Kidney Cancer

  • 3% of all cancers
  • Majority are found ‘by accident’ on scans done for other reasons
  • Most kidneys cancers have not spread to lymph nodes or other organs at the time of diagnosis
    • They therefore usually have a high cure rate
  • Not all kidney lesions are cancers: some are benign
Risk Factors
  • Smoking
  • Obesity
  • Hypertension
  • Dialysis
  • Family history
  • Hereditary syndromes (rare)
What Type of Cancer is it?
  • Renal Cell Carcinoma (RCC) is the most common type (90%). RCC is sub-classified into
    • Clear Cell RCC
    • Papillary RCC
    • Chromophobe RCC
  • The pathologist will be able to provide the exact type and grade of the cancer either from a biopsy or once it is removed
Stage of Cancer: How Far Has it Gone?

Just like all other cancers, the answer to the question is based on the international TNM classification system. The key questions for RCC include:

  • What is the size of the cancer?
  • Has it entered into the venous drainage of the kidney?
  • Has it spread into surrounding organs?
  • Has the cancer spread to the lymph nodes?
  • Has the cancer spread to other organs of the body?

This information will largely be obtained from the scans that are done prior to your treatment.

What Investigations Will I Require Prior to Treatment?

Important information will need to be gathered before a treatment plan can be established. Some of the tests required will include:

  • Blood test – especially to check kidney function
  • Imaging studies
    • CT scan of the chest, abdomen and pelvis – to determine stage of disease
    • Nuclear Medicine scan – to quantify function of each kidney. This scan is not always required.
    • Occasionally MRI scan is required
  • Biopsy – is sometimes required. Your doctor will be able to discuss this with you.
What Are My Treatment Options?

There are several options available but not all will be suitable for your needs. Your Urologist will be able to advise you which would be the most appropriate for your situation. A brief summary of each of the available options is included below.

  • Surgical – is the mainstay for curative treatment
    • Radical Nephrectomy
      • Where the whole kidney that contains the cancer is removed
    • Partial nephrectomy
      • Where only the cancer is removed and the remainder of the kidney left behind
      • Is not always an option: it will depend on the nature, size and location of the cancer
      • Carries additional risks compared to a radical nephrectomy that your surgeon will discuss with you
    • Active surveillance
      • Involves regular scans where the size of the lesion is monitored: some will increase in size at which time active treatment can be pursued
      • Usually reserved for small kidney lesions or where the risk of intervening currently outweighs the benefits
    • Other
      • Ablative – cryotherapy or radiofrequency ablation
        • Is not the gold standard treatment for cure: long-term cancer outcomes are not known
        • Is best suited for people in whom the risks of surgical treatment are high
      • Systemic treatment
        • Immunotherapy, targeted therapy
          • These are used in the setting of kidney cancer that has spread to lymph nodes and/or other organs
          • Are administered by a Medical Oncologist
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