Renal Cell Carcinoma (Kidney Cancer)

Renal Cell Carcinoma (Kidney Cancer)

Overview

Kidney cancer refers to cancer that develops within the kidney. The different types of renal cancers are renal cell carcinoma, urothelial carcinoma, oncocytoma or renal sarcoma. Wilm`s tumour is a common renal tumour in children.

What are the signs and symptoms?

The most common signs and symptoms are

  • Blood in Urine
  • Lower abdominal or back pain
  • Loin swelling or mass
  • Fever or anaemia
  • Loss of weight and easy fatigue
  • The classic triad of haematuria, loin pain and loin mass is rarely seen now.

Evaluation

  • Urinalysis, cytology, culture and sensitivity should be performed to exclude urinary tract infection.
  • Renal function tests are to be done if planning for nephrectomy, however, if one kidney is functioning well the renal function should be normal.
  • Blood tests to detect iron-deficiency anaemia (from haematuria) or polycythaemia
  • CT renal scanning before and after intravenous contrast is the best initial investigation.
  • MRI or ultrasound scanning may be used if the results are equivocal.
  • Intravenous urogram (IVU) may be needed, especially to show any obstruction to flow.
  • Cystoscopy can exclude bladder tumours as a cause of haematuria.
  • Renal angiography may possibly be required to assess the blood supply.
  • CXR/ CT chest or PET CT for metastatic workup if required
  • Metastases: skeletal survey or bone scan may be required for bone metastases. A brain CT scan may also be indicated, depending on symptoms.
  • Renal biopsy may be indicated - in patients with metastatic disease planned for systemic therapy

Treatment options

  • Surgery is the mainstay of treatment for renal cancers
  • Partial/ Radical nephrectomy either open or minimally invasive is preferred treatment of choice.
  • Minimally invasive procedures like radiofrequency (RF) ablation, cryoablation, microwave ablation, laser ablation and high-intensity focused ultrasound ablation may be an option for patients not suitable for open or laparoscopic surgery.
  • Chemotherapy is usually not effective in renal cell cancers.
  • Patient may require immunotherapy or molecular therapy in case of advanced renal cell cancer.

What we offer in our centre?

All the above treatment options for renal cell carcinoma are available in our centre including

  1. Laparoscopic and open surgery for Renal cell carcinoma
    • Lap/open Radical nephrectomy
    • Lap/open Partial nephrectomy
    • Radical nephroureterectomy
  2. Molecular and immunotherapeutic drugs for advanced renal cell carcinoma
  3. Strontium or Samarium therapy for bone metastasis
  4. Ablative procedures for those who are not fit for surgical resection

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