Kidney cancer: Causes, risk factors and treatments

Kidney cancer originates in kidney cells. The cancerous cells divide and grow out of control and create a tumour. There are different types of kidney cancer and the most prevalent type is Renal Cell Carcinoma (RCC).  

RCC affects the cells in the lining of very small tubes (tubules) in the nephrons, the parts of the kidney that filter the blood. It is common for one kidney to have only one tumour. It is very rare for two or more tumours to occur in the same kidney or in both kidneys.  

Kidney cancer is a relatively rare cancer, says WHO. Fewer than three people in every hundred have kidney cancer around the world.   

What are the risk factors for kidney cancer?  

All types of cancer result from abnormal changes (mutations) in particular genes within the cells of the body. Kidney cancer is known to be related to a number of risk factors, including:  

Age and gender  

It is more common for men than women to develop kidney tumours over 60.  

Lifestyle factors   

Overweight or obesity, as well as smoking, are major risk factors. Cigarettes have chemicals known as carcinogens that damage the genes of kidney cells.   

Medical conditions and treatments   

Certain medical conditions and treatments such as Cystic kidney disease, dialysis, renal stones, high blood pressure (Hypertension), previous radiotherapy, long-term use of non-steroidal anti-inflammatory medications, and Hepatitis C infection can increase the likelihood of developing kidney cancer.  

Inherited conditions   

Inherited conditions like von Hippel-Lindau (VHL) syndrome, Birt-Hogg-Dubé syndrome, tuberous sclerosis and hereditary papillary RCC (HPRCC) or a family history of kidney cancer can lead to cancer in a person.  

What are the stages of kidney cancer?   

The different stages of cancer are identified based on how big the tumour is and how far the cancer has spread. This is called staging. Information from the tests and scans used to diagnose cancer is used to determine the stage of the disease. There are several staging systems for kidney cancer.  

The most well-known one is called the TNM system. This stands for Tumor, Nodes and Metastasis. Each letter is assigned a number to describe the size and extent of cancer. Once the T, N and M categories have been assigned, this information is combined with categorising cancer as stage I, II, III or IV. The stages identify cancers that have a similar prognosis (outcome) or course of treatment.  

Treatments for kidney cancer  

Surgery   

Nephrectomy is usually the first thing doctors consider, and it can cure early-stage kidney cancer. The tumour can be removed in one of two ways:   

Partial nephrectomy (or nephron-sparing surgery) removes only the portion of the kidney that contains the tumour. A radical nephrectomy will remove the whole kidney together with the tumour.   

Nephrectomies can be performed openly or laparoscopically (keyhole) and sometimes with the assistance of a robot.  

A variety of ablative techniques can be used to treat small kidney tumours, including cryotherapy (freezing), radiofrequency ablation (heating) and high-intensity ultrasound. These techniques are less invasive than surgery and have shorter recovery times.   

Biological and targeted therapies   

There are several biological and targeted treatments available for advanced kidney cancer, including immunotherapy, targeted therapy and monoclonal antibodies. Immunotherapies, such as interferon and interleukin stimulate the immune system to attack the cancer cells.  

For advanced kidney cancer, the first systemic treatment was cytokines in the early 1990s; however, in recent years, they have been superseded by targeted therapies.   

New immunotherapies and vaccines are now available as advanced treatments for kidney cancer. One of the most promising advances in treating advanced kidney cancer has been the development of targeted therapies.  

The drugs block the pathways involved in the development of new blood vessels (angiogenesis), which is essential for the proliferation of cancer cells. Additionally, they inhibit the growth and division of cancer cells.  

Radiotherapy   

Although kidney cancer is generally considered to be less sensitive to radiation than other types of cancer, recent research in this field has reviewed the effectiveness of radiation therapy for kidney cancer. For example, radiotherapy can be very successful at controlling symptoms and slowing down the growth of metastases in the brain, liver, lung and pancreas.   

The following is the advice to reduce the risk of Kidney cancer   

• Avoid smoking   
• Maintain a healthy weight  
• Find out if you are exposed to certain toxins at work or home. Toxins such as cadmium, asbestos and trichloroethylene may increase the risk of kidney cancer.   
• Taking care of kidneys is important for people with pre-existing kidney disease. They may be at increased risk for kidney cancer. Control high blood pressure. If you have Diabetes, keep your blood sugar levels in check.  
• Take note of specific risk factors that can’t be changed but should still be monitored. Some diseases, such as von Hippel-Lindau disease, may have been inherited and caused kidney cancer.   

In conclusion

Living with a serious illness is not easy. Cancer patients and those who care for them face various challenges and problems. Coping with these problems may become less stressful when you have helpful information and support from friends and relatives. It is important to remember that everyone is different, and the same treatments and approaches may not work for everyone. Always have the advice of friends and family and discuss it with medical professionals.