In a rather interesting study presented recently at the European Congress on Obesity in Glasgow, it has been revealed that obese and tall children are more likely to develop kidney cancer during adulthood as compared to their average-sized peers. For this research, scientists enrolled 301,422 individuals born between 1930 and 1985 and measured their weight and height at the ages from 7 to 13 years. The researchers observed them for the next 32 years and found that 1,010 individuals among them had renal cell carcinoma (RCC). Among the study participants, 680 were men. Men are twice as likely as women to develop kidney cancer. According to scientists, children who earlier had average height and later grew above average had an 8 per cent increased risk of RCC.
Renal cell carcinoma is the most common form of kidney cancer especially in adults. There are 4 stages of kidney cancer. While the first two stages are mild and moderate, the last two stages are severe, advanced forms, where the cancer cells spread to other organs. Till now, the exact cause of RCC has not been found. But, doctors believe that something probably goes wrong in kidney genes that leads to RCC. There are several factors including smoking, obesity, hepatitis C, acquired cystic kidney disease etc. that may increase your risk of developing kidney cancer like RCC. If you develop this condition, you will experience symptoms like blood in pee, unexplained weight loss, satiety, fever, back pain in one side, fatigue, high blood pressure etc. Most of the kidney cancers are diagnosed before they spread to different organs. As far as their diagnosis is concerned, doctors perform certain tests, physical exam, and ask about your health history. To confirm the condition, they will conduct urine test, blood test, intravenous pyelogram (X-ray of your kidneys), CT scan, ultrasound, MRI, or renal arteriogram. After confirmation of the disease, based on the stage of kidney cancer, treatment will be planned. Read on to know about these treatment options.
Surgery
Though there are various remedial options, surgery is the first line of treatment for kidney cancer in maximum number of cases. In this procedure the surgeon removes the malignant tumour. However, you may need follow-up treatments post a surgery to get rid of the residual cancer cells that the operation couldn’t remove. There are basically 6 types of surgeries available for kidney cancer in India. These include:
- Radical nephrectomy
Also known as complete nephrectomy, radical nephrectomy is the most common type of surgery for kidney cancer used for patients in an advanced stage where the cancer cells have spread to other organs as well. Here, the urologic surgeon removes the entire affected kidney along with the fat surrounding it, the adrenal gland, surrounding tissues, nearby lymph nodes, and a portion of the ureter. Usually it is considered as a safe procedure but does carry the risks of infection, bleeding, and injury in other nearby organs. You can opt for open surgery, robotic surgery, or laparoscopic surgery which is a minimally invasive surgery.
- Simple nephrectomy
This is a surgical method for kidney cancer in which only the affected kidney is removed. Life after this procedure isn’t that tough as living with one functional kidney is possible.
- Partial nephrectomy
Also known as nephron-sparing surgery, partial nephrectomy involves removal of only the tumour, not the kidney. In some cases, along with the tumour, at least 10 per cent of kidney tissues are also removed if the cancer cells have spread to those tissues. Partial nephrectomy can be performed either through open or robot-assisted laparoscopic surgery. This procedure is used for patients with smaller tumours (less than 4 cm). Also, doctors consider this treatment option the best for those cases, where a radical nephrectomy might hurt the unaffected kidney also. If you have tumours in two kidneys instead of one, in that case, tissues from both will be partially removed. Though the efficiency of your kidneys in this scenario may reduce, the remaining tissues wok well enough to support a healthy life.
Cryoablation
This is a minimally invasive procedure in which doctors freeze the tumours to destroy them. Occasionally called cryotherapy or cryosurgery, this treatment option requires only three to four small incisions through which ultra-thin cryoablation needles are inserted into the tumour site. Now, argon gas is delivered inside the tip of the needles where it cools below -100 degree Celsius. As a result of this, an ice ball forms around the needle which engulfs the tumour and kills few affected surrounding tissues sparing the healthy ones. After that, youy doctor may put ultra-thin thermal sensors at the margin of the tumour to ensure that the entire tumour is destroyed. It takes around 2 to 3 weeks to completely recover after this surgery. Doctors advise to refrain from physical activities post the treatment to avoid any complication. Also, they follow the patient closely post cryoablation and perform MRI scans at first, third, and sixth months. It has fewer complication, shorter recovery time, small incision and less scarring.
Radiofrequency ablation
It is also a non-invasive treatment option for kidney cancer. It includes high-energy radio waves to destroy the tumour. Usually considered safe and efficient, in this surgical procedure a needle is placed through the skin into the tumour by making a small incision. This needle contains an electrode through which high-frequency electric current is passed to kill the tumour cells completely. Radiofrequency ablation is considered ideal for patients with tumour of less than 4 cm in size in one kidney or those who may have difficulty with surgery.
Arterial embolization
Your kidney tumours need blood to grow and if that blood flow is stopped, they may shrink. Arterial embolization stops blood flow to the kidney. In this procedure a thin tube is inserted to the large blood vessel of the groin. After that, it is moved up toward the renal artery that supplies blood to the kidneys. Then, special gelatin sponges are injected through the tube into the artery. These sponges get bigger and solid and block the flow of blood to the kidney tumour leading to shrinkage. Arterial embolization is performed to relieve the symptoms of kidney cancer before the actual surgery and to avoid the probability of heavy bleeding from a large tumour during the surgery.
Biologic therapy
Also known as immunotherapy, biological therapy is a new way of treating kidney cancer that uses your own defence mechanism to control tumour growth. It is done by training the immune system to recognize the cancer cell and destroy it with the help of certain drugs or by using antibodies. The antibodies actually block the self-defence mechanism used by cancer cells to prevent attack and destruction by the body’s immune cells making them vulnerable to an immune attack. Biological therapy is used to treat kidney cancer that has spread to other organs. It is also applicable to cases where surgery has failed and the cancer relapses. Though immunotherapy is used in India to treat kidney cancer, it doesn’t have home-grown immunotherapy drugs. Also, this treatment method is expensive (costs around 1 crore per year).
Targeted therapy
There are basically three types of targeted therapy, namely anti-angiogenic agents, multikinase inhibitors, and m-TOR inhibitors. The first one prevents the blood vessels from feeding the tumour leading to its shrinkage. The second one involves usage of drugs or other substances to find and target specific molecules in the cancer cells that send signals to the cancer cells to grow. The drugs stop the growth of the cancer cells preventing any harm to healthy cells around them. The third one blocks an enzyme pathway that allows cancer cells to grow. Targeted therapy is used in malignant kidney tumours with specific gene mutation.
Radiation therapy
It is a treatment option for kidney cancer that involves the use of high-energy X-rays to destroy cancer cells. Radiation therapy is used only if there is any complication in undergoing surgery, the patient needs a therapy to get relief from the symptoms of the condition and the kidney cancer has spread to other parts as well.
Chemotherapy
Chemotherapy isn’t considered to be that effective for kidney cancer. However, it is still used in some cases, but only after a targeted therapy or immunotherapy. Through chemotherapy, anti-cancer drugs are administered to the patient through the vein or orally. This therapy is used especially when the kidney cancer tumour has spread to other parts of the body as well.