Cancer - Kidney

Kidney cancer is the eighth most common cancer in men and the tenth in women. The most common type of kidney cancer is renal cell carcinoma that forms in the lining of the renal tubules in the kidney that filter the blood and produce urine. Approximately 85 percent of kidney tumors are renal cell carcinomas. When kidney cancer spreads outside the organ, it can often be found in nearby lymph nodes, lungs, bones or liver, as well as the other kidney.

The current gold standard treatment is laparoscopic partial nephrectomy surgery. However, some patients could benefit from minimally invasive, kidney-sparing treatment, such as those with high surgical risk, underlying illnesses, multiple recurrent tumors, borderline kidney function or only one kidney.

Additionally given the recent success of percutaneous cryoablation, patients with kidney cancer may elect to avoid surgery and have their tumor treated this way. The urologist and interventional radiologist work together in a multidisciplinary team to determine whether a less invasive percutaneous ablation can be done safely and effectively.

Prevalence and Risk Factors

More than 32,000 Americans each year are diagnosed with kidney cancer-many of them don't have symptoms. Typically, those with kidney cancer are past the age of 40 and twice as often are men.

Other risk factors include:

• Smoking
• Obesity
• High blood pressure
• Long-term dialysis
• Von Hippel-Lindau syndrome

Symptoms

The incidence of kidney cancer is on the rise. Fortunately, the availability of modern imaging technology has led to more frequent detection of small, asymptomatic tumors that otherwise would be undetected. Often, small tumors do not cause symptoms and are discovered on CTs, MRIs or ultrasounds that are performed for some other reason, such as standard imaging studies (CT or ultrasound) performed during many emergency room visits. These small tumors are often the best candidates for nonsurgical treatment options. Common symptoms may include:

• Blood in the urine
• Side pain that does not go away
• A lump or mass in the side of the abdomen
• Weight loss
• Fever
• Feeling very tired

Kidney Cancer Diagnosis

In addition to a basic physical exam, urine test and blood tests, several other techniques can be used to diagnose kidney cancer. CT scan, MRI or ultrasound can be performed to see inside the body and identify a tumor. An image-guided needle biopsy can be done to remove tissue samples and look for cancer cells. At the time of diagnosis, 25 to 30 percent of patients have metastases.

In a biopsy, a sample of tissue from the tumor or other abnormality is obtained and examined by a pathologist. By examining the biopsy sample, pathologists and other experts also can determine what kind of cancer is present and whether it is likely to be fast or slow growing. This information is important in deciding the best type of treatment. Open surgery is sometimes performed to obtain a tissue sample for biopsy. But in most cases, tissue samples can be obtained without open surgery with interventional radiology techniques.

Treatments include Radiofrequency Ablation of the Kidneys and Transarterial Chemoembolization.