Prof. Dr. Raj Nagarkar, MD & Chief of Surgical Oncology and Robotic Services, HCG Manavata Cancer Centre, Nasik

Kidneys form one of vital organs in the human body, the major contributors to our physical wellbeing. These bean-shaped organs, about the size of a fist, are located on either side of the spine and carry out primary bodily functions like purifying the blood, flushing out toxins, and maintaining electrolyte and fluid balance. When malignant cells start growing in kidneys, it is defined as Kidney Cancer or Renal Cell Carcinoma, one of the top 10 diagnosed cancers worldwide in adults, in all genders.

Kidney cancer is an abnormal growth of malignant cells in either or both kidneys that clump together, forming a mass. Contrary to the belief, not all kidney tumours are cancerous. They can either be benign, malignant, or indolent – meaning latent. If the tumour turns out to be malignant, it is categorized under Kidney Cancer. If not treated on time, these cells not only interfere with the functioning of the kidneys but also spread to other nearby organs and result in fatality.

Treating Kidney cancer demands medical specialists with world-class expertise, including nephrologists, oncologists, surgical oncologists, and radiologists.

Symptoms of Kidney Cancer

Unlike other cancers, Kidney cancer doesn’t present with any significant signs and symptoms in the initial stages. However, if you notice the following changes in the body, meet your doctor immediately.

• Excruciating pain in the back that doesn’t go away with rest and medication
• Sudden loss of appetite and aversion toward food
• Unintended weight loss
• Fever
• Nausea and tiredness
• Bleeding in urine

Causes

The reasons behind Kidney cancer are not defined as one or multiple causative factors. Kidney cancer can be caused by certain mutations in the kidney cells which cause changes in the structure of the DNA. These changes might trigger cell growth and mutate faster, leading to further accumulation that may grow beyond these vital organs and metastasize. However, the other risk factors include:

• Old age
• Smoking and indiscriminate use of tobacco
• Overweight
• High blood pressure
• Getting treated for kidney failure. Patients on prolonged dialysis are at risk of kidney cancer.
• Family history or inherited syndromes like von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis complex, hereditary papillary renal cell carcinoma, or familial renal cancer.

Types of Kidney Cancer

There are many types of Kidney cancer, which are categorized based on the malignant cells’ behaviour, structure, and mutations.

• Renal Cell Carcinoma:

It is the most common type of Kidney cancer diagnosed among adults. It develops in the proximal renal tubes, thus disrupting the filtration process.

• Urothelial Cell Carcinoma:

Also defined as Transitional Cell Carcinoma, this is a rare type that starts in the renal pelvis, an area where urine gets accumulates before getting transported into the urinary bladder.

• Sarcoma:

A sporadic type of Kidney Cancer, Sarcoma, happens in the soft tissue layering the connective tissue around the kidneys and spreads to other parts of the day at a rapid rate.

• Wilms Tumour:

Diagnosed often in children, Wilms Tumour is also known as Nephroblastoma. Though a rare type of cancer, it is usually detected in children aged between 3 to 5 and is less common as they age.

• Lymphoma:

Lymphoma happens when lymph nodes get enlarged and affect the kidneys. Lymphoma increases the size of the kidneys and presents as a lone mass in the kidney.

Diagnosis

Kidney cancer is diagnosed by running blood and urine tests and coordinating the results with imaging tests, including Ultrasound, X-Ray, PET-CT, and MRI. A biopsy sample – extracting a small sample of cells or tissue from the affected area and testing it later under the microscope helps understand malignant cells’ behaviour, structure, and mutations, based on which staging is done.

Treatment

The first step towards treating Kidney cancer is surgery. The surgical may remove the entire affected kidney – complete nephrectomy or only the part of the diseased kidney – partial nephrectomy.

In the case of smaller tumours, non-surgical treatment options like Cryoablation – freezing of cancer cells or radiofrequency ablation – heating or burning the cancer cells is also an option.

The other treatment options include radiation therapy, immunotherapy, and targeted therapy.

Chances of Reoccurrence

There are chances for Kidney cancer to recur, and it is often detected within the first three years of treatment. Maintain a healthy lifestyle, practice nutritional eating habits, quit smoking, keep up with your doctor’s appointments, and take medications on time to prevent a recurrence.

Remember, early diagnosis plays a crucial role in combating cancer. So, if you ever notice any unusual symptoms like the one mentioned in this article, see your doctor immediately.