renal%20cancer
RENAL CANCER

Renal cancer is the disease in which certain tissues of the kidney starts to grow uncontrollably and form a tumor.

It is also called as renal adenocarcinoma or hypernephroma.

Classic triad of symptoms are flank pain, palpable abdominal mass and gross hematuria.

Surgical Intervention

  • The preferred treatment for renal cell carcinoma
  • The choice of surgical procedure depends on the extent of the disease, as well as patient-specific factors such as age & comorbidity
  • May be carried out through a conventional approach or by a minimally-invasive approach

Partial Nephrectomy or Nephron-Sparing Surgery (NSS)

  • Indicated in patients w/ solitary kidney, one kidney w/ contralateral renal function & bilateral synchronousrenal cell carcinoma (RCC)
  • Used for patients w/ small unilateral tumors
  • Only the diseased or injured portion of the kidney is removed
  • Contraindicated in patients w/ confirmed nodal metastases

Radical Nephrectomy

  • The most widely used approach & the preferred procedure if there is evidence of invasion into the adrenal gland,renal vein or perinephric fat
  • Involves the removal of the entire kidney along w/ a section of the tube leading to the bladder, ureter, adrenalgland & fatty tissues surrounding the kidney

Other Procedures

Adrenalectomy

  • Considered in patients w/ large upper pole tumors or abnormal-appearing adrenal glands on
  • Computed tomography (CT) scan & must be decided on an individual basis

Cryoablation

  • Indicated for <3 cm solitary renal tumor located away from the collecting system

Cytoreductive or Debulking Nephrectomy

  • Mostly involves the removal of the primary tumor from the kidney
  • Recommended in patients w/ good performance preceding systemic therapy

Radiofrequency Ablation

  • An alternative treatment in patients w/ contraindications to nephrectomy, Von Hippel-Lindau disease & unfit elderly patients
  • Creates molecular friction, denaturation of cellular proteins & cell membrane disintegration
  • Heat-based tissue destruction w/ a high-frequency electrical current (400 to 500 kHz)

Metastasectomy

  • The lungs, bones, brain & liver are the most common sites of metastasis
  • Done in conjunction w/ radical nephrectomy but may also be performed following a relapse after surgery

Risks & side effects of surgery

  • Short-term risks includes reactions to anesthesia, excess bleeding (may require blood transfusions), blood clots & infections
  • Damage to internal organs & blood vessels (spleen, pancreas, aorta, vena cava, large or small bowel) during surgery
  • Leakage of urine into the abdomen (after partial nephrectomy)
  • Kidney failure (if the remaining kidney fails to function well)
Editor's Recommendations
Most Read Articles
09 Nov 2017
Treatment with fesoterodine shows efficacy in patients with nocturnal urgency secondary to overactive bladder syndrome and low nocturnal bladder capacity with a mismatch between nocturnal urine production and bladder capacity, reports a recent study.
14 Nov 2017
The 5-year survival rates for human papillomavirus (HPV)-associated cancers vary greatly according to age and race, with Caucasians and younger patients tending to have better survival, according to a recent US study.
01 Nov 2017
High-grade serous carcinomas (HGSCs) of the pelvis, whether associated with serous tubal intra-epithelial carcinoma lesions or not, appear to have shared biologic origin in the distal fallopian tube, according to a recent study.
28 Nov 2017
The use of oral androgen receptor inhibitor enzalutamide may benefit chemotherapy-naïve patients with metastatic castration-resistant prostate cancer and low baseline prostate specific antigen irrespective of disease burden, signifying that targeting the androgen receptor signalling pathway is a therapeutic option in similar patients, suggests a recent study.