Kidney cancer – More hope than ever

Dr Sylvia Rodrigues expands on why there is more hope than ever when looking at the treatment options for kidney cancer.

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Kidney cancer is a significant health concern worldwide. It originates in the cells of the kidneys (two bean-shaped organs located near the middle of the back). The kidneys play a crucial role in filtering blood, removing waste, and balancing bodily fluids. When cells in the kidney begin to grow uncontrollably, they can form tumours, leading to cancer. 

Types of kidney cancer

The primary type of kidney cancer is renal cell carcinoma (RCC), which can be further categorised into various subtypes:

• Clear cell renal cell carcinoma is the most common subtype, accounting for about 80% of RCC cases.
• Papillary renal cell carcinoma makes up about 15% of RCC cases.
• Chromophobe renal cell carcinoma is a less common form that tends to have a better prognosis than other types.
• Transitional cell carcinoma arises in the renal pelvis and can resemble bladder cancer.
• Wilms tumour primarily affects children and is rare in adults.

Symptoms of kidney cancer

Kidney cancer often develops without noticeable symptoms in its early stages. Many patients are diagnosed incidentally during imaging tests for unrelated issues. However, as the disease progresses, symptoms may include:

• Blood in urine
• Flank pain or persistent back pain
• Unexplained weight loss
• Fatigue or general malaise
• Palpable mass in the abdomen

These symptoms can overlap with other conditions, making it crucial to consult a healthcare professional for accurate diagnosis.

Risk factors

Certain factors can increase the likelihood of developing kidney cancer:

Age: The risk increases significantly after age 50.

Gender: Men are about twice as likely to develop kidney cancer compared to women.

Obesity: Excess body weight is linked to higher rates of RCC.

Smoking: Tobacco use increases the risk for several cancers, including kidney cancer.

Hypertension: High blood pressure may also contribute to increased risk.

Family history: People with a strong family history have a higher chance of developing kidney cancer.

Treatment options

The management of kidney cancer typically involves a combination of surgical and non-surgical approaches:

Surgery

The primary treatment for localised RCC is surgical intervention, which may involve:

Radical nephrectomy: Removal of the entire kidney along with surrounding tissues. This approach is often recommended for larger tumours or those that have invaded surrounding structures.

Partial nephrectomy: Removal of only the tumour and some surrounding healthy tissue. This option preserves more kidney function and is increasingly preferred when possible.

Radiation therapy

While not commonly used as a primary treatment for RCC, radiation therapy can help relieve symptoms or treat metastases. It may be particularly useful for patients who experience bone pain due to metastatic spread.

Targeted therapy

Targeted therapies are designed to attack specific characteristics of cancer cells. These drugs can inhibit tumour growth by blocking pathways that promote cancer cell proliferation. 

Immunotherapy

Immunotherapy has emerged as a cornerstone in RCC treatment. This approach harnesses the body’s immune system to fight cancer cells effectively. 

Stereotactic body radiation therapy

A newer option that delivers high doses of radiation precisely to tumours while sparing surrounding tissue is stereotactic body radiation therapy (SBRT). 

This technique has gained attention for its effectiveness in treating tumours located near vital organs without requiring invasive surgery. This makes it an attractive option for patients who are medically inoperable or prefer non-invasive treatments.

Other ablative therapies

Radiofrequency ablation uses radio waves to generate heat to destroy cancer cells. Microwave ablation uses microwaves to generate heat, and cryoablation involves freezing of the tumour cells.

More hope than ever

Kidney cancer remains a significant health issue globally, with renal cell carcinoma being its most common form. Early detection through awareness of symptoms and risk factors can lead to better outcomes. 

With advancements in treatment options, including surgery, targeted therapies, immunotherapy, local ablative therapies, patients now have more hope than ever for effective management and improved survival rates.

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