Kidney cancer - the most common cancer of the genitourinary system, although it took a very modest place in the general range of cancers.
In the past 20 years have seen a stable and continuous growth of the disease and currently available for kidney cancer, accounting for approximately 4.5% of all cancer pathology.
Our article tells about the principles of treatment and symptoms of kidney cancer, diagnosis and prognosis of patient survival.
Suffer Kidney cancer most often in people aged 60 years, male patients 2 times more than women.The incidence of this disease increases from south to north, that is, the smallest number of cases observed in India, China, South America and the largest in Canada and Scandinavia.However, it is in Denmark and Sweden, in contrast to the rest of the world, there has been a significant decrease in detection of renal cancer, in other countries, the total number of cases increased by about 3% per year.
tend to cause kidney cancer remain unclear, but the elimination of certain risk factors can significantly reduce the risk of this disease.
- Smoking. This habit is a major risk factor for cancer in general and in particular renal cancer.Smoking increases the chance of developing the disease by 30 - 60%.If the patient stops smoking, his condition is slowly returning to normal, although not completely.It is believed that quitting smoking can reduce the risk of kidney cancer is already available at 15%.
- Obesity. Overweight is no less dangerous in terms of occurrence of kidney cancer than cigarettes.Overweight increases the risk of ill by 20%.Diet also plays a role.Vegetarians suffer from kidney cancer less often than people who consume a lot of animal protein.
- High blood pressure. There is evidence that hypertension increases the risk of kidney cancer by 20%.However, it is not clear, cause cancer or high blood pressure drugs, which in this case takes the patient.
- Long-term exposure to chemical toxins. work on chemically hazardous industries increases the risk of kidney cancer.The most dangerous are weaving, paper and rubber, rubber production, as well as occupational exposure to dyes, oils and salts of heavy metals.
- Dialysis. This procedure is used to treat kidney failure during their chronic diseases.In patients receiving long-term dialysis, as well as the risk is greatly increased after kidney transplantation.
proved that kidney stones or cysts in the kidneys increased risk of cancer of the body is not observed.The conclusion is obvious - the greatest risk of kidney cancer are smokers, obese people with high blood pressure.
Danger described the disease lies in the fact that it is a long time can not be yourself.Sometimes the first signs of kidney cancer can occur when the disease is already running strongly.The presence of the following signs speaks of large tumors and the running process, the presence of only 1 or 2 symptoms of kidney cancer is possible at earlier stages.
- Gross hematuria
This is blood in the urine, visible with the naked eye.Isolation of blood clots, accompanied by renal colic (see. Renal colic symptoms).When running the oncology process expressed hematuria causes anemia, acute urinary retention (bladder tamponade blood clots), ureteral obstruction.
actually reveal this manifestation of kidney cancer is not very easy.Women, because of the physiological characteristics of the act of urination is not often pay attention to the color of your urine, and males do not always, if a little blood.Guess why cancers of the urinary system detected more frequently in winter, especially in men?Because blood in the urine is very noticeable if to urinate on the snow.
back very non-specific sign of the disease.Pain constant, aching, dull, not very intense, localized in the lower part of the chest with the transition to the upper part of the waist.Pain is a common symptom of cancer of the right (left) kidney, as occurs on the affected side, it arises from the stretching and compression of the renal capsule nerve tumor.
- presence of visible (palpable) tumor
Kidney Cancers often grow to very large sizes, and patients can find a tumor in his stomach, or pay attention to the asymmetry of the belly in the mirror.Usually it is 3-4 and the stage of the process is felt lumpy, dense formation on the right or the left.
- signs of cancer intoxication
They are not manifestations of kidney cancer per se, but are common symptoms of the presence of oncological diseases.These include: weakness, fatigue, loss of appetite, progressive weight loss, increased sweating, periodic rises in body temperature to low numbers (up to 37 - 37,90S), anemia.Temperature increase in the early stages due to the immune response to tumor antigens, and only later on - is caused by inflammation and necrosis.
- Other symptoms
for kidney cancer are typical symptoms of compression of the inferior vena cava - swelling of the legs, deep vein thrombosis leg extension saphenous veins abdominal wall, liver dysfunction.If there metostazov in the surrounding tissues and distant organs, symptoms due to their location - with metastasis to the bone - pathological fractures and severe pain in the bones, metastases in the liver - jaundice (see jaundice symptoms.), With the defeat of the lungs - a cough, sputum with bloodbrain - headache, neuralgia, etc.
Usually, the first sign of the disease is blood in the urine of visible or detectable by laboratory tests..Also, in cases of suspected renal oncology performed blood chemistry to identify possible kidney failure, this data can dramatically affect the treatment strategy.
From instrumental methods is the safest renal ultrasound.Modern ultrasound equipment can detect cancer of the urinary system is already at a very early stage.All patients with more than one risk factor for this survey is recommended to not less than once a year.
gold standard in the diagnosis of kidney cancer is a computed tomography (CT) is the most secure and reliable method of detecting the disease.If a patient is scheduled surgery, the CT scan of the kidneys almost always performed.
kidney biopsy is performed when the instrumental methods can not distinguish benign from malignant tumors.Such situations do not occur often, so a biopsy at this form of cancer is rarely used.
- 1 stage - a tumor of 4 cm and did not germinate kidney capsule;
- Stage 2 - the tumor up to 7 cm, invades the kidney capsule, but not incorporated into the adjacent organs, metastasis to regional lymph nodes do not have;
- 3 stage - a tumor 4 - 7 cm, grows into adjacent organs, usually a ureter and \ or containers, but not beyond the capsule Gerota (connective tissue sheath that surrounds the kidney and perirenal fat), there are isolated metastases to regional lymph nodes;
- Stage 4 - the presence of metastases in distant lymph nodes or organs.
treatment of kidney cancer
treatment of any cancer of any stage must begin no later than 2 weeks from the time of diagnosis - it's the law.
- Surgical removal of the kidney (nephrectomy) - is the gold standard in the treatment of this type of cancer.Only nephrectomy gives hope to the patient for a final cure.The operation is performed open way, sometimes in the presence of the small size of the tumor (up to 4cm), kidney removal is carried out using a laparoscope.
- kidney resection - removing part of the kidney with a tumor is performed in the presence of small sized tumor in one of the poles.It is shown that in the presence of a single functioning kidney.
There is a reasonable question, but what if the cancer affects only one kidney, and resect it can not be?Modern replacement therapy (hemodialysis, peritoneal dialysis, transplantation) allows the patient to live quite comfortably without really kidney, and significantly longer than with uncured cancer.
- Embolization - is performed when it is impossible to remove the tumor.Under ultrasound or x-ray control into a vessel that feeds the tumor probe is introduced and the vessel is sealed.Deprived of blood flow to the tumor dies.
- Ablation - a tumor in the center of the instrument is entered and the tumor destroyed by ultrasound or cold.
ablation and embolization is performed when surgical treatment for any reason impossible.Cancer is not a cure, but it extends the life of the patient in the years to come.Also, the indication for these types of treatments are inoperable tumors, appealing persistent bleeding.
- Radiation therapy - as an independent method has shown the low efficacy in renal cancer.Used in inoperable states, as well as preoperative preparation for nephrectomy.
- Chemotherapy - used in the presence of metastases or
preventive measure before surgery.
Wilms tumor or nephroblastoma - neoplasm deriving from embryonic kidney tissue.Sick children exclusively, the most endangered age 2 - 5 years, but can occur and of twelve teenagers.The reasons are unknown, but the hereditary nature of the disease has been proven.
Symptoms of kidney cancer in children are the same as in adults - a sharp weight loss, pain of varying intensity and localization, increasing the size of the kidneys, fatigue.Features of Wilms tumor in that it can no visible signs grow to large sizes, so most of the parents found the baby about the feeling of the abdomen.
treatment with surgery alone.
prognosis of kidney cancer, as with any cancer depends on what stage started therapy.The usual criterion for the effectiveness of treatment in oncology is a five-year survival:
- When kidney cancer stage 1, it is about 90%
- 2 stages: 65 - 70%
- 3 stages: 50%
- Five-year survival in stage 4 does not exceed 10%
- the best prognosis is Wilms tumor, if it has not metastasized, the full recovery occurs in 70 - 90% of cases.