A B C D E F G H I J K L M N O P R S T U V W

CANCER OF THE KIDNEY

What is Cancer of the Kidney?

Growths of the kidney are tumours which lie within the substance of the kidney. The majority are malignant (cancerous) and are more common in men. These tumours may produce blood in the urine and pain in the loin, but can often grow to quite a large size without the patient being aware of it. A doctor may be able to feel the enlarged kidney. A tumour of the kidney can also produce vague symptoms, with a loss of appetite and weight and unexplained tiredness. This may be due to the fact that some tumours produce chemical substances into the bloodstream which affect other organs and tissues of the body in various ways.

How does Cancer of the Kidney occur?

No particular cause has been identified for kidney tumours, but they appear to be more common in cigarette smokers.

Treatment Involved for Cancer of the Kidney

A kidney x-ray (intravenous pyelogram or urogram) or an ultrasound scan will often have been done to make the original diagnosis. Sometimes a special CT x-ray scan, and very rarely, an arteriogram (x-ray of the blood vessels of the kidney) will also be necessary to be sure of the exact size and position of the tumour. The urologist will try to discover whether the tumour has spread using blood tests, a chest x-ray, and possiby a bone scan. Sugical removal of the whole kidney containing the tumour is usually advised. However, in some cases, part of the normal kidney can be left behind. This is called partial nephrectomy. Your general health will not be affected by the removal of one kidney, provided the other is normal. This is ensured by doing the tests mentioned above. Occasionally when there is a very widespread tumour, or if you are medically unfit for major surgery, a procedure to block the main kidney artery and starve the tumour of blood may be advised. This procedure is called embolization. It is performed in an x-ray department. A fine catheter tube is passed from a small incision in the groin into the leg artery and into the artery which supplies the kidney. When it is certain that the tube is in the correct place, a substance can be injected which blocks the artery to the tumour. Without a blood supply, its growth is stopped or slowed down. Kidney tumours do not respond to radiotherapy, nor is chemotherapy of proven benefit at the moment.

Nephectomy

This is the name of the operation to remove a kidney, and it requires a general anaesthetic. An incision is made in the flank just below the rib cage. Immediately after the operation it is usual to have a catheter tube in the bladder. A small drainage tube is often left in the area of the incision for the first few days. To begin with, it will be painful to move, but you will probably be able to sit out of bed after 24 hours. Most patients require intravenous fluids for the first 24 to 48 hours after the operation.

After treatment for Cancer of the Kidney

Many patients are worried that their remaining kidney will not provide sufficient function after the other kidney has been removed. The removal of a kidney should not affect you in this way. Many people are in fact born with only one kidney, which is quite sufficient for their needs. The operation to remove the kidney cuts through the muscles of the flank and therefore you must expect considerable pain when you begin to move after the operation. The pain will improve quite quickly over the first few days. Most pateints will be discharged home after 7 to 10 days, but will still experience discomfort when walking for the first 2 to 3 weeks. Full activity, including lifting, housework and sports, is usually not possible for the first 6 weeks. It is common to experience some numbness just below the incision. This is due to damage to nerves in that area, and may persist for several months. Some patients will notice a slight swelling of the abdomen just in front of the incision. This is nothing to worry about. Any larger swelling in the region of the incision itself should be reported to your doctor. The ward staff will try to ensure that you can cope when you go home. Help will be needed in the first 2 to 3 weeks. The first follow-up visit to outpatients will be at 6 8 weeks. Thereafter outpatient reviews should occur at 6 monthly or yearly intervals. If at the time of operation, the tumour is confined to the kidney, the outlook is very favourable. The outlook is variable in other cases and depends upon the extent of spread. For tumours which have spread, the chemotherapy used for other tumours has little to offer in kidney cancer. New forms of immunotherapy are currently being assessed These involve a technique of injecting specially treated cells, which in turn persuade the body to specifically destroy tumour cells. It is impossible to comment on success rates at present.

If Cancer of the Kidney is left untreated

A few kidney tumours are very slow growing. However, once the symptoms of pain and bleeding have occurred, an untreated kidney tumour is bound to cause further trouble. If left untreated, it is probable that nearly all cases would ultimately be fatal.