Kidney Cancer

Kidney Cancer

Kidney cancer is a condition when the cells in the kidney grow abnormally and out of control. This disease usually attacks people over the age of 60. While kidney cancer that occurs in children is called Wilms tumor.

The kidney is an organ that functions to filter metabolic waste from the blood and remove it in the form of urine. In addition, the kidneys also produce the enzyme renin as a blood pressure controller and the hormone erythropoietin which functions in the formation of red blood cells.

Just like other cancers, kidney cancer that is detected and treated early can increase the patient's chances of recovery. However, the success of treatment also depends on the type of cancer, the age of the patient, and other factors.

Causes of Kidney Cancer

Kidney cancer occurs due to gene mutations (changes) in kidney cells. This mutation causes kidney cells to grow abnormally and out of control. The group of abnormal cells then form a tumor that can spread to the whole kidney, or even to other organs of the body.

The exact cause of the mutation is not yet known. However, there are several factors that can increase the risk of kidney cancer, namely:

  • Smoking
  • Suffering from hypertension
  • Suffering from obesity
  • Having a history of kidney cancer in the family
  • Aged more than 50 years
  • Undergoing long-term kidney failure treatment, such as dialysis
  • Work in an environment where there is a risk of exposure to certain chemicals, such as equipment cleaning chemicals (trichloroethylene)
  • Suffering from genetic diseases, such as Von Hippel-Lindau syndrome
  • Male gender

Types of Kidney Cancer

Based on its characteristics, kidney cancer can be divided into several types, namely:

  • Renal cell carcinoma
    Kidney cancer is the type that most often attacks adults. Renal cell carcinoma begins in the layer of the renal tubules, which are a series of tubes that function to transport body fluids and blood to the kidneys.
  • Urothelial carcinoma
    Urothelial carcinoma is a type of kidney cancer that starts in the renal pelvis. Treatment for this type of kidney cancer is usually the same as bladder cancer , because it comes from the same cells.
  • Sarcoma
    This type of kidney cancer is very rare. Sarcoma begins in the connective tissue that surrounds the kidney organ.
  • Wilm's tumor
    Wilm's tumor is the most common type of kidney cancer in children. Generally, Wilms tumor is diagnosed in children under 10 years of age.

Symptoms of Kidney Cancer

Kidney cancer generally does not cause symptoms when it is still in the early stages. If it has entered an advanced stage, the symptoms of kidney cancer that can appear are:

  • Lumps around the waist or abdomen
  • Pain around the lower back and waist
  • A fever that never subsides
  • Excessive sweating, especially at night
  • Weight loss for no apparent reason
  • Loss of appetite
  • Pale, weak, and easily tired
  • Bloody urine ( hematuria )
  • Lack of blood ( anemia )

When should you go to the doctor?

As explained above, early stage kidney cancer generally does not cause symptoms. Therefore, if you have a condition or disease that is at risk of causing kidney cancer, check your kidney health regularly with a doctor .

Immediately check with a doctor if you experience symptoms of kidney cancer, especially if the complaint has been going on for a long time. Early detection and treatment can prevent life-threatening complications.

After being declared cured of kidney cancer, still do routine check-ups with the doctor. This is to prevent the recurrence of cancer.

Kidney Cancer Diagnosis

To diagnose kidney cancer, the doctor will ask questions about complaints, when the symptoms appear, and the patient's medical history. Next, the doctor will perform a physical examination to detect the presence of lumps or swelling around the lower back and waist.

The doctor will also perform supporting examinations so that the diagnosis obtained is more accurate. The supporting examination includes:

  • Blood tests, to measure the number of red blood cells, check kidney function and tumor markers ( tumor markers )
  • Urine test , to detect infection or blood in the urine
  • Scanning with USG, CT scan, or MRI , to see the condition of the kidney in more detail
  • Kidney biopsy, to detect cancer cells by taking and examining a sample of kidney tissue

Kidney Cancer Stage

The results of the examination above will be used by the doctor to determine the stage of kidney cancer. Based on the level of severity, kidney cancer is divided into four stages, as explained below:

  • Stage 1
    The tumor is no more than 7 cm in diameter and has not yet spread to the surrounding glands.
  • Stage 2
    Cancer has a diameter of more than 7 cm, but has not yet spread to the surrounding glands.
  • Stage 3
    Kidney cancer has spread to surrounding lymph nodes.
  • Stage 4
    At this stage, the cancer has spread to other organs, such as the intestines, pancreas, or lungs.

Kidney Cancer Treatment

The treatment for kidney cancer given by the doctor will be adjusted to the size, location, stage of the cancer, and the patient's overall health condition. Treatment methods that can be performed by a doctor are:

Operation

Surgery is the most common procedure used to treat kidney cancer. However, surgery can only be done if the tumor is still in the early stages. Common types of kidney cancer surgery are:

  • Partial nephrectomy , to remove a certain part of the kidney affected by cancer
  • Radical nephrectomy, to remove the entire kidney where there are cancer cells

Kidney cancer surgery can be done with two techniques, namely open surgery and laparoscopic or keyhole surgery. Open surgery is done by making a large incision in the abdomen or buttocks, while laparoscopy is done by making a small incision.

Ablation therapy

Ablation therapy is performed if the patient's condition does not allow for surgery. There are two ways that can be done in ablation therapy, namely:

  • Cryotherapy, which is a procedure to freeze and destroy cancer cells using liquid nitrogen
  • Radiofrequency ablation, which is therapy performed with high-powered sound waves to destroy tumors

Ablation therapy generally does not cause serious complications. However, this therapy can cause side effects in the form of bleeding around the kidney and damage to the ureter, which is the channel that carries urine from the kidney to the bladder.

Embolization

Embolization is performed if kidney cancer has entered an advanced stage and the patient's condition does not allow for surgery. This procedure aims to inhibit or reduce the blood supply to the cancer cells in the kidney. Thus, cancer cells in the kidney will die or disappear slowly.

Radiotherapy

Radiotherapy is a therapy to kill cancer cells using high-powered X-rays. One of the types of radiotherapy used is external radiotherapy. This action is performed by directing radiation rays to the kidneys from outside the patient's body.

Radiotherapy cannot cure kidney cancer. However, this therapy can slow the progression of cancer and help control symptoms.

Radiotherapy can be done if kidney cancer has spread to other parts of the body, such as bones or brain. However, radiotherapy can cause side effects, such as fatigue, diarrhea, or changes in skin color in the area affected by radiation.

Targeted therapy

Target therapy is the administration of specific drugs to overcome kidney cancer. This therapy can be given to deal with advanced stage kidney cancer that is not cured by other therapies. The drugs given in this therapy are:

  • Sunitinib
    This drug works by inhibiting protein kinase, which is an enzyme that helps the growth of cancer cells so that the development of cancer can be stopped. Sunitinib is available in capsule form.
  • Pazopanib
    Just like sunitinib, pazopanib also works by inhibiting the growth of cancer cells. Pazopanib is available in tablet form.
  • Sorafenib
    This drug works to stop the formation of new blood vessels that cancer cells need to grow.
  • Everolimus and temsirolimus
    These two drugs work by inhibiting or disrupting the function of MTOR, a protein that helps cancer cells grow and divide. Inhibition of MTOR function will prevent the development of cancer cells.

Complications of Kidney Cancer

Kidney cancer that is not treated immediately can cause a number of complications, such as:

  • High blood pressure (hypertension)
  • High levels of calcium in the blood
  • Increased erythrocytes
  • Liver or spleen disorders
  • Spread of cancer cells to other organs ( metastasis )

Kidney Cancer Prevention

Given that the cause of kidney cancer is not known for certain, there is no way to prevent this disease. However, living a healthy lifestyle can help reduce the risk of kidney cancer. Some of the efforts that can be made are:

  • Stop smoking
  • Maintain normal blood pressure
  • Maintain an ideal weight
  • Increase fruit and vegetable consumption
  • Exercise regularly
  • Using personal protective equipment in a work environment that is prone to exposure to hazardous chemicals
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