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Cancer of the kidney - Causes, symptoms and treatment. MF.

  • Cancer of the kidney - Causes, symptoms and treatment. MF.

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    Cancer of the kidney, ureter and bladder is referred to as malignant neoplasms of the urinary tract.
    Kidney cancer is a malignant tumor that develops from the renal parenchyma and is capable of rapid disruptive growth and metastasis.

    More often, a kidney tumor occurs in men, the average age of patients is 55-75 years.

    Reasons for developing kidney tumors:

    - Smoking - The risk of developing kidney cancer in smokers increases by 30-60%.
    - Changing the hormonal background.
    - Hereditary causes, family tumors.
    - Overweight - obesity increases the risk of kidney cancer by 20%.

    Symptoms of kidney cancer

    1. Nonspecific symptoms:

    body temperature rises, weakness, fatigue, dizziness, weight loss and decreased appetite.

    2. Specific symptoms:

    At the initial stages of the tumor, the kidneys are asymptomatic and are detected accidentally, when examined for other diseases. As the tumor grows, the following symptoms appear:

    Hematuria - the appearance of blood in the urine, in small amounts or in the form of massive clots that occur without cause and rapidly disappearing. Massive hematuria is an indication for urgent hospitalization and performing an operation to remove the tumor.

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    A palpable tumor formation in the abdominal cavity or enlarged kidney.

    Pain: may occur during hematuria with obstruction of the ureter, with the extension of the capsule of the kidney or its germination by the tumor, with the germination and compression of nerve trunks or large veins of the abdominal cavity.

    Diagnosis of kidney cancer

    Kidney tumor examination includes:

    - Ultrasound examination of the organs of the abdominal cavity, kidneys, retroperitoneal lymph nodes: allows to reveal the nodule formation in the organ, to estimate its size, the involvement of surrounding tissues, large vessels and lymph nodes.
    - Computed tomography and magnetic resonance imaging are used for more accurate diagnosis of neoplastic kidney damage, exclusion of distant metastases.
    - In unclear cases, some patients are shown percutaneous puncture biopsy of a kidney tumor under the supervision of an ultrasound or computed tomography: performed by means of a thin needle injected under local anesthesia into the tumor and taking a small piece of tissue under a microscope. This technique allows you to confirm the presence of a malignant tumor in almost 100% of cases.
    - Excretory urography ( X-ray images) - a rather outdated method of research, allows to assess the functional capacity of the organ when planning organosaving operations( kidney resection).
    - Radioisotope study of the kidneys - scintigraphy , allows to assess the kidney function and the degree of its violation under the influence of the tumor and also to suspect the nature of the tumor( benign or malignant).
    - In some cases, with large tumors of the kidney, angiography is used - a study of renal vessels with intravenous contrast, it allows to evaluate the involvement of large nearby vessels in the process.

    Angiography. The arrow shows a tumor in the lower pole of the kidney, the kidney artery

    is ad- vanced. Cystoscopy is an endoscopic examination of the bladder, used to identify the source of haemorrhage in bleeding, exclusion of the bladder tumor.
    - Additional methods for detecting a kidney tumor are: radiography of the chest, it is possible to study the skeleton to exclude distant metastases.

    Kidney growth stage:

    Stage 1: tumor not more than 7 cm, limited to renal tissue;
    Stage 2: tumor more than 7 cm, limited by renal tissue;
    Stage 3: a tumor involving large veins, either with adrenal invasion or surrounding tissue or the presence of metastases in the surrounding lymph nodes;
    Stage 4: the tumor grows into nearby organs, there is more than 1 metastasis in the nearby lymph nodes or distant metastases.

    Schematic representation of the tumor of the upper pole of the kidney with germination in the adrenal and pelvis

    Treatment of malignant tumors of the kidney

    The leading method of treatment, which gives hope for recovery, in the case of any malignant tumor, including kidney cancer, is surgical.

    Several variants of operations on the kidney are possible:

    - nephrectomy - removal of the affected kidney entirely, performed at 2-3 stages of the tumor process, with large sizes of formation and germination in the renal pelvis, provided the normal functional capacity of the second kidney;
    - resection of the kidney - removal of a part( 1/3 or half) of the kidney with a tumor, used for small tumors( not more than 4 cm), in young patients and in violation of the function of the second kidney.
    - combined operations - removal of the kidney with a part of nearby organs, large vessels, used for large tumor sizes, sprouting it into the above tissues.

    In some cases, radiotherapy is added to the treatment - irradiation on the bed of the removed kidney, in the presence of a large tumor and metastases in the nearby lymph nodes. In the presence of distant metastases, in case they are single, they perform operations for their removal. In the event that metastases are numerous and can not be removed, immunotherapy and chemotherapy are used to reduce tumors in size.

    Prevention of genitourinary cancer

    First of all, giving up smoking leads to a decrease in the incidence of genitourinary cancer, in particular, the risk of kidney cancer is reduced by 15%.Of great importance is the fight against obesity, eating fruits and vegetables reduces the risk of developing kidney cancer.

    Consultation of a doctor for kidney cancer

    1. Does kidney cancer often occur and what are the predictions of its treatment to date?
    Kidney cancer occurs, now, more and more often and is about 3% among malignant diseases of internal organs.
    The results of treatment depend on the stage of the tumor process, the size of the tumor, in the initial stages the survival rate of patients is close to 90%

    Oncologist doctor Barinova N.Yu