The kidneys are part of the urinary system. Its function is to clean the blood by filtering, filter waste materials in the blood and ensure that the excess fluid is excreted from the body as urine. While the kidneys, each of which is the size of a fist and resembling a bean, also regulate blood pressure; It produces hormones that help control red blood cells and other body functions.
KIDNEY CANCER is the abnormal growth of cells of the kidney tissue.
When healthy cells change and grow out of control in one or both kidneys, they begin to form a mass called a renal cortical tumor. Kidney tumors can be benign or malignant or indolent. A malignant tumor is cancerous, tends to grow, and can metastasize to other tissues or vital organs of the body. Slow-growing tumors are also cancerous, but they rarely spread to other parts of the body. Benign tumors can grow but do not spread. It is usually treatable if diagnosed at an early stage.
Although the causes of kidney cancer are not known, a number of risk factors that can trigger cancer formation are defined. Factors that can increase the risk of kidney cancer include:
• Old age: The risk increases as you get older. For this reason, it is recommended not to delay doctor visits and go for regular screening after the age of 40.
• Family history of kidney cancer: If there is a genetic predisposition, the risk increases.
• Smoking: As with all types of cancer, smokers have a higher risk of developing kidney cancer. While the length of the smoking period increases the risk, quitting smoking can reduce the risk.
• Obesity: Obese people are at higher risk than individuals with a healthy weight. Excessive weight gain and fat can cause kidney function disorders and increased cancer cell formation.
• Hypertension: High blood pressure increases the risk of kidney cancer.
• Kidney failure treatment: The risk of developing kidney cancer is higher in people who are treated for chronic kidney failure and take dialysis for a long period of time.
• Radiation: There may be a risk for women undergoing radiation therapy due to cancers in the reproductive organs.
• Long-term use of drugs: Some drugs, especially pain relievers, may cause dysfunction in the kidneys.
• Exposure to Chemicals: Metal workers exposed to chemicals such as petroleum, lead, asbestos and cadmium are at risk.
• Hippel-Lindau (VHL): It is a genetic disorder that causes tumors in the kidneys.
• Tuberculosis: It is a type of disease that causes seizures and intellectual disability as well as forming tumors in many different organs.
Kidney cancer may show no obvious symptoms in its early stages and can sometimes be found during tests for another condition or cause. As the tumor grows, symptoms begin to appear. That's why it's usually diagnosed after it starts to spread. Kidney tumor symptoms may include:
• Blood in the urine (Hematuria)
• Presence of a lump or mass in the abdomen
• Pain in the back, abdomen and sides
• Swelling and sudden pain in the lumbar region
• Extreme fatigue
• Appetite and weight loss
• Night sweats
• High fever of unknown cause
• Bone pain
Some of these symptoms only occur when the cancer has progressed and spread to other parts of the body, such as the bones, lungs, brain.
Kidney cancers may not show symptoms in their early stages. Therefore, it is important to have regular check-ups for early diagnosis without waiting for the disease to show symptoms. In case of symptoms, the doctor may refer to some tests after listening to the person's medical history and performing a physical examination. A number of tests and imaging techniques performed to obtain information such as the size, shape, location of the tumor, the degree of involvement of the lymph nodes and whether it has metastasized are as follows:
Urine tests: Urine sample is taken to detect if the urine contains blood.
Blood tests: By looking at the creatinine levels, it can be determined whether the kidney is performing its normal function or if the red blood cell values are low (anemia).
Magnetic resonance imaging (MRI): Allows the visualization of the internal organs using radio waves, powerful magnets and computer.
Computed tomography: Three-dimensional images are taken showing the tissues as well as the surrounding tissues. This test is usually done with intravenous contrast (dye). People with impaired kidney function may not be able to tolerate the dye.
Ultrasonography: It is used to detect tumors with different densities than healthy tissues.
Renal mass biopsy: Kidney cancer biopsies are the process of taking a sample from the tissue by inserting a thin needle into the tumor in order to reveal the structure of the lesion detected in the kidney.
Treatment depends on your general health, your age, and how advanced the cancer is. The most common treatment is surgery. There are surgical options such as only the part of the kidney that contains the tumor (partial nephrectomy) or the removal of the entire kidney and some of its surrounding tissue (radical nephrectomy). If one kidney is removed, the remaining kidney can usually function as good as two kidneys would. The surgery can be performed by open surgery or laparoscopic surgical methods.
Apart from surgical methods, chemotherapy or radiation, biological or targeted treatment methods can be used. In targeted therapies, it is aimed to provide healing without damaging the normal cells of the person, and drugs that act on certain cancer cells can be used in this direction.
After the doctor has the knowledge of the stage of the tumor, he or she can plan the treatment more effectively. The stage of kidney cancer is from 1 to 4 in roman numerals. The higher the numbers, the more critical the phases. These phases are as follows:
Stage I: In stage 1 kidney cancer, there is a cancerous growth up to 7 cm inside the kidney. It did not metastasize to lymph nodes or other organs.
Stage II: A tumor larger than 7 cm is found in the kidney. It has still not spread to the lymph nodes and other organs.
Stage III: There are various combinations of tumor sizes and locations that make up this stage. For example, if a tumor of any size has grown into tissue around a large vessel or kidney, or has spread to nearby lymph nodes, your cancer is in stage three.
Stage IV: The tumor has spread to the surrounding lymph nodes and distant organs such as bones, lung, liver.
Renal cell carcinoma is the most common type of cancer in adults. It covers 90% of tumors. Young children are more likely to develop a type of cancer called Wilms' tumor (nephroblastoma).
Although it is not possible to prevent genetic factors, it is possible to make some changes in lifestyle and environmental factors. Taking steps to improve a person's overall health can help reduce their risk of kidney cancer. The measures that can be taken to reduce the risk are as follows:
• Quitting smoking: There are many methods of quitting, including support programs, drugs, and nicotine fulfilment products to quit smoking and tobacco products. Together with your doctor, you can determine the most suitable treatment for you.
• Healthy weight maintanence: Overweight or obese people should reduce the amount of calories and control their weight with a healthy diet program. Being physically active by exercising regularly is also extremely important.
• High blood pressure control
• Sleep patterns: Adequate and quality sleep helps the body to regenerate and stay fit.
• Avoiding stress
• Prevention of chemical exposure: Prevention of occupational chemical exposures can reduce the risk of kidney cancer.
• Avoiding unnecessary supplementation
Because the cause of kidney cancer is not fully known, it is not possible to completely prevent the disease. However, small changes in habits can be made to improve the quality of life.