
Options in Addition to Surgery
Surgery isn’t the only way to manage kidney cancer.
Immunotherapy stimulates your body’s natural defenses (also known as your immune system) to boost your ability to fight cancer. It involves substances made by your body or in a lab. These substances are man-made versions of natural proteins that can reduce the size of kidney cancers in a small percentage of patients. This is generally only employed in cases where the tumor has spread to other parts of the body and surgery would not be curative.
Cryotherapy uses an external probe, often guided by a radiologist using ultrasound, to freeze and kill the tumor. This is often a good option for small tumors in patients who do not want or cannot tolerate surgery.
Arterial embolization is a procedure that stops blood supply to a tumor in the kidney. It may be used before surgery to reduce bleeding from a large tumor, to relive pain or to control other symptoms.
Radiofrequency ablation “cooks” a tumor with high-energy radio waves and is similar to cryoablation.
Radiation therapy uses high energy x-rays or other types of radiation to kill cancer cells or stop them from growing. A machine sends these x-rays into your body and to the cancer. In kidney cancer, radiation therapy is often used to help with symptoms in patients who cannot have surgery.
Chemotherapy is less effective for treatment of kidney cancer than for some other cancers. It uses anti-cancer drugs which may be injected into the vein or taken by mouth as pills. These drugs kill the cancer cells or stop them from growing. It works best on kidney cancer which contains spindle cells known as sarcomatoid variant.
Support for Healing the Whole You
Dealing with cancer treatment can be difficult. At Central Maine Healthcare we offer many different support services to help you fight the disease. Our nurse navigators assist you through the entire process of diagnosis, treatment and recovery. And our social workers can connect you with the counseling and information you and your family need to manage the emotional, spiritual, financial and practical needs that come with a cancer diagnosis.