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Kidney Cancer

Kidney Cancer - What it is

​The two kidneys lie at the flanks of the body just behind the intestines, next to the spine. Kidneys form urine to clear some of the toxins produced by the body. The urine drains from the kidneys into ureters and then into the bladder. From the bladder, urine is passed out of the body. The cells that make up the kidney can become cancerous.

How common is Kidney Cancer?

Kidney cancer accounts for less than 1 percent of all cancers. It is slightly more common in men than in women, and is mainly detected in people in their middle-age.

Kidney Cancer - Symptoms

​It is important to seek medical advice if blood is seen in the urine. A bulge may also be noticed on one side of the tummy associated with pain and discomfort. There may also be weight loss or fever.

Kidney Cancer - How to prevent?

Kidney Cancer - Causes and Risk Factors

Kidney Cancer - Diagnosis

​If kidney cancer is suspected, a scan (such as computed tomography scan) is done to look at the kidneys in detail. If this test confirms abnormalities, surgery or a biopsy (removing a small piece of tissue from the tumour to look at under a microscope) will be required to obtain the diagnosis.

Kidney Cancer - Treatments

Surgery Surgery is the recommended treatment for early stage kidney cancer. Removal of the kidney is called nephrectomy. A person can live a normal lifespan with only one kidney if the other kidney is normal. Some patients with symptoms of pain and bleeding with minimal cancer spread elsewhere can also be offered surgery.

Sometimes radiation therapy is given. High-energy rays are focused onto the kidney cancer to relieve pain when the cancer is advanced and cannot be removed surgically. Another use for radiotherapy to the kidney cancer is to stop bleeding from the cancer. Systemic therapies, which comprise of targeted therapy and immunotherapy1, are used in advanced kidney cancer. It is not a cure but can prolong the life of the individual. There are an increasing number of new targeted therapies that have been developed in this setting2,3.

Prognosis of Kidney Cancer

Clinical examinations scans and pathology reports all help the medical team decide what the progress of kidney cancer is. The appropriate course of treatment may then be recommended. The treatment strategy will vary from person to person. Prognosis of kidney cancer depends on the extent of the disease (stage), the state of health of the individual as well as response to treatment.

Kidney Cancer - Preparing for surgery

Kidney Cancer - Post-surgery care

Kidney Cancer - Other Information

I have been diagnosed to have advanced kidney cancer. I have read about spontaneous remissions. What does that mean?

Occasionally, patients with advanced kidney cancer involving the lungs, have temporary disappearance of the kidney cancer in the lungs. After a while, the cancer returns. The reason for this is unknown.

My mother has advanced kidney cancer and she is not fit for surgery. Her urine is always heavily bloodstained. What can be done to stop the bleeding?

Radiotherapy to the kidney cancer may be able to stop the bleeding. Bleeding may also be stopped by embolisation. During this procedure, a thin tube is inserted through blood vessels in the groin and threaded up to the bleeding kidney. A gelling agent is injected into the blood vessel that supplies the cancer. This stops bleeding in most patients.

I have bloodstained urine periodically. Although I have seen a doctor on many occasions, only antibiotics have been prescribed. What more can be done?

There are a variety of causes of bloodstained urine, including infection, stone disease, and cancer of the urinary tract. Let your doctor know about your concerns regarding cancer. You may have to be referred to a urologist for further investigations.

Can I live a normal life with one kidney?

Yes, you can survive with one functioning kidney. Even with a slight impairment of functioning of the one kidney, one can still live normally and may not need dialysis.

How can I prevent recurrence of the cancer once I am in remission?

There are no proven recurrence prevention strategies at this point. You should continue with close follow up with your cancer specialist and maintain a healthy lifestyle. 

References

1. Fyfe G, Fisher RI, Rosenberg SA, et al. Results of treatment of 255 patients with metastatic renal cell carcinoma who received high-dose recombinant interleukin-2 therapy. J Clin Oncol 1995; 13:688. 
2. Motzer RJ, Hutson TE, Tomczak P, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol 2009; 27:3584. 
3. Hudes G, Carducci M, Tomczak P, et al. Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 2007; 356:2271. 


For further enquiries on kidney cancer, please call the Cancer Helpline at (65) 6225 5655 or email to cancerhelpline@nccs.com.sg.

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