What is kidney cancer
Most malignant kidney tumors are renal cell carcinoma, which develops from the epithelium of the renal tubules. It grows inside the parenchyma, gradually increasing, and does not affect the pyelocaliceal system for a long time, therefore it does not cause pain or blood in the urine.
The classic triad of symptoms - blood in the urine, pain in the side and a palpable tumor - is rare today and indicates an advanced process. The modern reality is different: a significant part of tumors are detected by chance at an early stage.
Risk factors
- Smoking is the most proven modifiable factor
- Obesity
- Arterial hypertension and long-term use of certain drugs
- Chronic kidney disease, especially in patients on long-term dialysis
- Hereditary syndromes, including Hippel-Lindau disease
- Kidney cancer in close relatives
- Male gender and age over 50 years
- Occupational exposure to certain industrial substances
Symptoms
- Painless blood in the urine, sometimes one-time and therefore ignored
- Dull pain or heaviness in the lower back and side
- Palpable formation in the abdomen with large tumors
- Prolonged increase in temperature for no apparent reason
- Unexplained weight loss, weakness, lack of appetite
- Anemia or, conversely, increased red blood cell levels
- Increased blood pressure
- Sudden onset varicocele, especially on the right
- Swelling of the legs due to compression of large veins
- Bone pain, cough, neurological symptoms with metastases
Diagnostics
- Ultrasound of the kidneys is usually the first method by which a formation is detected
- CT scan of the abdominal organs with intravenous contrast is the main method: determines the size, location, relationship to the vessels and the collecting system
- MRI - for contrast intolerance, to assess venous spread
- CT scan of the chest to exclude metastases to the lungs
- Bone scintigraphy for suspected bone metastases
- General and biochemical blood test, assessment of the function of both kidneys
- General urine test
- Kidney biopsy - performed in certain situations: for small tumors, planning ablation, suspected metastasis of another tumor or lymphoma
An important feature: unlike most oncological diseases, the diagnosis of kidney cancer is often made and operated on without a preliminary biopsy - the characteristic picture on a CT scan with contrast is quite convincing, and final confirmation is obtained after examining the removed tissue.
Treatment
The main treatment for localized kidney cancer is surgery. The choice of volume depends on the size of the tumor, its location and the condition of the second kidney.
- Kidney resection (organ-conserving surgery) - removal of only the tumor with part of the surrounding tissue; preferred option for small lesions as it preserves kidney function
- Laparoscopic radical nephrectomy - removal of the kidney through several punctures; less trauma and faster recovery
- Open nephrectomy - for large tumors, vascular extension or complex anatomy
- Ablative techniques such as radiofrequency and cryoablation for small tumors in patients at high surgical risk
- Active surveillance - for very small lesions in elderly patients with severe comorbidities
- Targeted and immunotherapy - for advanced and metastatic kidney cancer
- Palliative nephrectomy and radiation therapy - to control symptoms in advanced cases
Life after surgery
- After one kidney is removed, the second one takes over its function; with an initially healthy second kidney, quality of life usually does not suffer
- Regular monitoring of creatinine and urinalysis
- Blood pressure control
- Caution with nephrotoxic drugs, including over-the-counter pain medications
- Adequate drinking regime, limiting salt
- Observation by a urologist on an individual schedule with CT and ultrasound
- Quitting smoking affects both the risk of relapse and the condition of the remaining kidney
Prevention and early detection
- Quitting smoking
- Maintaining normal body weight
- Blood pressure control
- An annual kidney ultrasound, especially if there are risk factors, is the easiest way to detect a tumor at an early stage.
- Mandatory examination for any episode of blood in the urine
- Regular monitoring for chronic kidney disease and dialysis
Where kidney cancer is examined and treated in Tashkent
If a kidney mass is detected, the main thing is to quickly perform a CT scan with contrast and get advice from a urologist who knows organ-preserving and laparoscopic techniques.
In Tashkent, examination and surgical treatment of kidney tumors are carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic; Further systemic treatment for an advanced process is determined together with oncologists.
If a mass in the kidney is found on an ultrasound, do not put off a CT scan: it is this that distinguishes a simple cyst from a tumor and determines all further tactics. Clinic contacts are below on the page.
