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Kidney cancer or renal cancer is a tumor that originates from the uncontrolled growth of kidney cells. Depending on the type of cell affected, kidney cancer can be given different names. The most common type is renal adenocarcinoma, such as clear cell carcinoma, which affects the renal parenchyma.
Other types of kidney cancer can also occur, such as transitional cell carcinoma that affects the ureters. In children, a particular type of tumor is called a Wilms tumor. Not all renal tumors are malignant, however those that are can reach the renal medulla, renal vein and sometimes the vena cava.
Epidemiology
Overall, cases of kidney cancer have increased, but the reasons are not yet fully understood. The disease is more common in patients between 50 and 70 years of age, being twice as common in males than in females.
According to world data, renal carcinoma accounts for 3% of malignant tumors with an incidence of 9.6 cases per 100,000 inhabitants. According to WHO data in 2008, just over 4,000 people were diagnosed with kidney cancer in Brazil, of which 61.7% were men. Although the numbers are not large, the death rate is high. In Brazil, according to Globocan, the mortality rate for the disease is 54%. In the USA and Australia this rate is 24% and 37%, respectively. Worldwide, this mortality rate is 42.5%.
Renal clear cell carcinoma accounts for approximately 70 to 90% of cases and affects the cells of the proximal convoluted tube. Papillary carcinoma is the second most frequent and may account for 10 to 15% of cases. Chromophobe carcinoma varies from 4 to 5% of cases. Other less common types of kidney cancer are tumors of the collecting ducts and sarcomatoids, each representing about 1% of cases.
Approximately 54% of diagnosed kidney cancers are confined to the kidney, 20% are locally advanced, and 25% have metastases. About 40% of diagnoses are made when the tumor is in an advanced stage, according to the Brazilian Society of Urology.
Causes
As with other types of cancer, the exact causes of kidney cancer are not fully known. In general, it is believed that toxins or chemical agents circulating in the blood cause mutations in the DNA of kidney cells and lead to the onset of cancer. Products such as pesticides, organic solvents, heavy metals, aflatoxins, etc. are some examples of toxic agents that can cause DNA mutations.
In addition, exposure to highly ionizing radiation can also cause cell mutations that lead to tumors. Other possible causes recently identified as triggering kidney cancer are: cigarettes, obesity , hypertension and the presence of genetic predisposition.
Kidney cancer risk groups
Some risk factors are studied as possible triggers of kidney cancer. These factors outline some risk groups, as discussed below:
– Elderly: people of advanced age are at greater risk of developing the disease.
– Men: men are more likely to develop the disease than women.
– Smokers: cigarettes have been identified as one of the risk factors for the disease. This risk decreases as soon as the patient stops smoking . Studies show that smokers are twice as likely to develop kidney cancer.
– Obese: Obesity is one of the factors that increase the development of kidney tumors.
– Hypertensive: it is not known for sure how hypertension influences the appearance of kidney cancer, but studies indicate that there is a correlation between the disease and high blood pressure.
– Patients who received dialysis: this type of patient, who received dialysis for a long time, has a higher risk of developing the disease.
– Patients exposed to toxic agents: toxic agents such as cadmium, asbestos, pesticides, etc., can trigger the disease.
– Von Hippel-Lindau disease: This inherited disease increases the risk of many tumors, such as kidney cancer.
– Patients with hereditary cases of papillary renal carcinoma: this hereditary condition is a major risk factor for the disease.
Patients belonging to the above risk groups should be constantly monitored and tests performed to check for any kidney abnormalities.
Kidney cancer symptoms
Kidney cancer rarely causes signs or symptoms in its early stages, which makes the disease more dangerous and diagnosed, in most cases, only in advanced stages. In the advanced stages, symptoms begin to appear. Some of the signs are:
– Hematuria or blood in the urine, characterized by a red or pink color in the urine.
– Abdominal or back pain , just below the ribs, at the height of the kidneys.
– Fatigue and weight loss.
– Febres .
– Abdominal bloating.
Kidney cancer diagnosis
In most cases, kidney cancer is diagnosed by CT scan or imaging tests such as MRI. If the tomography or imaging tests show any abnormality, the doctor may order other tests, such as blood and urine tests and a biopsy of part of the kidney. The doctor still assesses whether or not the tumor has fat. If the tumor mass contains fat, it is, in most cases, a benign tumor called renal angiomyolipoma. If the tumor does not have fat, it is a carcinoma.
Once diagnosed, cancer can be divided into stages according to its size and severity:
– Stage I: tumor up to 7 cm in diameter. The tumor is confined to the kidney.
– Stage II: the tumor is larger than in stage I, but is still confined to the kidney.
– Stage III: in this stage, the tumor expands to other sites in the kidney and neighboring tissues and can reach the adrenal gland. It can also reach lymph nodes.
– Stage IV: the cancer becomes metastatic, reaching other organs such as bones, brain , liver and lung .
It is extremely important to diagnose kidney cancer as soon as possible. According to the National Study on Renal Cancer of the Brazilian Society of Urology, 40% of cases of the disease are identified when the tumor is in stage III or IV, which hinders the chances of treatment and cure of the disease.
Kidney cancer complications
Some complications of kidney cancer stem from the kidney’s inability to properly perform its functions. These symptoms are known as paraneoplastic syndrome and can affect up to 20% of patients with kidney cancer. Many of the symptoms that the patient presents are due to the production of substances that alter the functioning of the organism. These hormone-like substances can cause:
– Hypertension .
– Increased levels of calcium in the body.
– Changes in liver function.
– Increased red blood cell count.
– Increased breast size.
– Cushing’s syndrome (caused by increased production of cortisol by the adrenal gland). Cushing’s Syndrome itself can lead to other complications, such as insomnia, skin thinning, exaggerated hunger, restlessness, excessive thirst, fat deposition on the face, neck and trunk.
In addition to the complications mentioned above, kidney cancer can reach stage IV and spread to other organs, originating other tumors (metastasis). The organs most commonly affected are the adrenal gland, bones, brain , liver and lungs .
Kidney cancer treatments
Treatment for kidney cancer will depend on the cell type reached, the stage of the cancer and the involvement of other organs or structures.
Surgery
When kidney cancer has not reached other organs, that is, it is not metastatic, surgery can be performed to remove the tumor mass. In that case, the surgery is called a nephrectomy. In radical nephrectomy, the kidney, some of the surrounding tissue, and the lymph nodes are removed. If the adrenal is affected, it can also be removed. Nephrectomy can be performed by the conventional method or by video laparoscopy.
Another approach is partial nephrectomy. In this case, the doctor removes the tumor and a portion of the surrounding tissue. This treatment may be indicated when the tumor is small or when the patient has only one kidney. In general, partial nephrectomy is indicated as it avoids further complications of complete removal of the kidneys.
Other treatments
When surgery is not possible, the doctor may prescribe other treatments to reduce the tumor mass. Some of the tools used in this strategy are:
– Suppression of blood flow to the tumor.
– Treatment to freeze the cancer cells (cryoablation).
– Treatment to burn off the cancer cells (radiofrequency ablation).
The choice of these therapies will depend on the location of the tumor and its stage.
Treatment of metastatic kidney cancer
When kidney cancer reaches other organs, treatment becomes more complicated and offensive. In this case, the doctor may treat the patient with immunotherapy with drugs such as interleukin-2 and alpha interferon.
Other drugs can be used to target cancer cells. In this regard, some of the drugs used are bevacizumab, pazopanib, sorafenib, temsirolimus and everolimus. Depending on the organ affected, the doctor may choose a specific chemotherapy for the tumor.
kidney cancer herbal medicine
Currently there are no medicinal plants with proven action against kidney cancer. However, there are studies that indicate that the saponins of the medicinal plant tribulus inhibit the proliferation of kidney cancer cells. Ginseng has also been studied as an inhibitor of renal tumor proliferation.
Medicinal plants can also be used to improve the patient’s quality of life and the symptoms he presents with chemotherapy. In this sense, phytotherapy can improve the patient’s sleep, appetite and disposition. Some herbs used in this regard are:
– Valerian : to improve sleep.
– Chamomile : to calm and improve sleep.
– Melissa : to improve gastrointestinal symptoms.
– Burdock : used due to its diuretic properties.
– Espinheira-santa : used due to its diuretic properties.
– Bilberry : used to improve gastrointestinal symptoms.
Kidney cancer homeopathy
Homeopathy can be used as a complementary therapy to improve the patient’s symptoms. Some medications can be used to reduce pain, increase disposition, quality of life, improve appetite and sleep. Available options include:
– Traumel S
– Graffite
– Calendula
– Sulphur
– Passion flower
– Valerian
Talk to your homeopath to find out which treatment option is best for you and which preparation is necessary.
Kidney cancer tips
Some tips can help you take better care of yourself and overcome kidney cancer. First of all, don’t view the diagnosis of kidney cancer as a death sentence. Understand how the disease works and always seek help from your doctor and your family members.
Try to exercise or do some other activity that you enjoy so you can withstand the impact of the disease. Always talk to your doctor if adverse events from treatments are difficult to bear.
If you already have a family history of kidney cancer or some other type of tumor or are part of a risk group, regularly see a doctor. At the first symptoms, consult a professional so that he can guide you in the best possible way.
Kidney cancer prevention
Although it is not known exactly what causes kidney cancer, some preventive measures can be taken:
– Avoid smoking . Toxins present in cigarettes can cause changes in the DNA of cells and lead to the development of tumors.
– Eat a balanced diet, giving preference to fruits, vegetables, fiber and cereals.
– Avoid the consumption of foods rich in sodium, preservatives, dyes or other additives.
– Take vitamins that fight free radicals that can be harmful to the body, such as vitamin C , vitamin E and vitamin A.
– Practice physical activity regularly. Sports help eliminate toxins from the body that damage cells.
– Control blood pressure . Hypertension can overwhelm kidney cells and cause harmful mutations.
– Avoid contact with toxic substances such as pollutants, chemicals, pesticides, etc. If you work with solvents, heavy metals or other carcinogenic products, wear proper protective equipment.
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