Kidney Cancer - Symptoms, causes and treatment

Kidney cancer is a condition when there is an abnormal and uncontrolled growth of cells in the kidney. Kidney cancer is one of the most common types of cancer. Although it can be experienced by anyone, kidney cancer most often occurs in people aged 50 years and over.

The kidneys are a pair of organs located on the right and left sides of the lower back ribs. This organ functions to filter metabolic waste in the blood and dispose of it in the form of urine.

In addition, the kidneys also produce the enzyme renin which functions to control blood pressure and the hormone erythropoietin which functions in the formation of red blood cells.

Causes of Kidney Cancer

Kidney cancer occurs as a result of DNA in kidney cells mutating, which changes its genetic structure and properties. This mutation causes kidney cells to grow abnormally and uncontrollably. As a result, this collection of abnormal cells forms a tumor that can spread throughout the kidneys or other organs of the body.

It is not known exactly what causes DNA mutations in kidney cells. However, there are several factors that can increase the risk of kidney cancer, namely:

• Smoke
• Have hypertension
• Have excessive weight
• Have a family history of kidney cancer
• Over 50 years old
• Undergoing long-term treatment for kidney failure, such as dialysis
• Working in an environment that results in exposure to certain chemicals, such as cadmium
• Suffering from congenital disorders, such as Von Hippel-Lindau syndrome
• Male gender

Types of kidney cancer

Based on its characteristics, kidney cancer can be divided into several types, namely:

• Renal cell carcinoma

  This type is the most common in adults. Renal cell carcinoma It begins in the lining of the renal tubules, which are a series of tubes that transport body fluids and blood to the kidneys.

• Urothelial carcinoma

  Urothelial carcinoma is a type of kidney cancer that begins in the renal pelvis. Treatment for this type of kidney cancer is usually the same as for bladder cancer because it originates from the same cells.

• Sarcoma

  This type of kidney cancer is a very rare type. Sarcoma It begins in the connective tissue surrounding the kidney.

• Wilm's tumor

  Wilm's tumor is the most common type of kidney cancer in children. Generally, this type is diagnosed before the child is 10 years old.

Symptoms of Kidney Cancer

Symptoms of kidney cancer are generally not felt by patients when they are still in the early stages. However, if it has entered an advanced stage, the symptoms of kidney cancer that can appear are:

• Lumps or swelling around the lower back and waist
• Pain around the lower back and waist
• Fever that doesn't go away
• Sweat a lot at night
• Losing weight
• Loss of appetite
• Pale, weak, and easily tired
• Bloody urine (hematuria)
• Lack of blood (anaemia)

When to go to the doctor

As previously stated, kidney cancer generally causes no symptoms at first. Therefore, if you are at high risk of suffering from this condition, you need to have your kidney health checked regularly by your doctor.

Immediately see a doctor if you experience the symptoms of kidney cancer above, especially if the symptoms and complaints occur continuously. Prompt diagnosis and treatment will reduce the possibility of complications that can be life threatening.

Keep doing regular checkups to the doctor even though you have recovered from cancer. It aims to prevent the recurrence of cancer.

Kidney Cancer Diagnosis

To diagnose, the doctor will ask questions about the symptoms and complaints experienced by the patient, when these symptoms appear, as well as the patient's medical history. Next, the doctor will perform a physical examination to detect any lumps or swelling around the lower back and waist.

The doctor will also perform a follow-up examination to confirm the diagnosis. These follow-up examinations include:

• Blood tests, to check for signs of impaired kidney function
• Urine test, to detect infection or blood in the urine
• Imaging tests, such as ultrasound, CT scan, or MRI, to examine the kidneys in more detail
• Biopsy, to detect the presence of cancer by taking a sample of kidney tissue

Kidney cancer stage

In addition to diagnosing, the results of the examination will also be used by doctors to determine the stage of kidney cancer. Based on the severity, kidney cancer is divided into 4 stages, namely:

• Stage 1

  At this stage, the cancer is no more than 7 cm in diameter and has not spread to the surrounding glands.

• Stage 2

  Stage 2 kidney cancer indicates the cancer is more than 7 cm in diameter, but has not spread to the surrounding glands.

• Stage 3

  In stage 3, cancer in the kidney has spread to the surrounding lymph nodes.

• Stage 4

  This stage is the most severe stage of kidney cancer. At this stage, the cancer has spread to other organs.

Kidney Cancer Treatment

Treatment of kidney cancer is adjusted to the size, location, and stage of the cancer, as well as the patient's overall condition. There are several treatment methods that doctors can use to treat kidney cancer, namely:

Operation

Surgery is the method most often used to treat kidney cancer. Surgery can be done if the cancer is still at an early stage with the aim of removing the tumor. There are 2 types of kidney cancer surgery, namely:

• Partial nephrectomy, which is a surgical procedure that removes certain parts of the kidney that are affected by cancer
• Radical nephrectomy, which is a surgical procedure that removes all parts of the kidney that contain cancer cells

Kidney cancer surgery procedures can be performed with 2 techniques, namely by open surgery which requires large incisions in the abdomen or back or by laparoscopy which only requires small incisions.

Ablation therapy

Ablation therapy can be done if the condition of the patient with kidney cancer does not allow surgery. This therapy can be done in 2 ways, namely:

• Cryotherapy

  Cryotherapy is a therapy that aims to destroy cancer cells by freezing them.

• Radiofrequency ablation

  Radiofrequency ablation is a therapy used to destroy cancer cells by heating the cells.

Ablation therapy generally does not cause serious complications, but it has side effects in the form of bleeding around the kidneys and damage to the ureters, the tubes that carry urine from the kidneys to the bladder.

Embolization

Embolization can be done if the cancer has entered an advanced stage and the patient's condition does not allow surgery. This procedure aims to block or reduce the blood supply to cancer cells in the kidney by injecting a special substance through a catheter into the renal vein.

By blocking the blood supply to the cancer, the cancer cells in the kidneys will slowly die.

Radiotherapy

Radiotherapy is a treatment method that uses high-energy X-rays to kill cancer cells. One type of radiotherapy used is external radiotherapy, by directing radiation rays to the kidneys from outside the patient's body.

Radiotherapy cannot completely treat kidney cancer, but it can reduce the patient's symptoms and slow the progression of the cancer.

This method is used if the cancer has spread to other parts of the body, such as the bones or brain. However, radiotherapy has some side effects, such as fatigue, diarrhea, or changes in skin color in the area exposed to radiation.

Target therapy

Targeted therapy is the administration of special drugs to treat kidney cancer. This therapy is generally used to treat advanced kidney cancer that does not heal with other therapies. Drugs that can be given in this therapy are:

• Sunitinib

  This drug works by inhibiting protein kinase, an enzyme that helps cancer cell growth, so that cancer development can be stopped. Sunitinib is available in capsule form.

• Pazopanib

  This drug works by inhibiting tyrosine kinase, an enzyme that stimulates cancer cells, so that the growth of cancer cells can be stopped. Pazopanib is available in tablet form.

• Sorafenib

  This drug works to stop the growth of cancer cells by preventing the formation of new blood vessels that cancer cells need to grow.

• Everolimus and Temsirolimus

  Both of these drugs work by inhibiting or interfering with the function of the MTOR protein found in cancer cells, so that the number of cancer cells does not increase.

Complications of Kidney Cancer

Kidney cancer can cause complications if not treated immediately. Some of these complications are:

• High blood pressure (hypertension)
• High levels of calcium in the blood
• Erythrocyte increase
• Disorders of the liver or spleen
• Spreading cancer cells

Kidney Cancer Prevention

Given the cause of kidney cancer is not known with certainty, then there is no way to prevent this disease. The best effort that can be done is to change the lifestyle to be healthier so that the risk of kidney cancer is reduced.

Steps that can be taken include:

• Quit smoking
• Maintain blood pressure
• Maintain ideal body weight
• Increase consumption of fruits and vegetables
• Exercise regularly
• Using personal protective equipment in a work environment that is prone to exposure to hazardous chemicals