World Kidney Cancer Day 2022: Who Is At A High Risk Of Developing Kidney Cancer? – Our kidneys work in tandem with the rest of the body to keep the entire body balanced. Therefore, kidney function is essential in preventing the body from becoming overly stressed. However, kidney diseases, such as kidney cancer, can impair kidney function. Tumours from the tubules that produce urine in the kidney cause kidney cancer or renal cell carcinoma that can spread throughout the body. This happens when healthy cells in one or both kidneys overgrow and lump together (called a tumour). Dr Sanjay Gogoi, HOD and Consultant Urology, HCMCT Manipal Hospital, Dwarka shares an understanding of various forms of kidney cancer, helping in early diagnosis and timely treatment.
What Are The Various Kinds Of Kidney Cancer?
- Different types of kidney cancer can be seen in various age groups. The one which affects the elderly (Aged above 50) is renal cell carcinoma, also known as RCC, the most common type of kidney cancer. It has subtypes like Clear Cell Renal Cell Carcinoma. Some are called papillary renal cell carcinoma. In a nutshell, renal cell carcinoma accounts for the most cases of kidney cancer in older adults.
- In children, we have a type of kidney cancer called Wilms’ Tumor which tumour is also called nephron blastoma. This cancer is seen in children as young as 1-2 years.
- Other rare types of kidney cancer include transitional cell carcinoma (TCC) of the kidney and upper collecting system, i.e., the pelvis of the kidney and the upper urethra.
In terms of incidence wise, probably RCC will top the list, followed by TCC.
What Are The Symptoms?
Most of the time, kidney cancer cases are presented with no gross symptoms. However, the symptoms may include blood in urine and weight loss, and some may present with a slowly increasing lump in the abdomen. Some people will also present with the side effect of the metastasis of a primary kidney tumour. For example, a patient had a sudden fracture of a forearm due to minimal trauma. When his case was investigated, it was found out that kidney cancer had spread to a particular bone, weakening it and leading to a fracture.
- Weightlessness is one of the most common symptoms of kidney cancer.
- Some people will present with various symptoms, which are called paraneoplastic syndrome.
- Some may come with endocrine dysfunction or the appearance of a big pimple on the forehead or scalp.
- Some may present with tumour development in the brain, a part of the kidney tumour constellation of presentation. This disease is called Von Hippel-Lindau Syndrome.
- Some may present with small skin lesions, skin tumours, and skin tags on the forehead or upper torso of the body.
- Children present with enlarged swollen in the abdomen.
How Is It Diagnosed?
- Clinical diagnosis is possible in identifying blood in urine, a person coming with blood in urine or blood loss in urine if he’s investigated. But simple methodologies like an abdomen ultrasound can pick up a kidney cancer to diagnose it. So does a CT scan which can accurately look at the kidney tumours.
- A CT scan has the added advantage of being able to tell which segment of the kidney can be preserved after the kidney tumour is dealt with. We can also look at other back factors, let’s say, whether the disease has spread to the surroundings, which means if the disease metastasized to the lymph nodes or other essential organs like the liver, the screen, lungs and so on.
- Once we can identify the disease as a kidney tumour, we sometimes ask them to get another test called a PET CT scan, which enables us to remember the spread of the disease to the rest of the body. That would mean from head to toe. So, these are the game itself investigations.
How Can It Be Treated?
- Treatment depends on the age group. This is because there are different tumours in different age groups. For example, the standard treatment method for kidney tumours was the excretion of the whole kidney; even today, the same process is used for transitional cell carcinoma. But for other types of tumours like renal cell carcinoma, what has happened in the last two decades is that we have realized the necessity to preserve as much of kidney tissues as possible so kidney failure can be prevented.
- A new treatment has evolved called a partial nephrectomy, whereby only the tumour containing part of the kidney is removed. If possible, the rest of the kidney is preserved. This treatment method is done by open surgical, laparoscopic, or even automated procedures. This is the most effective method. Preservation of kidney function is as known as nephron sparing surgery.
Who Is At A High Risk Of Developing Kidney Cancer?
The elderly age group who are beyond the age of 50 are at risk due to age factors:
- Smoking has a different risk of kidney cancer. A smoker and people exposed to industrial chemical agents are at the highest risk.
- Some can develop kidney cancer due to genetic disposition.
- People on dialysis tend to establish acquired cystic renal disease or high-risk renal cyst.
- People with congenital diseases like polycystic kidney disease are at high risk.
- The patient comes with multiple cysts that disfigured the entire shape of the kidney.
