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Kidney Cancer

Kidney cancer, also known as renal cell carcinoma, is among the top ten most common cancers in the world and includes any cancer derived from renal tubular epithelial cells. Clear cell, papillary, and chromophobe renal cell carcinoma are the major subtypes of kidney cancer. In the United States, the median age at diagnosis is 64 years, and men have higher incidence rates of kidney cancer than women. The risk of developing kidney cancer is increased with age, excess body weight, hypertension, and smoking. Chronic kidney disease, kidney transplantation, and acquired kidney cystic disease have been associated with kidney cancer.

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Ep 219 GU ASCO Highlights: Key Takeaways for Clinicians with Dr. Ben Maughan & Dr. Shilpa Gupta

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Kidney Cancer Diagnosis

Widespread use of imaging techniques, such as ultrasonography and CT scans, performed for a reason unrelated to cancer screening, have led to many incidental findings of renal cell carcinoma. Clear cell renal cell carcinoma often presents with exophytic growth, heterogeneity, or hemorrhage. Symptoms of hypercalcaemia, fever, and erythrocytosis may occur in kidney cancer patients with paraneoplastic syndromes. A diagnosis can be made with a renal core biopsy or a partial or radical nephrectomy specimen is used to confirm malignancy. Staging is assessed with CT imaging with contrast enhancement of the chest, abdominal cavity, and pelvis. MRI is useful for evaluating the extent of the tumor into the vena cava tumor thrombus. Laboratory tests, such as hemoglobin, leukocyte and platelet counts, lactate dehydrogenase levels, and serum-corrected calcium levels, are run for a prognosis.

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Kidney Cancer Treatment

Kidney cancer treatment varies with the type and stage of the disease. Interventions for localized renal cell carcinoma include partial or radical nephrectomy, ablation, or active surveillance. Ablative therapies and active surveillance are often used for elderly patients or patients with competing health risks where surgery is not an option. Metastatic renal cell carcinoma can be managed with tyrosine kinase inhibitors, such as sunitinib, or immunotherapies, such as cytokines that enhance anti-tumor immune activity

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References

[1] Hsieh, J. J., Purdue, M. P., Signoretti, S., Swanton, C., Albiges, L., Schmidinger, M., Heng, D. Y., Larkin, J., & Ficarra, V. (2017, March 9). Renal cell carcinoma. Nature reviews. Disease primers. Retrieved December 3, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5936048/

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