Renal cell carcinoma

December 31, 2014

Overview

Renal cell carcinoma (also known as, RCC, hypernephroma, renal cancer) is the most common from of kidney cancer arising frm the prximal renal tubule. It is the most common type of kidney cancer in adults. Initial treatment is most commonly a radical or partial nephrectmy. Where the tumur is confined to the renal parenchyma, the 5-year survival rate is 60-70%, but this is lowered considerably where metastases have spread. It is resistant tradiatin therapy and chemtherapy, although some cases respond timmuntherapy. Targeted cancer therapies such as sunitinib, temsirlimus, bevacizumab, interfern-alpha, and possibly srafenib have improved the utlk for RCC (progressin-free survival), although they have not yet demonstrated improved survival.

Symptoms

Abdominal pain and swelling
Back pain
Blood in the urine
Swelling of the veins around a testicle (varicocele)
Flank pain
Weight loss

Other symptoms that can occur with this disease:

Excessive hair growth in females
Pale skin
Vision problems

Causes

Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50 - 70.

The exact cause is unknown.

The following may increase your risk of kidney cancer:

Dialysis treatment
Family history of the disease
High blood pressure
Horseshoe kidney
Polycystic kidney disease
Smoking

Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)

Prevention

Stop smoking. Follow your health care provider's recommendations in the treatment of kidney disorders, especially those that may require dialysis.

Diagnosis

The health care provider will perform a physical exam. This may reveal:

Mass or swelling of the abdomen
A varicocele in the male scrotum

Tests include:

Abdominal CT scan
Blood chemistry
Complete blood count (CBC)
Intravenous pyelogram (IVP)
Liver function tests
Renal arteriography
Ultrasound of the abdomen and kidney
Urine tests

The following tests may be done to see if the cancer has spread:

Abdominal CT scan
Abdominal MRI
Bone scan
Chest x-ray
Chest CT scan
PET scan

Prognosis

Sometimes both kidneys are involved. The cancer spreads easily, most often to the lungs and other organs. In about one-third of patients, the cancer has already spread (metastasized) at the time of diagnosis.

How well a patient does depends on how much the cancer has spread and how well treatment works. The survival rate is highest if the tumor is in the early stages and has not spread outside the kidney. If it has spread to the lymph nodes or to other organs, the survival rate is much lower.

Complications

High blood pressure (hypertension)
Too much calcium in the blood
High red blood cell count
Liver problems
Spread of the cancer

Treatment

Surgery to remove of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer is removed with surgery.

Hormone treatments may may the tumor smaller in some cases.

Chemotherapy is generally not effective for treating kidney cancer. However, the drug interleukin-2 (IL-2) may help some patients. It is a very powerful drug that can have severe side effects.

Newer medicines to treat kidney cancer include:

Sorafenib (Nexavar)
Sunitinib (Sutent)
Temsirolimus (Torisel)
Bevacizumab (Avastin)

Radiation therapy usually does not work for kidney cancer.

Resources

Call your health care provider any time you see blood in the urine. Also call if you have any other symptoms of this disorder.

You can ease the stress of illness by joining a support group whose members share common experiences and problems.