Understanding Kidney (Renal) Cancer and Treatment Choices

Kidney cancer develops when kidney cells within the body undergo changes, leading to uncontrolled growth. These abnormal cells cluster together to form lumps of tissue known as tumors. These tumors can potentially replae normal kidney cells and even spread to other areas of the body.

An Insight into Kidney Function

The kidneys, are two bean-shaped organs which are approximately the size of a fist, and reside in the lower back, with one kidney positioned on either side of the spine. These vital organs perform several key functions, including the production of hormones that regulate blood pressure and the quantity of red blood cells. Moreover, they play a significant role in filtering blood to eliminate waste, excess fluid, and salt. The resulting waste, transformed into urine, travels through tubes called ureters to the bladder before being expelled from the body through another tube called the urethra.

Development of Kidney Cancer

Kidney cancer begins its development when the cells constituting the kidney undergo changes or mutations. These altered cells lose their proper functionality and multiply uncontrollably. Over time, this unregulated growth can impact the normal functioning of the kidney. While kidney cancer usually originates in one kidney, there are instances when it affects both kidneys.

The progression of kidney cancer can lead to its spread beyond the kidney to other regions of the body such as bones, liver, lungs, or brain. This dissemination, termed metastasis, complicates treatment strategies and renders the cancer more challenging to address effectively.

Options for Kidney Cancer Treatment

When facing kidney cancer, you and your healthcare provider (Dr. Pooli) will collaborate to determine the most suitable treatment plan for you. Potential treatment avenues include:

Surgery

The foremost treatment option for kidney cancer, surgery involves removing the tumor. Surgical intervention is recommended under the following conditions:

If you are in good health and expected to recover from the surgery.

In the case of a small tumor, a partial nephrectomy may be performed. This procedure entails removing only the section of the kidney containing the tumor, thereby preserving partial kidney function. This approach could also be considered for larger tumors, especially if cancer is present in both kidneys or if you possess only one kidney. While preserving part of the kidney offers benefits, there exists a potential risk of leaving behind residual cancer cells.

Larger tumors confined to the kidney may require distinct surgical approaches based on tumor size and location. Options range from a simple nephrectomy, where the entire kidney is removed (as one can function with a single kidney), to a radical nephrectomy that also involves removing the adrenal gland situated atop each kidney. Often, nearby fatty tissue and lymph nodes are removed in a process known as lymph node dissection. The removal of lymph nodes aids in preventing the spread of cancer, as these nodes are often the initial targets of cancer migration. Analyzing these lymph nodes for cancer assists in determining the cancer’s stage, a crucial factor in deciding whether additional treatments are necessary after surgery.

In instances where kidney cancer has spread beyond the kidney, but medical professionals believe that removing the original kidney tumor in combination with other treatments could be beneficial, a radical nephrectomy coupled with the removal of nearby lymph nodes might be undertaken. Additionally, any tumors in other body parts could be surgically removed, or alternative treatments may be explored. Although surgery may not always lead to a complete cure, it can alleviate symptoms like pressure, pain, or bleeding.

If symptoms such as pain, pressure, or bleeding arise due to tumors that have spread, surgery may be performed to address these symptoms. However, it’s important to note that this form of intervention does not offer a definitive cure for the cancer itself. This form of treatment is known as palliative therapy, aimed at enhancing the quality of life and managing discomfort.

Immunotherapy

This treatment involves the administration of medicines that enhance the immune system’s ability to combat cancer. These medicines simulate the actions of the body’s own immune system chemicals. Immunotherapy is sometimes referred to as biologic therapy.

Targeted Therapies

These therapeutic approaches involve medications designed to target specific genes or proteins predominantly present in or on cancer cells. The objective is to impede the growth and spread of cancer cells to other parts of the body.

Chemotherapy

While chemotherapy employs medicines to eliminate cancer cells, its effectiveness in treating kidney cancer is often limited. Targeted and immunotherapy have largely replaced chemotherapy in kidney cancer treatment. Nonetheless, chemotherapy is occasionally utilized for specific types of kidney cancer.

Radiation Therapy

This method employs powerful energy beams to eliminate cancer cells. While not as effective as other treatment options for kidney cancer, radiation therapy might be considered for individuals who are not suitable candidates for surgery. In most cases, radiation therapy is used to address issues stemming from metastatic kidney cancer, such as kidney cancer that has spread to the bones (bone metastasis). It can also assist in stabilizing weakened bones at risk of fracture due to metastasis.

Local Treatment (Ablative Therapy)

Ablative therapies are employed to eradicate kidney tumors. While the long-term effectiveness of these treatments is not fully understood, they can be beneficial when surgery is not a viable option. These treatments involve inserting a needle-like probe through the skin and into the tumor. This is guided by imaging techniques such as CT scans or ultrasounds. Two common methods of ablation are radiofrequency ablation (RFA), which employs an electric current to kill cancer cells, and cryoablation, which utilizes extremely cold gas to freeze cancer cells. Anesthesia is used to ensure patient comfort during these procedures.

Consideration of Daily Life Impact on Health

Numerous factors in your daily life have a significant impact on your overall health. Aspects like transportation, financial challenges, housing, access to food, and childcare can all influence your well-being. Difficulties in reaching medical appointments due to transportation issues or financial constraints might hinder access to necessary care. Financial limitations can also affect your ability to afford necessary medications. Additionally, residing far from grocery stores can pose challenges in obtaining nutritious food. If you encounter concerns in any of these areas or others, it’s recommended that you discuss them with your healthcare team. They are likely aware of local resources that can provide assistance, or they may have personnel who can offer guidance and support.

In summary, kidney cancer is a complex condition that demands tailored treatment approaches. By collaborating closely with your healthcare provider and discussing your concerns and preferences, you can make informed decisions about the most suitable treatment strategy for your specific situation.