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Medical & Legal Information on Kidney Cancer: Causes & Treatment Options
• Kidney Cancer Overview
• Risk Factors
• What Causes Kidney Cancer?
• Diagnosing Kidney Cancer
• Signs and Symptoms
• Treating Kidney Cancer
Kidney Cancer Overview
Kidney Cancer (renal cancer) begins with cancerous (malignant) kidney cells that grow out of control and form a tumor. Nearly every form of kidney cancer initially appears in the kidney in the lining of tubules (tiny tubes). Many cases of renal cell carcinoma are found in the early stage before the cancer can metastasize (spread) to distant sites and organs of the body.
Treating the disease is usually more successful during its early stage. However, tumors can grow quite large in size before being detected. Most renal cancer tumors begin growing as non-cancerous (benign) or cancerous (malignant) cyst (flood-fluid sac).
An All Too Common Disease
Statistics maintained by the Kidney Cancer Association and the American Cancer Society revealed that in 2015, more than 50,000 of the approximate 1.3 million new cases of diagnosed cancer in the United States involved kidney cancer. Fortunately, because of advancements in surgical procedures, diagnostic tools, and treatment options, more than 200,000 individuals living in America are survivors of this form of cancer.
In recent years, numerous drugs have been approved by the FDA (Food and Drug Administration) that are designed to target specific carcinoma cells in various ways. Even though renal cancer is one of the leading common cancers in women and men, early detection through a diagnosis can minimize many of its harmful effects.
Doctors, researchers, and scientists have yet to determine the exact cause of kidney cancer. However, specific factors are thought to increase the potential risk of its development. As an example, renal cancer happens more often in individuals who are 40 years or older. Other risk factors include:
- Smoking – Cigarette and cigar smokers are twice as likely to develop kidney cancer as non-smokers.
- Gender – Women are only half as likely to develop kidney cancer as men.
- Obesity – Carrying excess weight can cause significant changes to body hormones and increased the potential risk of developing the disease.
- Long-Term Pain Medication Use – Prescription and over-the-counter pain medications are known to increase the potential risk of kidney cancer development.
- Long-Term Dialysis – Individuals receiving dialysis treatment after their kidneys have stopped working have a higher risk of developing renal cancer.
- Genetics – Inheriting papillary renal cell carcinoma or von Hippel-Lindau disease seems to increase the potential development of renal cancer.
- Family History – Siblings are especially at risk of developing the disease if their parents and ancestors have a history of kidney cancer.
- Exposure to Chemicals – Exposure to some herbicides, organic solvents, benzene, asbestos or cadmium can increase the potential of kidney cancer development.
- High Blood Pressure – Doctors do not know if the increased risk of developing the disease is the result of high blood pressure or if it is possibly the treatment medication.
- Lymphoma – Scientists have directly linked patients with lymphoma and the increased potential developing kidney cancer.
- Ethnicity – Blacks have a slightly higher risk of developing the disease than Caucasians.
Having one or every risk factor in no way guarantees the individual will have an increased potential of developing kidney cancer.
What Causes Kidney Cancer?
Even though the risk factors listed above can increase the potential of developing kidney cancer, there is no clear correlation that any developing abnormal kidney cells can over time become cancerous.
New research on changes in the structure of DNA in a normal kidney cell is revealing insight to the cause of some cancers. Normal DNA provides guidance to every ‘oncogene’ cell in the body to grow, divide and live long enough to reproduce before dying. However, any change in the DNA structure which could be caused by numerous factors can turn off the guidance of oncogenes, causing the formation of cancerous cells.
- Inherited Gene Mutations – Scientists are recognizing that some inherited DNA changes have the potential to cause specific kidney cancer syndromes, including the tumor suppressor gene von Hippel-Lindau (vHL) disease. Other genes have been linked to hereditary renal cell carcinoma, Birt-Hogg-Dube syndrome, leiomyoma, and familial renal cancer that are known to increase the potential risk of kidney cancer development.
- Acquired Gene Mutations – Alternatively, some kidney cancer-related DNA mutations can be acquired instead of inherited, including non-inherited sporadic RCC that can be acquired during an individual’s lifespan, leading to renal cancer.
Diagnosing Kidney Cancer
Early detection of cancer can improve the patient’s outcome. Doctors can perform various tests to detect cancer early, however, none of them are recommended to screen patients for kidney cancer who are at average risk of the disease. Diagnosticians will perform tests and imaging that include:
- Urinalysis (Urine Test) – This test is usually a part of a comprehensive medical checkup where trace amounts of blood are detected in the urine. However, numerous other diseases, conditions, and injuries can cause blood to be found in the urine including a bladder infection, a UTI (urinary tract infection), noncancerous (benign) kidney stones, and bladder cancer.
- Imaging Tests – MRI (magnetic resonance imaging) and CT (computed tomography) Scans can detect small kidney cancers cells. However, these tests are not commonly performed due to the high cost. Instead, doctors will perform an ultrasound as a more affordable solution for detecting kidney cancer during its early stage.
- Intravenous Pyelogram (IVP) – The doctor may recommend x-raying the kidneys after injecting a dye the travels through the urinary tract. This dye can highlight tumors and make them easier to detect.
Usually, kidney cancer is not detected by accident but is instead identified when the doctor is diagnosing other conditions including gallbladder problems. Typically, kidney cancer is not associated with pain and its survival rates are extremely high for individuals who are found to have the disease during the early stage.
Signs and Symptoms
For most individuals, kidney cancer has no obvious symptoms or signs. However, the most common indicators of the disease include:
- Hematuria (blood in the urine)
- Extreme tiredness (fatigue)
- A lump (tissue mass) in the lower back, abdomen or side
- Non-injury associated lower back pain
- Low red blood cell count (anemia)
- Ongoing non-infection associated fever
- Unexpected weight loss not associated with dieting
- Swelling of the legs or ankles
If the renal carcinoma spreads to other areas and organs in the body, the disease has the potential of causing other symptoms including bone pain, coughing up blood and shortness of breath.
Treating Kidney Cancer
After the doctor verifies their diagnosis of the presence of kidney cancer, they will next stage the disease to determine the treatment options that might include:
- Biological therapy (immunotherapy)
- Targeted therapy
- Active surveillance
Usually, the doctor will recommend the patient participate in various treatments that will be used concomitantly. These treatments will be conducted by a treatment team that could include a urologist, radiologist, radiation oncologist, medical oncologists and other specialists including nurse practitioners, physician assistants, nurses, social workers, physical therapists and other health care professionals.
Before the patient chooses the treatment or treatments, it is essential to discuss every option and all potential side effects with each healthcare provider. In addition, obtaining a second opinion is usually the best idea to be fully informed of the benefits and the potential downside of every treatment choice.
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