Kidney Cancer: Causes, Symptoms and Diagnosis
Posted On: March 24, 2018
Kidneys are an important part of the human body and make a part of the urinary or renal system. Kidneys manage the waste removal system in your body by removing extra fluid and waste products from the blood in the form of urine.
This urine gets collected in a hollow space, known as the renal pelvis, located in the center of each kidney. The urine passes from the renal pelvis and gets collected in the bladder via a long tube, known as the ureter. It then leaves the bladder through a shorter tube, called the urethra.
Apart from the main functioning of eliminating the waste products from the body, kidneys even help in making certain substances that help in controlling the blood pressure and making the red blood cells.
On the top of each kidney, there is an adrenal gland. The kidney and the adrenal gland are surrounded by a layer of fatty tissue as well as fibrous tissue.
When your kidneys undergo any damage, due to infection or any underlying disorder, their functioning gets hampered. This can further lead to major health disorders, as kidneys carry out the vital function of removing excess fluid and waste products from your body.
What is Kidney Cancer?
Like other cancer types, kidney cancer occurs when the cells in the kidney start growing uncontrollably. The build-up of extra cells leads to formation of a tissue mass which is known as a growth, tumor or cysts.
Some cysts stand to be benign, which means they don’t spread to other body parts and are not harmful. The benign tumors can be treated or removed; they don’t harm the tissues around and don’t even grow back.
But sometimes, these cysts prove to be malignant which means they not only just grow in size but even spread to other parts of the body. They are a threat to life and even if they can be removed, they tend to grow back. Malignant cancers are the most dangerous of all and in most of the cases; these cancers prove to be fatal.
The malignant cancer cells spread to other body parts by breaking away from the kidney tumor. These cells can then travel through your lymph vessels to the nearby lymph nodes and can even spread through the blood vessels to the lungs, liver or the bones.
Once they get spread, the kidney cancer cells are likely to get attached to other tissues and grow in order to form new tumors which can damage the tissues.This is why timely diagnosis is so important in cancer because it helps in knowing if the tumor is cancerous or benign.
Causes of kidney cancer and risk factors?
The precise reasons that lead to kidney cancer, or for that matter any other cancer, is not yet known. Studies are still being conducted to find out what exactly makes the normal cells to divide and grow in an uncontrollable manner.
However, there are certain risk factors that can subject you to this deadly disease. Some of the commonly associated risk factors with kidney cancer happen to be:
Smoking: It is known to increase the risk of developing renal cell carcinoma (RCC). The intensity and amount of smoking has a direct impact on the severity of risk. It is even seen that the risk drops when you stop smoking.
Obesity: Your weight had the major impact in your overall well-being. From subjecting you to various disorders like diabetes, hypertension, blood pressure and others, being overweight can even put you at a risk of developing renal cell carcinoma (RCC). Obesity can even lead to changes in some of the hormones which can eventually lead to RCC.
Family history: If you happen to have a strong family history of the renal cell cancer, then the chances are high for you to suffer from RCC. The risk will be very high if your brother or sister had cancer. The precise reason as to what makes renal cancer run in family is not yet known. It is suspected that it could be due to shared genes, or exposure of both sufferers to an unfavorable environment that triggered the cancer cell growth.
Workplace exposures: Some studies state that workplace exposure to certain substances can also increase your risk of renal cell carcinoma. Some of such substances include cadmium (a metal type), organic solvents, like trichloroethylene and some herbicides.
High blood pressure: You will be at higher risk of suffering from kidney cancer, if you are suffering from high blood pressure. Some of the medicines as used for treating high blood pressure can also increase the risk of kidney cancer.
Diuretics: As per some studies, diuretics (water pills) are also linked to a mild increase in your risk of developing RCC. However, it is not yet clear if the risk increases because of the medicines or due to high blood pressure for which they are used.
Advanced stage kidney disease: If you are suffering from an advanced kidney disease that requires dialysis you will be at a higher risk of RCC.
Gender: The chances of renal cell carcinoma are more common in men as compared to women. This is because men are more into smoking and they even tend to be exposed to cancer causing chemicals at their workplaces.
Race: Among the different races, the African Americans and American Indians are known to have higher rates of RCC as compared to other races. However, the precise reasons to it are still not known.
Other Health Conditions
There will be a higher risk of you suffering from kidney cancer, if you happen to be suffering from any of the health conditions as mentioned below:
Von Hippel-Lindau disease: This condition often leads you to develop different types of tumors and cysts in various parts of the body. If you suffer from this medical condition, then you will be at an increased risk of developing the clear cell RCC, particularly at a younger age. You may even have benign tumors in the eyes, pancreas, brain, spinal cord, and other organs; plus a type of adrenal gland tumor which is known as the pheochromocytoma. This condition is often caused by mutations (changes) in the VHL gene.
Hereditary leiomyoma-RCC: In this condition, you will develop smooth muscle tumors known as the leiomyomas (fibroids) of the skin as well as uterus (in women) and even have a higher risk of developing papillary RCCs. This condition is often linked to the changes in the FH gene.
Hereditary papillary renal cell carcinoma: If you have this condition then you will develop the tendency of having one or more papillary RCCs. However, you will not have tumors in other body parts, which usually happens with the other conditions as stated here. The hereditary papillary renal cell carcinoma is associated with the changes in the MET gene.
Birt-Hogg-Dube (BHD) syndrome: In this condition, you will develop multiple small benign tumors of skin and it will even increase your risk of suffering from the different kidney cancers as RCCs and oncocytomas. You may even develop benign or malignant tumors in other tissues. BHD is associated with the gene, FLCN.
Familial renal cancer: In this condition, you tend to develop tumors known as paragangliomas in the head and neck area. One can even develop tumors called the pheochromocytomas of the adrenal glands and thyroid cancers. This condition increases your risk of developing cancer in both your kidneys before the age of 40. Familial renal cancer occurs owing to the defects in the genes SDHB and SDHD.
Cowden syndrome: This syndrome is known to increase your risk of thyroid, breast and kidney cancers and is associated to the changes in the PTEN gene.
Tuberous sclerosis: In this syndrome, you will develop multiple tumors, mostly benign in various parts of the body such as eyes, skin, lungs, brain, kidneys, and heart. Though most of these tumors are non-cancerous but in some rare cases, they can be detected as clear cell RCC. This syndrome is associated with changes in genes TSC1 and TSC2.
Hereditary renal oncocytoma: It is an inherited tendency, wherein people develop a kidney tumor known as the oncocytoma. This cancer type is mostly benign in nature, which means it is not cancerous.
What are kidney cancer symptoms and signs?
Blood in the urine: One of the most common symptoms of kidney cancer is blood in urine, known as Hematuria. Slightest amount of change in blood color making it appear brownish, pinkish or red. The blood in urine can be very inconsistent, and when the amount of blood in urine is very less, it will only be detected at the time of urinalysis. Sometimes blood in urine can even occur due to cysts, kidney stones, infection in kidney or bladder. If you notice blood in your urine, consult a doctor without any delay.
Lower back pain: One rare symptom associated with kidney cancer is back pain. However, it happens to be a common concern in people above the age of 40 which mostly happens because of musculoskeletal injury or disk degeneration. Around 41 percent of people suffering from RCC complain of back pain. But it is not experienced by most people unless cancer reaches a later stage. Intensity of the pain in case of RCC tends to vary. Some people experience a sharp pain while some have very mild ache.
A mass or lump around the abdomen: If you have a mass or lump in your abdomen, back or side, it could be indicative of kidney cancer. The lump usually feels like thickening, hard or bulging bump under your skin. However, kidneys lumps can’t be felt so easily. When the lump is discovered, the doctor will conduct various diagnostic tests like CT scan or ultrasound to confirm the same. Also, all lumps are not always cancerous. So your doctor will have to conduct various tests to know whether the lump is cancerous or not.
Sudden weight loss: Loss of weight is also a common symptom with kidney cancers. This normally occurs very quickly, as cancer spreads to other organs in the body. There will be a loss of appetite as you will not feel like eating.
Fever: It’s normal to catch a fever owing to cold, change in weather or any other condition. But if the fever is recurring and has no known reasons, it could be a possible symptom of kidney cancer.
Anemia and fatigue: In most cancer types, fatigue happens to be a most common symptom. And it even happens during the treatment process. People suffering from cancer often state that it is one of the most difficult symptoms to manage. Fatigue backed by cancer is enduring and it tends to interfere with your everyday activities.
Like fatigue, anaemia is also commonly associated with kidney cancer. People who are suffering from kidney cancer tend to have lower red blood cell count. This happens because kidneys signal the body to produce red blood cells. But cancer interferes with this signalling thus leading to lesser production of the RBCs. Moreover, anaemia can trigger dizziness, breath shortness, and fatigue and cause the skin to look pale.
The symptoms associated with kidney cancer are common with other health problems as well. This is why it is important that you get yourself diagnosed to ensure if you are suffering from kidney cancer.
Kidney Cancer Diagnosis
If your symptoms are indicative of kidney cancer, then your doctor will conduct some tests to figure out the precise cause behind the symptoms.
Firstly, the doctor will conduct a physical exam and along with that, the following tests will also be done:
Urine tests: Your urine sample will be checked in the lab to see if it contains blood and various other signs of disease.
Ultrasound: The sound waves as used during the ultrasound will make a pattern of echoes when they bounce off the organs in your abdomen. These echoes will then create a picture of the kidney and the surrounding. The picture helps in revealing the kidney tumor.
Blood tests: Your blood will be checked for various substances like creatinine. If there exists a high level of creatinine, it means your kidneys aren’t functioning efficiently.
CT scan: This test is done to see your urinary tract and lymph nodes clearly. If there is a tumor in the lymph nodes or urinary tract, it will be clearly seen during a CT scan.
MRI: This test is used in making the detailed pictures of the urinary tract and lymph nodes. The MRI scan can reveal presence of cancer in the lymph nodes, kidneys and other tissues in your abdomen.
IVP: In this test, you will be given an injection of dye through a vein in the arm. The dye will travel through your body and gets collected in the kidneys. The dye makes your kidneys show up on the x-rays. A series of x-rays will then track the dye as it moves from your kidneys to the ureters and bladder. If there is any problem with your kidneys or if there is a tumor, it will be shown on the x-ray.
Biopsy: This process calls for removing a tissue from cancer affected area. For diagnosing kidney cancer, the doctor will insert a tiny needle into your kidney and remove a small tissue sample. To guide the needle to the kidneys through skin, your doctor will use CT scan or ultrasound.
Determining Kidney Cancer Staging
When kidney cancer is diagnosed, your doctor will then focus on learning the extent or stage of cancer. Knowing the extent of cancer proves highly helpful in choosing the right treatment.
The staging process depends on the kidney tumor size and if it has invaded the surrounding tissues or has spread to other parts of your body. In order to determine the stage of kidney cancer, your doctor will conduct either of the following tests:
Blood tests: The blood will be tested for substances like calcium or LDH as kidney cancer patients tend to have higher levels of LDH or calcium in their blood. The blood test will even help in knowing if your liver is working properly.
Chest X-ray: Your chest’s x-ray would be done to see if there is a tumor in the lung, which mostly happens in the later stage of kidney cancer when it starts spreading to other parts of the body.
CT scan: The CT scans of chest and abdomen will be done to see if cancer has spread to your lungs, lymph nodes or any other body part.
MRI: An MRI helps in revealing cancer in the lymph nodes, blood vessels, and other tissues in the abdomen.
When any cancer spread from its area of origin to any other part in the body, the tumor so spread carries the same abnormal cells and the same name. For instance, if the kidney cancer spread to your lungs, it will still be called kidney cancer and not lung cancer. You will be treated for kidney cancer only and sometimes it is even known as the distant disease.
Stages of Kidney Cancer
Stage I: This is the primary stage of kidney cancer; here the tumor will be equal to the size of a tennis ball. And the cancer cells will only be found in area of their origin i.e. the kidneys.
Stage II: As cancer enters the next stage, it will be bigger than a tennis ball. However, in this stage also, the cancer cells will be in the kidney only.
Stage III: Now the tumor size will be bigger and it will even spread to one of the nearby lymph nodes. In some cases, cancer can even grow out and reach to the nearby blood vessels.
Stage IV: This is the last stage of kidney cancer wherein the tumor will grow through the layer of the fatty tissue plus the outer layer of fibrous tissue surrounding the kidney. The cancer cells can even spread to the lymph nodes, liver, lungs, bones, or other tissues.
Treating Kidney Cancer
Once kidney cancer is diagnosed and the stage has also been determined, the commonly recommended treatment options include surgery, targeted therapy, and biological therapy. Depending on your case, you may either receive just one treatment, or a combination.
Your doctor will choose the right treatment type for you considering the following:
- Tumor size
- If tumor has spread to other tissues outside the kidney
- If it has spread to other body parts
- Your age and overall health
Surgery for kidney cancer will be done with the goal of removing the tumor while also preserving the normal functioning of the kidney. It is done in two ways; one method involves removing the tumor from the affected kidney and is known as partial nephrectomy. The other method involves removing the affected kidney known as nephrectomy.
Radiation therapy is often used for controlling or reducing the symptoms of kidney cancer, which spreads to other parts of the body like brain and bones. It makes use of high-powered energy beams, like X-rays, for killing the cancer cells. It is even used for controlling or reducing symptoms of cancer that spread to other body areas like brain and bones.
Targeted therapy works by blocking the unusual signals as present in the kidney cancer cells that let them multiply. It precisely helps in treating cancer that has spread to other areas of your body.
A team of specialists will help you in planning the treatment. You may even have to consult a urologist, surgeon who holds expertise in solving the problems related to the urinary tract. Urology oncologists, radiation oncologists and medical oncologists can also help you with the treatment of kidney cancer.
Kidney cancer, like all other cancers can be extremely daunting, both physically and mentally. Delayed diagnosis and treatment can often result in death. This is why it is important that you take great care of your health and if you notice any unusual symptoms that hint at a disorder related to kidney, seek medical assistance at the earliest.
At Shalby Hospitals, we bring to you the most effective treatment for kidney cancer focused on supportive, medical and surgical care. Our healthcare team will help you know the possible treatment choices, the expected results, as well as the possible side effects - cancer treatments often affect the healthy cells which results in the side effects.
Our team of expert oncologists, radiation oncologists and medical oncologists, nurses and paramedical staff will provide you with complete assistance and supportive care for controlling the pain and other symptoms, as well as relieving the side effects of treatment.
ABOUT THE AUTHOR
Center Of Excellence
- Spine Surgery
- Radiology and Imaging
- Pulmonology and Chest
- Plastic Surgery
- Pathology And Microbiology
- Paediatrics and Neonatology
- Paediatric Orthopaedics
- Orthopaedic and Trauma
- Organ Donation
- Ophthalmology and Glaucoma
- Obstetrics and Gynaecology
- Obesity Surgery
- Neuro Science
- Maxillofacial Surgery
- Liver Transplant in India
- Knee Joint Replacement
- Intensive and Critical Care
- Infertility and IVF
- Infectious Diseases
- Hip Joint Replacement
- Hair Transplant
- General Surgery
- General Medicine
- Gastroentero Surgery
- ENT Surgery
- Endoscopy and Laparoscopy
- Endocrinology – Diabetology
- Emergency Medicine
- Dental Cosmetic and Implantology
- Cosmetic and Aesthetic
- Cardiothoracic and Vascular Surgery
- Arthroscopy – Sports Injury