Kidney Cancer

 

A Definition of Kidney Cancer:

Kidney Cancer Stage 1The kidney is an organ about the size of your fist whose job is to filter the blood and remove waste products and excess fluid from the body. In addition to making urine, the kidney performs other important functions, many of which we are only beginning to appreciate. Most people are born with two kidneys.

Cancer that forms in the tissues of the kidneys is called kidney cancer. The term kidney cancer includes three subtypes, and a number of genetic conditions:

  • Renal cell carcinoma forms in the lining of the nephrons, small tubules that filter the blood. This is also called renal parenchymal cancer.
  • Renal pelvis carcinoma forms in the center of the kidney where the waste products are collected as urine and passed to the bladder.
  • Wilms tumor is a type of kidney cancer that most commonly develops in children under age 5. This is also called nephroblastoma.
  • TSC, VHL, BHD, HLRCC and SDHB are only a few of the genetic conditions that can lead to kidney cancer. If there is cancer in the family, it is important that the doctor know that in planning a treatment strategy.

Kidney cancer is the 14th most common cancer in the world, with 274,000 new cases diagnosed in 2008. This data comes from the World Cancer Research Fund International, which has data by country and gender: kidney cancer statistics

In recent years, there have been exciting advances in diagnostic and therapeutic approaches to kidney cancer. Recent advances in available treatment include:

  • A new class of targeted drugs that that inhibit tumor growth by blocking angiogenesis, or blood supply, to tumor cells
  • Another class of targeted drugs that block a growth pathway within cancer cells
  • Clinical trials of other new therapies to attack kidney cancer
  • “Nephron sparing” kidney surgery to preserve long-term kidney function
  • Radiology-based ablation procedures for nonsurgical therapy of kidney cancer
  • Minimally invasive surgical procedures to treat early forms of kidney cancer

Your medical team will help you explore the options that are best for your own situation.

Kidney Cancer – Basic

IKCC strives to provide kidney cancer information in a form easily read and understood. There are many resources on the internet that go into greater detail. (See Resources)

Kidney cancer is a kind of cancer that originates in the kidney. Cancer is “cell growth out of control.” Beyond that, cancer is more than 100 different diseases. In the kidney there are several different cell types. The cell type is important because the strategies or drugs needed to halt the advance of each type will be different.

The most important questions to ask your doctor first are:

  • What is the SIZE of the tumor that has been found.
  • Is this a TUMOR or a CYST?
  • Is the tumor WELL CONTAINED, or has it spread beyond the kidney?

Based on a scan, your doctor may not yet have enough information to answer all of these questions. You and your doctor will work out a plan to gather the additional information needed. Other questions to consider:

  • Are there other family members who have had cancer?
  • At what ages?
  • What kinds of cancer?

Be sure to report this information to your doctor. Cancer is more often found among older people. If anyone in the family has had cancer under the age of 50, or if this person has had multiple kidney cancer tumors, possibly on both kidneys, it is possible that there is a genetic alteration that might be promoting cancer, or failing to stop it. If this is true, then it will be important for you to meet with a genetic counselor and determine what genetic alteration might be present. It will be important for your doctor to have this information in order to plan an appropriate treatment strategy for you.

It is best to find kidney cancer when tumors are small. Smaller tumors can usually be removed without great injury to the kidney. Once the tumor is out the doctors can examine the tumor tissue and tell you with confidence what cell type you are dealing with. Based on that information, they can tell you whether the cell type is or is not one of the more aggressive types, or whether the tumor has been removed and is unlikely to recur.

Once a kidney cancer tumor has spread beyond the kidney capsule we say that it has “metastasized.” There may already be some metastatic spots visible in some other part of the body. These spots are called “mets.” Treatment of the mets is as important as treatment of the primary tumor.

Remember that as your treatment plan is composed, YOU are as important a member of the team as any of the doctors. YOU need to understand what is happening, and feel comfortable with the plan. The following articles are intended to help you learn the medical vocabulary your doctors will use, and understand the basic strategies available. Your doctors will guide you through the options they recommend. Ask any and all questions, and feel free to contact one of the many kidney cancer support organizations in the world.

Introduction to Kidney Cancer, by Robin Martinez

Written by Robin Martinez. Robin is a full-time mental health worker at Mt. St. Vincent Home in Denver, Colorado. She cared for her husband who died of kidney cancer. As the primary moderator of the KIDNEY-ONC online support group since 1998, she has spoken with and provided information and comfort to thousands of people with all kinds of kidney cancer. Since KIDNEY-ONC moved to SmartPatients in 2012, she has been the owner and moderator of these key online discussions.

Kidney Cancer for Ordinary People, by Ken Youner

Kidney Cancer for Ordinary People, by Ken Youner.
Written by Dr. Ken Youner, updated by Deb Maskens, and reviewed by the Advisory Board of Kidney Cancer Canada. Dr. Youner was a gastroenterologist (stomach doctor) for 30 years, but even so he knew little about kidney cancer. When he was diagnosed with Stage IV kidney cancer, he retired from his practice and began to learn more about kidney cancer. He was an active member and moderator of the KIDNEY-ONC list, now at SmartPatients.com. Deb Maskens is a member of the Board of Kidney Cancer Canada and is vice-chair of the IKCC.