RENAL CANCER | ASSOCIATE PROF. CENK ACAR
RENAL CANCER




What is renal cancer?
Renal cancer (renal cell cancer) is the malignant tumor arising from kidneys. Renal cancer comprises 2-3% of all adult cancers. Renal cancer is generally seen in advanced ages (after 60 years of age). Some familial inheritant types can be seen in earlier ages. It is more frequent in males than in females. It most frequently arises from the cells in the kidney that filters the urine. Apart from this, it can spread through blood and lymph nodes and locate in other areas of the body (bones and lungs).

What are the signs of renal cancer?
With the widespread use of imaging methods including ultrasound and tomography today, it is possible to diagnose the majority of renal cancers which confined in the kidneys. Therefore, while classically patients presented with blood in urine, pain and a feeling of a mass in their flank region, now it is possible to diagnose renal cancer in patients without any complaints coincidentally (during check-up tests or other imaging studies for other reasons).

Again, renal cancer can impair some balancing mechanisms in the body and can cause fever and sweating during nighttime, fatigue, increased blood calcium levels, overly high values of blood in some patients, impairment of liver functions and weight loss.

What are the causes of renal cancer?
Like in many other cancer types, the cause of renal cancer also has not been clarified fully yet. It has been found out that the most important risk factors known for renal cancer include smoking and obesity. Furthermore, it has also been reported that positive family history for renal cancer and high blood pressure are also potential risk factors. Renal cancer is two times more frequent in smokers than in nonsmokers. Familial inheritance has been shown also in some renal tumor types (Von Hippel-Lindau syndrome and Familial papillary polyposis Coli syndrome-Papillary cell cancer). Life style changes, quitting smoking and living with a healthy body weight can reduce the cancer risk.

How renal cancer is diagnosed?
Since renal tumors have several types, a series of tests will carried out to establish your situation. Such tests include the medical history and imaging studies (including computerized tomography and MRI). Family history can sometimes give important information. Abdominal computerized tomography and/or MR imaging are used to establish the tumor size and to determine its spread to renal vessels, lymph nodes or surrounding organs. This is important to determine the treatment that will be applied later. Furthermore, physical examination, blood and urinary analyses are performed.

How is renal cancer treated?
When determining the treatment that is right for you, spread of the cancer outside the kidney of to the entire body, patient-dependent factors (internal diseases, drugs used and general medical condition), and availability of the treatment options in the hospital. However, the most important factor in the selection of treatment is the stage of the disease.

Renal cancer treatment:
• Partial nephrectomy (removal of only the cancer tissue)
• Radical nephrectomy (removal of the entire kidney)
• Cytoreductive nephrectomy (with the purpose of increasing the response to future chemotherapy by removing the entire cancer or a great portion of it although there is not spread in the body)
• Active surveillance (clinical follow-up for very small masses or in very old patients)
• Ablation treatments (Radiofrequency ablation (by heating) and Cryotherapy (by freezing)
• Chemotherapy, Immunotherapy and other drugs
• Radiation therapy (only to the kidney with intractable severe bleeding or to treat the bone pain in cancer with bone involvement)