Kidney cancer: the most important facts in brief
- Kidney cancer is a malignant growth of individual cells in the kidney
- The most common kidney tumor is renal cell carcinoma
- Kidney cancer symptoms are rare and non-specific
- Early diagnosis and treatment improves the chances of recovery
Kidney Cancer Definition: What is Kidney Cancer?
Kidney cancer is caused by the malignant (malignant) change and proliferation of individual cells in the kidney . These growths can originate from various kidney tissues and crowd out healthy tissue. By far the most common kidney cancer is renal cell carcinoma . This usually only affects one of the two kidneys , which is why patients rarely have problems with urination. Kidney cancer accounts for about 2% of all cancers . Most people with kidney cancer are diagnosed early and treated appropriately. With early diagnosis, the prognosis for a kidney tumor is favorable.
In addition to renal cell carcinoma, the rare renal pelvis carcinoma , which develops from tissue of the urinary tract, also falls under the term kidney cancer. Other types of cancer here are lymphoma, sarcoma , nephroblastoma (Wilms tumor), embryonic carcinoma or neuroblastoma . The cancer does not necessarily have to start in the kidney tissue, but can also arise from the metastases of other types of cancer, such as lymphatic cancer, lung cancer or breast cancer.
Epidemiology: Incidence of kidney cancer
Kidney cancer accounts for only about 2% of all cancers and is therefore a relatively rare tumor disease. In the UK, around 15,000 people are diagnosed with kidney cancer every year. Young people are rarely affected . The mean age at onset is 68 years for men and 71 years for women. Men fall ill almost twice as often as women . Robert Koch Institute estimates of incidence, mortality and survival rate in kidney cancer, 2016.⁴
Kidney cancer cause and risk factors
An exact kidney tumor cause could not be identified so far. However, certain factors appear to increase the risk of kidney cancer. These risk factors include:
- Gender, because men are almost twice as likely to have kidney cancer as women⁵
- Age, because the risk of kidney cancer increases with age⁶
- Smoking and passive smoking⁷
- alcohol consumption⁸
- lack of physical activity, overweight and obesity⁹
- high blood pressure¹⁰
- Regular use of certain medications, such as strong painkillers
- Contact with certain substances (e.g. asbestos, cadmium or halogenated hydrocarbons), which are particularly relevant in coal gas and coke production and in metal processing¹¹
- Terminal renal insufficiency (loss of function of the kidneys), e.g. due to drugs that damage the kidneys or repeated inflammation of the urinary tract¹²
- Kidney Transplant¹³
In addition to these risk factors, family disposition also plays a role in renal cell carcinoma. The cancer often occurs in patients with complex hereditary diseases such as von Hippel-Lindau syndrome or tuberous sclerosis.¹⁵
Typical kidney tumor symptoms
Kidney cancer hardly causes any symptoms , especially in the early stages . Accordingly, kidney cancer is accidentally discovered in more than half of the patients , for example during an ultrasound or preventive examination carried out for other reasons. Occasionally, however, symptoms that can indicate the kidney tumor also appear in the case of a kidney carcinoma. Typical kidney tumor symptoms are: In addition to such specific kidney carcinoma symptoms, kidney tumors also show unspecific symptoms , such as:
Diagnosis of kidney cancer: what is examined?
Kidney carcinomas rarely show specific symptoms. This is very problematic, because with cancer the following applies: The earlier the diagnosis is made, the more promising treatment is and the higher the chances of recovery!❗️If you recognize the above symptoms in yourself, you should consult a doctor without hesitation. This is especially true if you belong to the risk group for kidney tumors (see above: risk factors). If kidney cancer is suspected, various tests are initiated. These can help make an accurate cancer diagnosis. Possible examinations are in the S3 guideline diagnostics, therapy and follow-up care of renal cell carcinoma – version 2.0summarized from 2020. In addition to the physical examination, the most important methods are the blood test, the ultrasound examination, the computed tomography and the biopsy.
Kidney cancer: prognosis and course
As with other types of cancer, the earlier kidney cancer is detected and treated, the better the prognosis. Initially, renal cell carcinoma is limited to the kidney. Only when the tumor grows can the malignant growths infect nearby tissue, lymph nodes and organs and form secondary growths, so-called metastases.
Kidney Cancer Stages
Like other tumours, kidney cancer is divided into different stages according to the TNM classification . The classification is carried out depending on
- the size of the tumor (T: 1-4)
- the involvement of the lymph nodes (N: 0-1)
- the presence of metastases (M: 0-1).
Example: T1 N0 M0 indicates a small tumor confined to the kidney with no lymph node involvement and no metastases. The exact classification of a kidney tumor into the renal carcinoma TNM stages is usually only possible after surgical removal of the tumor. Based on the renal carcinoma TNM stages, kidney cancer is divided into stages I to IV.
Kidney cancer prognosis: chances of recovery and life expectancy
If kidney cancer is detected early , the chances of a cure are good. Of course, a prerequisite is appropriate and timely treatment, because as soon as the cancer has spread and affected other organs and lymph nodes, the kidney cancer prognosis becomes worse.
How can kidney cancer be treated?
Which treatment method is used for kidney cancer depends on the tumor stage (size, location, extent and aggressiveness of the tumour) and on individual patient factors , such as their age. Depending on the findings, various surgical or drug measures are available. If the kidney tumor has not yet spread to other organs, surgery is the most promising treatment method. The aim here is complete kidney cancer cure. On the other hand, in the case of metastatic kidney cancer , systemic treatment with medication or the performance of symptom-relieving surgery is recommended.
Curative surgery for kidney cancer
If kidney cancer hasn’t spread to lymph nodes or distant organs , removing the tumor is a promising treatment. In the standard therapy for renal cell carcinoma, the entire affected kidney is removed (nephrectomy). This is often done by laparoscopy, a so-called keyhole technique. If adjacent lymph nodes are already affected, these are also removed. The tasks of the removed kidney are taken over by the healthy one. The aim of this operation is the complete cure of kidney cancer.²³In the case of small tumors, it is often sufficient if only part of the kidney is removed. Such an organ-preserving operationis particularly useful if the patient only has one kidney or the second kidney is not working properly. Because in the case of kidney loss on both sides, the patients are dependent on regular blood washing, the so-called dialysis.
Symptom-relieving surgery for kidney cancer
The (partial) removal of the kidney does not always make sense – for example, if the renal cell carcinoma has already spread to lymph nodes or distant organs. In this so-called palliative situation , the removal of tumors is only promising in combination with systemic therapy. Alternatively, in the case of metastatic kidney cancer, the resection of metastases in other organs can be useful. Tumor embolization , which is used primarily in older patients, is also a treatment option for kidney cancer. The blood vessel that leads to the kidney is closed with a catheter so that the tumor is no longer supplied with blood and stops growing. This can produce at least short-term effects.
Kidney cancer systemic therapy
If the kidney cancer has already spread metastases to distant organs, suppressing the tumor with systemic therapy can make sense. Various medications are used here, which act throughout the body – i.e. systemically. With systemic therapy, symptoms can be alleviated and the quality of life improved.✔ Immunotherapy : In addition to foreign substances (e.g. viruses), the immune system can also fight diseased cells such as tumor cells . This is where immunotherapy comes in: The immune system is stimulated by certain substances (e.g. interferons, interleukins) to recognize and eliminate kidney cancer cells.✔ Antibody therapy: Antibody therapy is a further development of immunotherapy. In the case of metastatic kidney cancer, the so-called PD-1 inhibitor nivolumab is administered.✔ Targeted Therapy : In the case of renal cell carcinoma, a molecular, targeted therapy is also an option. This is directed against messenger substances, binding sites for messenger substances and the signaling pathways in the cells and thus influences tumor growth.✘ Chemotherapy : In cytostatic treatment (chemotherapy), fast-growing tumor cells are killed. Since chemotherapy is hardly effective in renal cell carcinoma, it is not used in renal cancer.✘ Radiation therapy: Renal cell carcinomas are not sensitive to radiation. Accordingly, radiation therapy is only used in the final stages to relieve pain.
Alternative treatment for kidney cancer
The classic treatment methods are not always the best choice for old patients or patients with severe health problems . On the other hand, active waiting can be useful here . The tumor is checked regularly (e.g. by ultrasound) and only removed from the kidney if the risk of metastasis increases and the tumor is growing very quickly. Another option for pre-stressed and old patients are ablative therapy methods . This includes the treatment and ideally the destruction of the renal cell carcinoma with cold (cryoablation) or heat (radiofrequency ablation).
Kidney cancer: aftercare and rehabilitation
After medical treatment for kidney cancer, follow-up care and rehabilitation begin . Possible consequences of the kidney tumor therapy are treated, the recurrence of the cancer is observed and the patients are supported mentally, physically and socially.
Prevention and screening of renal cell carcinoma
The best prevention of kidney cancer is avoidance of the (avoidable) risk factors and a healthy lifestyle . This includes not smoking and alcohol, regular exercise and a healthy and balanced diet. In addition, certain substances such as asbestos or cadmium and the regular use of painkillers should be avoided. In addition, people at particularly high risk and people in the second half of life should have regular check -ups and an ultrasound of the kidneys. In this way, kidney tumors can be detected and treated at an early stage. After all, the earlier kidney carcinomas are diagnosed, the better the chances of recovery and a healthy, long life!
The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.