Renal Cell Carcinoma

What is Renal Cell Carcinoma ?

The kidneys are bean-shaped organs that are located on each side just below the rib cage. The kidneys help to filter the blood and get rid of excess water and waste in the form of urine.

Renal Cell Carcinoma happens to be the most common form of kidney cancer in adults. The symptoms show up as the cancer advances.

Symptoms of Renal Cell Carcinoma

The most common symptoms of renal cell cancer are as follows:

  • Blood in the urine (haematuria)
  • Pain in the sides of back
  • Presence of palpable mass in the abdomen or on the side of the back
  • Swelling around the left testicle
  • Weight loss
  • Night sweats
  • Unexplained fever

Causes of Renal Cell Carcinoma

The exact cause of renal cell carcinoma is yet to be identified, but several factors can contribute to renal cell carcinoma, it includes the following:

  • Smoking is one of the most common reasons for developing cancer, the more a person smokes, the more the risk of cancer
  • Obesity plays a major role in increasing the risk of renal cell cancers
  • Exposure to asbestos, heavy metals.
  • Cystic kidney disease
  • Polycystic kidney disease

Stages of Renal Cell Carcinoma

The most common system used for staging lung cancer is the TNM system.

T stands for Tumour. It is used to describe the size of the tumour. It also helps to determine whether the tumour has grown into other parts of the organ or tissues around the organ. It is represented by a range of 1 to 4. The higher the number means the larger the tumour.

N stands for Lymph Nodes. It helps determine if cancer has spread to the lymph nodes around the organ. NX means the impact on lymph nodes cannot be determined. N0 means cancer hasn’t spread to nearby lymph nodes while N1, N2, and N3 means cancer has spread to lymph nodes. N1 to N3 also shows the range that how many lymph nodes are affected.

M stands for Metastasis. It is used to determine if cancer has spread to other parts of the body through blood or lymphatic system. MX means the metastasis cannot be determined; M0 means cancer has not spread to other body parts while M1 indicates that it has spread to other body parts.

Sometimes lowercase letters like a, b and c are used to divide the tumour, lymph nodes, and metastasis into subcategories. Also lowercase “is” is used to denote carcinoma in situ. E.g. Tis

For the convenience of grading the extent of spread of cancer, the cancer is classified into 5 broad stages.

Stage 0

It is the earliest stage of cancer. In this stage, cancer is present only in the innermost lining of the kidney. It has not spread anywhere. This stage can also be called as carcinoma in situ.

Stage I

In this stage, the tumour is seen to be of 7 cm or smaller and is only localized in kidney. It has not spread to the any lymph nodes or any distant organs (T1, N0, and M0).

Stage II

The tumor is seen as larger than 7 cm and is only located in the kidney. It has not spread to any lymph nodes or any distant organs (T2, N0, and M0).

Stage III

Stage III is an advanced stage of cancer in which one of the following instances can occur:

A tumor of any size is localized in kidney. It has spread to the nearby lymph nodes but not to other parts of the body (T1 or T2, N1, M0) or the tumor has grown into major veins or may or may not have spread to regional lymph nodes. It has not spread to other parts of the body (T3, any N, and M0).

Stage IV

In 4th stage which is considered as the most advanced form of cancer, the following can happen:

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Renal Cell Carcinoma

Risk Factors

Certain factors increase the chances of developing renal cell carcinoma. These are as follows:

Smoking
Obesity
Family history of kidney cancer
Chronic Kidney Disease
High Blood Pressure
Gender (Men more likely to get cancer)
People of the African race are more at risk of developing kidney cancer.

Diagnosis of Renal Cell Carcinoma

Renal cell carcinoma is diagnosed by the following tests:

  • Tissue Biopsy: A sample of tissue is collected for by fine-needle aspiration technique to check for the cancer growth
  • Imaging tests: These tests include MRI, CT, and PET that help determine the extent of spread of cancer in kidneys and beyond the kidney.

Treatment of Renal Cell Carcinoma

Renal cell carcinoma can be treated by one or a combination of the following treatments:

  • Surgical removal of the whole kidney by a procedure known as radical nephrectomy
  • Radiation therapy to kill cancer cells in the affected area.
  • Chemotherapy to kill or restrict the growth of cancer cells.
  • Immunotherapy also called biologic therapy is designed to boost the body’s natural defenses to fight against cancer. It uses materials made either by the body or prepared in a laboratory to improve, target, or restore normal immune system function.
  • Targeted Therapy: It is a type of treatment that targets genes specific to cancer which is important for its growth and survival.

Prevention of Renal Cell Carcinoma

It is not possible to prevent kidney cancer, but some important steps can be taken to lower chance of getting it:

  • Stop Smoking
  • Maintain a healthy weight
  • Keep a check on blood pressure