(By Dr. Urmila Anandh, HOD, Nephrology, Amrita Hospital, Faridabad)
Kidney cancer develops when the cells in the kidneys undergo mutations and start multiplying without any control. This cancer is common in the elderly and often is seen in the sixth to eighth decade. The other risk factors of kidney cancer include:
- Smoking
- Obesity
- High blood pressure
- Patient with chronic kidney disease and dialysis
- Certain inherited conditions- tuberous sclerosis, Von-Hippel Lindau disease
- Family history of kidney cancer
The main type of kidney cancer is called renal cell carcinoma(RCC). The pathologist will look at the tumour cells and the most common diagnosis is called clear cell carcinoma. Besides RCC, the other cancers of the kidney include Wilm’s tumour, renal cell sarcoma, and transitional cell carcinoma.
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Symptoms:
Kidney cancer is often considered to be a physician’s cancer as the symptoms are often vague and subtle necessitating an initial consultation with the physician. Unlike other cancers in the abdomen, the commonest presentation is not within a lump or pain, but usually non-specific symptoms like fever, fatigue, weight loss, loss of appetite and swelling of legs. When these patients have blood in the urine that patients become aware of the seriousness of the clinical situation. Often lump in the side of the abdomen and back pain are later manifestations.
Kidney Cancer OR Something Else?
Blood in the urine is called hematuria. It can be painless and make the urine appear brown or cola coloured. Sometimes, it can be frank and appear pink or red. Occasionally this is associated with increased frequency of urination in the nights. Passing blood in the urine does not automatically mean that the patient has kidney cancer. This can happen in urinary tract infection (especially in infection of the bladder called cystitis), stones in the kidney (when hematuria is often accompanied by pain) and in some forms of inflammation of the kidney called glomerulonephritis.
A lingering back pain (without any history of injury) which persists and often lasts for long periods is a symptom which should not be neglected.
A low-grade fever which is not because of infection should not be neglected in the elderly and a visit to a physician is advisable. The physician on suspicion asks for laboratory tests where anaemia is a common finding. Sometimes hematuria is detected by routine urinalysis which is missed by the naked eye. This form of hematuria is called “microscopic hematuria”.
Diagnosis:
The definitive diagnosis is often made with a CT abdomen or MRI abdomen where the specialist notes a lump in the kidney. To look for the spread a PET-CT is often advised.
As the symptoms of kidney cancer are non-specific, the cancers are often large when they are diagnosed. However, it is rare to miss advanced-stage kidney cancer and imaging studies like ultrasound are CT are commonly used at the slightest suspicion.
As kidney cancer symptoms are non-specific, diagnosis is often made when it is least expected. Elderly people with the risk factors mentioned should be alert to the possibility of this diagnosis and seek medical help when they have persistent symptoms. Blood in the urine should not be neglected.
Ways To Reduce The Risk Of Kidney Cancer:
The steps that you can take to reduce the risk of kidney cancer are-
1. Stop smoking
2. Maintain healthy weight
3. Control blood pressure
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