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RENAL CELL CARCINOMA (RCC)

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RENAL CELL CARCINOMA

Renal cell carcinoma (RCC), commonly referred to as kidney cancer, is a type of cancer that originates in the cells of the kidney. It accounts for approximately 90% of all kidney cancers and typically affects adults between the ages of 50 and 70.

Renal cell carcinoma typically originates from a single tumor in one kidney, although it can also manifest as multiple tumors or affect both kidneys simultaneously. It’s also referred to as renal cell cancer.

Medical professionals employ various treatment approaches for renal cell carcinoma, and ongoing research explores novel methods. It’s essential to educate yourself about the condition and collaborate closely with your doctor to select the most suitable treatment option.

Causes of Renal Cell Carcinom

The precise cause of renal cell carcinoma remains uncertain to scientists. However, it is known that most kidney cancers develop due to genetic abnormalities within the kidney cells. The exact triggers for these genetic mutations are still unclear.

Risk Factors of RCC

Several factors can increase the likelihood of developing renal cell carcinoma, including:

  1. Smoking: Regular tobacco use can elevate the risk of developing the disease.
  2. Obesity: Being significantly overweight is associated with a higher chance of developing renal cell carcinoma.
  3. Long-term Use of Pain Medications: Prolonged intake of certain pain relievers like aspirin, ibuprofen, or acetaminophen may contribute to the risk.
  4. Hepatitis C: Having hepatitis C infection has been linked to an increased risk of renal cell carcinoma.
  5. Exposure to Certain Substances: Contact with specific substances such as certain dyes, asbestos, cadmium (a metal), herbicides, and solvents can raise the risk.
  6. Acquired Cystic Kidney Disease: Individuals, especially those undergoing dialysis, with acquired cystic kidney disease are at higher risk.
  7. Hereditary Conditions: Inherited conditions, particularly von Hippel-Lindau disease, can significantly increase the likelihood of developing renal cell carcinoma.

Symptoms of Renal Cell Carcinoma

In its initial stages, renal cell carcinoma typically doesn’t present noticeable symptoms. However, as the condition progresses, several warning signs may emerge, including:

  1. Presence of a Lump: A noticeable lump may develop on the side, belly, or lower back.
  2. Hematuria (Blood in Urine): Blood may be visible in the urine.
  3. Low Back Pain: Pain localized to one side of the lower back may occur.
  4. Unexplained Weight Loss: Significant weight loss may happen without an apparent cause.
  5. Loss of Appetite: A decrease in appetite may be observed.
  6. Fever: Fever, particularly if persistent, could be a sign of advancing disease.
  7. Fatigue: Feelings of tiredness or weakness may become pronounced.
  8. Anemia: Insufficient red blood cells may lead to anemia.
  9. Night Sweats: Episodes of excessive sweating during sleep might occur.
  10. Hypercalcemia: Elevated levels of calcium in the blood may be detected.
  11. Hypertension (High Blood Pressure): Blood pressure levels may rise unexpectedly.

Prevalence

  • Renal cell carcinoma is the most common type of kidney cancer in adults, accounting for approximately 90% of cases.
  • It is estimated that over 73,000 new cases of kidney cancer will be diagnosed in the United States in 2024.

Diagnosis of RCC

Your doctor will conduct a thorough examination to understand your symptoms better and determine the underlying cause. Initially, they will perform a physical assessment and inquire about your medical history, asking questions such as:

  • When did you first notice any symptoms?
  • Have you observed blood in your urine?
  • Are you experiencing any pain? If so, where? And does anything alleviate or exacerbate your symptoms?
  • Does anyone in your family have a history of von Hippel-Lindau disease or kidney cancer?
Following this, a series of diagnostic tests may be ordered, including:
  • Urine tests
  • Blood tests
  • Biopsy, which involves taking a sample of tissue for analysis
  • Liver function tests
  • Ultrasound, a non-invasive imaging technique that uses sound waves to create images of internal organs
  • CT scan (Computed Tomography), a specialized X-ray procedure providing detailed images of the body’s internal structures
  • Nephrectomy, a surgical procedure to remove part or all of a kidney to examine it for signs of renal cell carcinoma, typically performed when a tumor is suspected but not yet confirmed as cancerous

If the diagnosis confirms renal cell carcinoma, your doctor will determine its stage to formulate the most appropriate treatment plan. Cancer staging assesses the size of the tumor and whether it has spread to other areas of the body. Additional imaging tests may be conducted to examine the chest and abdominal regions, including:

  • Chest X-ray
  • CT scan
  • MRI (Magnetic Resonance Imaging), utilizing powerful magnets and radio waves to generate detailed images of internal body structures
  • Bone scan, which detects abnormalities in bone tissue indicative of cancer spread

Treatments for Renal Cell Carcinoma

Treatment options for renal cell carcinoma vary, and finding the most effective approach often involves trying several options. The optimal treatment plan depends on factors such as the cancer stage, overall health status, and potential side effects. Possible treatments include:

  1. Surgery: Removal of part or all of the affected kidney(s) may be recommended.
  2. Biologic Drugs: These medications stimulate the body’s immune system to combat cancer cells.
  3. Immunotherapy: Drugs like interferon-alfa or interleukin-2 are used to enhance the immune response against cancer.
  4. Targeted Therapy: This approach involves medications that specifically target elements crucial for cancer survival, such as tumor blood vessels or specific proteins.
    • Examples include axitinib, bevacizumab, cabozantinib, everolimus, lenvatinib, pazopanib, sorafenib, sunitinib, temsirolimus, and tivozanib.
  5. Ablation: Tumors are destroyed using extreme cold (cryoablation) or radio waves (radiofrequency ablation).

Although radiation and chemotherapy are not typically effective for renal cell carcinoma, they may be prescribed in certain cases to alleviate symptoms or when other treatments have been unsuccessful. It’s essential to discuss these options with your doctor to understand potential benefits and side effects.

Additionally, ongoing clinical trials explore novel treatments for renal cell carcinoma, offering opportunities to access new medications not yet widely available. Your doctor can provide information about suitable clinical trials and whether you might be eligible to participate.

Ensuring your comfort is crucial throughout the treatment process. Inform your doctor about any pain or discomfort you experience, as they can prescribe medications to alleviate symptoms and enhance your quality of life.

Home Care Remedies for Renal Cell Carcinoma

  • Eating a healthy diet rich in fruits, vegetables, and whole grains
  • Staying hydrated by drinking plenty of water
  • Engaging in regular physical activity
  • Managing stress through relaxation techniques such as deep breathing or meditation

Prevention of RCC

  • Avoiding tobacco use
  • Maintaining a healthy weight
  • Eating a balanced diet
  • Limiting exposure to environmental carcinogens

When to See a Doctor

  • If you experience any symptoms suggestive of kidney cancer, such as blood in the urine, persistent pain in the side or back, or unexplained weight loss, it is important to consult a healthcare professional for further evaluation and diagnosis.

Outlook/Prognosis for Renal Cell Carcinoma

  • The outlook for renal cell carcinoma varies depending on the stage at which it is diagnosed and treated.
  • Early detection and treatment offer the best chance of successful outcomes, with localized RCC having a five-year survival rate of over 90%.

Sources

  1. American Cancer Society. (2022). Kidney Cancer.
  2. National Cancer Institute. (2022). Renal Cell Cancer Treatment (PDQ®)–Patient Version.
  3. Urology Care Foundation. (n.d.). Kidney Cancer.
  4. American Society of Clinical Oncology. (2022). Kidney Cancer:

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