Each year, kidney cancer is diagnosed in about 190,000 people worldwide.1Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years.2 It is important to realize that with early diagnosis and treatment, kidney cancer can be cured. In fact, if found early, the survival rate ranges from 79 to 100 percent.3
A kidney tumor is an abnormal growth in the kidney. The terms "mass," "lesion," and "tumor" are often used interchangeably. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common kidney mass is a fluid-filled area called a cyst. Simple cysts are benign, do not turn into cancer and usually do not require follow-up care. Solid kidney tumors can be benign, but are cancerous more than 90 percent of the time.3
It is possible that kidney cancer can grow into the renal vein and vena cava. The renal vein is the kidney's primary draining vein and the vena cava is the vein that takes blood to the heart. The portion of the cancer that extends into these veins is called "tumor thrombus." Imaging studies, such as an MRI, can help to find out if tumor thrombus is present.
For a tumor to grow and spread, it must stimulate new blood vessels to provide the tumor with nutrients and oxygen. This process, known as angiogenesis. Kidney cancers are considered very angiogenic and are very efficient at travelling through the blood vessels in the body. They do this by secreting a protein called vascular endothelial growth factor (VEGF). VEGF acts on nearby blood vessels and stimulates them to sprout new vessels to supply the tumor.3
Kidney cancer can form in the small tubes inside the kidney. Those tubes are located in the center of the kidney where urine collects and used to filter blood. The most common kidney cancer is called renal cell carcinoma.
Causes & Risk Factors
Researchers have found several risk factors that make you more likely to develop kidney cancer. The following may increase your risk of developing kidney cancer:3
- Family history of kidney cancer
- Chronic kidney failure and/or dialysis
- Diet with high caloric intake or fried/sautéed meat
- Von Hippel Lindau disease (rare genetic disorder that causes tumor growths)
- Tuberous sclerosis (common genetic condition that produces growths in the body from birth throughout adulthood)
Unfortunately, kidney cancer does not have early symptoms but you should see your doctor if you notice the following:3
- Blood in your urine
- Lump in your abdomen
- Unexplained weight loss
- Pain in your side
- Loss of appetite
If cancer spreads (metastasizes) beyond the kidney, symptoms depend on the organ involved. Shortness of breath or coughing up blood may occur when cancer is in the lung. Bone pain or fractures may occur when cancer is in the bone. When cancer is in the brain, you may have neurologic symptoms.
In some cases, kidney cancer causes related conditions called paraneoplastic syndromes. These syndromes occur in about 20 percent of kidney cancer patients and can occur in any stage, including cancers confined to the kidney. Symptoms from paraneoplastic syndromes include weight loss, loss of appetite, fever, sweats and high blood pressure. In many cases, the paraneoplastic syndrome improves or disappears after the cancer is removed.
Screening and Testing for Kidney Cancer
Unfortunately, there are no blood or urine tests that detect kidney cancer. When kidney cancer is suspected, your doctor will order a kidney imaging study. The initial imaging study is usually an ultrasound or CT scan. In some cases, a combination of imaging studies may be needed to completely evaluate the tumor.3
If cancer is suspected, you should be evaluated to see if it has spread beyond the kidney (metastasized). An evaluation consists of imaging studies such as an ultrasound or CT scan. These tests may be followed by an MRI, X-rays and blood tests. You may also need a bone scan if you have had bone pain, recent fractures, or abnormal blood tests. Additional tests may be ordered if your doctor feels they are needed to completely evaluate the tumor.
The primary treatment option for kidney cancer is surgery to remove all or part of the kidney and the tumor; kidney cancer does not respond well to radiation and chemotherapy treatments.4
Radical Nephrectomy Versus Partial Nephrectomy (Kidney-Sparing)
The removal of the entire kidney is called a radical nephrectomy. Depending on your disease state and tumor location, you may not have to lose your entire kidney to surgery. Another surgical option called partial nephrectomy aims to remove only the diseased part of your kidney and spare the healthy, functioning kidney tissue.
Sparing kidney tissue is important because studies show that patients who have their entire kidney removed are more likely to suffer from chronic kidney disease (CKD) after surgery compared to patients who receive a kidney sparing partial nephrectomy.5
In fact, the American Urological Association states that partial nephrectomy is the gold standard treatment option for small to medium-sized kidney tumors or masses.4 In the appropriate patient the cure rate equals radical nephrectomy.
The da Vinci Surgical System uses state-of-the-art technology to help your doctor provide the gold standard treatment, where indicated, and also perform a more precise operation. da Vinci offers several potential benefits to patients facing kidney surgery, including:
- Excellent clinical outcomes and cancer control7
- Short hospital stay8
- Low blood loss7,8
- Precise tumor removal and kidney reconstruction8,9
- Excellent chance of preserving the kidney, in certain operations9
- Low rate of operative complications9
If your doctor is able to preserve your healthy, functioning kidney tissue, this can help to prevent future kidney disease and even dialysis.
This procedure is performed using the da Vinci Surgical System, a state-of-the-art surgical platform. By overcoming the limits of both traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for people around the world.
* In Nephrectomy, one incision is enlarged for removal of the kidney.
Are You a Candidate for da Vinci Surgery?
The following physicians are trained to use the da Vinci Surgical System at Lourdes for partial nephrectomy procedures:
Broome Urological Associates
Only you and your doctor can decide if da Vinci Surgery may be right for you.
World Health Organization; Global cancer rates could increase by 50% to 15 million by 2020; URL: www.who.int/mediacentre/news/releases/2003/pr27/en/
"Cancer Facts & Figures 2008", American Cancer Society, www.cancer.org , URL: www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf
'Kidney Cancer", American Urological Association Foundation, www.urologyhealth.org , URL: www.urologyhealth.org/adult/index.cfm?cat=04&topic=12 4
American Urological Association; Guideline for Management of the Clinical Stage I Renal Mass; 2009; URL: www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/renalmass09.pdf
Kunkle D, Egleston B, Uzzo R; Excise, Ablate or Observe: The Small Renal Mass Dilemma - A Meta Analysis and Review. The Journal of Urology, Vol. 179, 1227-1234, April 2008
Benway BM, Wang AJ, Cabello JC, Bhayani SB; Robotic Partial Nephrectomy with Sliding-Clip Renorrhaphy: Technique and Outcomes; European Association of Urology, Accepted December 28, 2008. Published online ahead of print on January 7, 2009
Rogers CG, Menon M, Weise ES, Robotic partial nephrectomy: a multi-institutional analysis; J Robotic Surgery (2008) 2:141-143 DOI 10.1007/s11701-008-0098-2
Bhayani SB, Das N., Robotic-assisted laparoscopic partial nephrectomy for suspected renal cell carcinoma. BMC Surgery 2008, 8:16 doi:10.1186/1471-2482-8-16.