Kidney cancer

Summary

Generally

Every year, about a thousand people are diagnosed with kidney cancer many countries. Both the younger and older can get the disease. Of those diagnosed with kidney cancer, just under half are in their 60-70s.

Kidney cancer is a serious illness, but knowledge about the disease has increased and treatments have improved in recent years.

symptoms

It can be difficult to detect kidney cancer. The most common is that the cancer is discovered by chance during, for example, an x-ray examination for other disorders. Symptoms that you can notice yourself are blood in the urine. Other symptoms are a lump in the upper abdomen or pain in the side of the back. You can also feel sick with prolonged fever, be unusually tired and lose weight. 

Treatment

If you have had kidney cancer that has not spread, the first treatment is that the tumor is removed. For larger tumors, the entire kidney with tumor can be removed, but if the tumor is smaller, only the part of the kidney where the tumor is located. The body can usually function as usual with the kidney remaining.

If the cancer has spread to other parts of the body, you often have to take medicines that slow the cancer tumor.

When and where should I seek care?

Kidney cancer can cause symptoms that are also common in other diseases. If you get blood in the urine, you should seek care at a health care center.

If you get other symptoms that cause you to worry about having kidney cancer, you can also contact the health center.

What is Kidney Cancer?

A cancer tumor is formed

If you get kidney cancer, a cancerous tumor has formed in the kidney. Getting cancer in both kidneys is rare.

In the body, the two kidneys are deep in, close to the spine. They are higher than the navel level. The kidney’s task in the body is to purify the blood from substances that are not needed, mainly residues from metabolism. Through the urine formed in the kidneys, the residual products can leave the body.

If the disease is detected late, the cancer may have spread to other parts of the body and formed metastases, also called daughter tumors. 

Cancer is damaged cells

The human body is made up of many billions of cells. In order for the body to grow and live further, most cells must be replaced regularly with new ones. This is done by dividing cells into two cells. Then an exact copy of the first cell has been created.

Sometimes damage occurs during cell division. Most often the cell’s genetic material, DNA, is able to repair the damage. But at some point, the cell can suffer damage that it cannot repair, and it then loses its ability to control its division and growth. It can cause cancer .

What characterizes cancer cells, among other things, is that they continue to multiply uncontrollably while not dying when their time is up. Often, the cancer cells clump together to form a tumor. If you have kidney cancer you have got such a cancerous tumor in the kidney.

Better treatments

Kidney cancer is a serious disease, but today there is more knowledge about the disease and in recent years the treatments have also improved.

How it will go depends greatly on the stage at which the disease is detected. If the cancer is completely confined to the kidney and you get it removed, you are usually free of the cancer, although there is a risk of relapse. About nine people out of ten who have had kidney cancer alone are still free from recurrence of the disease after five years.

If the cancer has spread to other parts of the body, chances are that you will be free from the disease. But even though the disease is very serious, you can often live for several years. There are ways to curb the disease with the help of various treatments, and you get specialized care to live as long and as well as possible.

More common in men

Kidney cancer is twice as common in men as in women. Those who get kidney cancer are usually in their 60s to 70s. It is unusual for you to get the disease if you are under 40 years of age. About a thousand people are diagnosed with kidney cancer every year.

Wilms tumor and renal pelvic cancer

It is very rare for children to get kidney cancer. The form of kidney cancer that can affect children and adolescents is primarily Wilm’s tumor .

There is also a completely different type of cancer called renal pelvic cancer, but then the cancerous tumor does not develop in the kidney but in the kidney’s part of the kidney pelvis, or in the part of the ureter that leads away from the kidney.

What is the cause of kidney cancer?

Smoking increases the risks

It is largely unknown why you get kidney cancer, but it is clear that smoking increases the risk. About one-third of those with kidney cancer have had it because they smoke or have smoked. Overweight and elevated blood pressure also increase the risk of getting the disease.

Hereditary kidney cancer very rare

It is unusual for kidney cancer to be hereditary. It is estimated that about five percent of all people with kidney cancer get it because of hereditary causes.

Von Hippel-Lindau’s disease is the most common hereditary disease that can cause kidney cancer. It means that you have a hereditary so-called tumor syndrome, which means that you have a greater risk of developing tumors in different parts of the body. It can be both harmless, benign or cancerous tumors. A person who is a carrier of the inheritance for the disease often gets sick before the age of 40 and usually gets tumors in both kidneys.

If you have only one relative who has had kidney cancer, and that person was older than 60 at the time of the illness, the risk is low that the cancer is hereditary.

symptoms

Blood in the urine one of the symptoms

The most common thing is that you have no symptoms at all, but that the kidney cancer is discovered by chance during, for example, an X-ray examination for other problems.

One of the more common symptoms that you may notice is blood in the urine. Other symptoms are a lump in the abdomen or pain in the side of the back. You may feel sick, have long-term fever or be unusually tired. You can also lose weight without changing your eating habits. All these symptoms can be present even in other diseases.

When and where should I seek care?

Contact the health center

Kidney cancer can cause symptoms that are also common in other diseases. If you are worried that you have kidney cancer, you can contact a health care center .

You should always seek care if you

  • has blood in the urine
  • is so tired that you can’t handle your everyday life or if the fatigue lasts a couple of weeks
  • lose weight without changing your habits
  • feel a lump in the stomach
  • has side pain.

Investigations and investigations

Several studies are needed

It is common for patients to undergo various examinations before the doctor can make a diagnosis. At the health care center, the doctor usually does a body examination . You can also have blood tests and then undergo various x-ray examinations, which are usually performed in hospitals.

Referral to specialists

If, after examinations, the doctor suspects that you have kidney cancer, you will receive a referral to the nearest urology clinic, where doctors specialize in kidney and urinary tract diseases.

Once the urology clinic has received the referral, a doctor’s appointment should be obtained within a few weeks. If you are not allowed to come to the urology clinic within this time frame, you should talk to your doctor. If it is not possible to get a time fast enough, you can ask for a referral to another hospital.

At the hospital you can meet the doctor who continues the investigation.

cystoscopy

If you have visible blood in the urine, you may have a cystoscopy . Then the doctor examines the inside of the urethra and bladder with the help of a narrow instrument that is inserted into the urethra. The instrument is used as a kind of binoculars or to transfer images to a monitor.

The examination is done to see if there is anything in the bladder that gives blood in the urine. Often, cell samples and tissue samples from the bladder can be taken at the same time. The cell samples are taken from the fluid that is flushed into the bladder during the examination, which is either discharged through the cystoscope or which is excised after the examination.

Just when the instrument is inserted into the urethra, it can feel uncomfortable so you usually get numb. After the examination, it is common for it to burn in the urethra during the first 24 hours. Sometimes you also get bleeding, but it usually goes quickly. It is usually good to go home immediately after the survey.

Computer tomography

If the kidneys do not have X-rayed before coming to urology clinic so you have to go through a CT scan . Then detailed images of the body are taken. During the examination, one must lie down on a breeze, which is slowly passed through an opening on a large apparatus while pictures are being taken. The examination usually takes five to twenty minutes and does not hurt.

If kidney cancer is detected, a lumbar CT scan is also usually performed.

Getting answers can take a few weeks

The answers to the surveys are weighed together. It may take up to a few weeks for all investigations to be completed and you get answers to what they have shown. If you have a tumor, the doctor now knows how big it is, where it sits on the kidney and if there is any suspicion that it has spread in the body. Based on this, any supplementary examinations and a treatment are recommended.

You see the doctor again to get all the information about his kidney cancer. Often, a breakdown of the development of the disease is used in various stages to describe the size of the tumor and whether the disease has spread. You also get information about the various treatments that are suggested.

New medical assessment

If you have been diagnosed with kidney cancer and are unsure if you are receiving the care and treatment that is best for you, you may receive a new medical assessment . You will then see another doctor, usually at another specialist clinic. Ask your doctor if you want to know more about how to get a new medical assessment.

Getting a cancer message

Ordinary but still scary

Every day, 160 people many countries receive a cancer message . For some, the word cancer means the same thing as death, even though most people who get cancer get healthy. New methods of treatment are constantly evolving, and although not all are completely healthy, there are good opportunities to live with the disease for a long time.

Often, you need plenty of time to talk to your doctor and other healthcare professionals after receiving a cancer message. It may be good to have a close relative during such conversations. The related person can act as a support and help to remember what has been said.

Help is available both within and outside the care

No matter how it goes, the message about the illness and the upcoming treatment means that life is turned upside down, not just for the sick person but also for many around. If you need to talk to someone, you can get help from patient associations and you can also contact the Cancer Counseling or Cancer Foundation.

For many, it usually feels easier once treatment has begun and you know what is going to happen. Almost all hospitals have special contact nurses who can provide additional support and help with various practical things. Most hospitals also have a curator who can support.

Treatment

The treatment depends on how the cancer tumor has developed

The treatment you receive depends on the size of the cancer tumor, where it is located in the kidney and whether the tumor has spread to other parts of the body.

If the tumor has not spread, you are usually operated on. Either the whole kidney is removed or just the part that contains the tumor. It is determined by the size of the tumor and where in the kidney it sits. Most often, the body can function as usual with the kidney remaining.

So the kidney surgery goes on

Often, the cancerous tumor is operated on through an abdominal incision. But you can also be operated on with puncture surgery , which is now often done with robot-assisted technology. The tumor is then removed using a peephole instrument, a thin metal tube with a lamp and a small video camera that is inserted into the body via several small holes.

An operation can take a long time depending on the size of the tumor and how easy it is to access it. Usually the operation takes a couple of hours. An operation with peephole usually takes a little longer than an operation with incisions.

If an incision is made it will usually be ten to twenty centimeters long. In surgery with peephole surgery, several small incisions are made on a few centimeters and a larger one, through which the kidney is removed from the body.

Preparations for the operation do not differ between the methods.

preparations

It is good to be in the best possible condition when it is time to operate. You can try to rest properly and eat useful. Sometimes you need to change your medication or other treatment if you have other illnesses.

If you smoke, the profits are many to stop before an operation . The wounds heal faster, they recover faster and the risk of infection of the operating wound and pneumonia are reduced.

Prior to the operation, you receive medicine for blood clots, since large surgeries increase the risk of blood clots. You can also see an anesthetist to talk about how to be anesthetized and what pain relief is needed.

You should not eat or drink anything from midnight the night before the operation.

After the surgery

If you are operated on by an incision in the abdomen, you are anesthetizedby anesthesia and also get back anesthesia , as the entire area of ​​the operation is anesthetized. Sometimes you only get back anesthesia and are then awake during the operation, but feel no pain.

After the surgery, you still get pain relief so that you can move quite freely. What is usually felt is precisely when to sit up or when to get out of bed. The physiotherapist is usually taught how to get out of bed to reduce the pain.

When you have a back anesthetic you do not feel when you are in need of kissing. Therefore, you may have a urinary catheter as long as the back anesthesia still works. A urinary catheter is a thin, soft tube that is inserted into the urethra, into the bladder, and empties the urine into a collection bag.

After about a week in the hospital, you usually go home. Then you get a clean bandage over the operating wound. You should change it if it becomes loose or looks messy. After about two weeks, the stitches are removed from the district nurse. Sometimes metal clips are used when the wound is sewn together, even these are removed by the district nurse after a few weeks. The wound may also have been sewn with stitches that disappear by themselves.

Often it takes just over a month before you recover. After puncture surgery, recovery usually goes a little faster. You should not lift heavily the first month after the operation, but otherwise you can live as usual.

One to three months after the operation, you are called to a doctor’s visit to the person who operated. Then you go through together if further treatment is needed and how close controls you need to go. It can also be good to have a close relative at the time.

Sometimes you can’t be operated on

If you have other serious illnesses, the risks of an operation can be too great. Then you have to go on regular checks instead.

For smaller tumors, instead of surgery, you can be treated with so-called minimally invasive treatment such as radiofrequency treatment (RF) where you kill the tumor by heating, or by freezing with so-called cryotherapy. These treatments are not as safe as surgery, but are a good alternative when you have other serious illnesses.

If you cannot get surgery, but have a large tumor that causes a lot of trouble, you can go through a treatment called embolization, which means that the blood vessels that supply blood and nourishment to the kidney are closed. This is done to reduce the size of the tumor. Then the doctor inserts a thin plastic tube into the blood vessels that go to the kidney, and by injecting drugs, the blood flow to the kidney is blocked. It is usually done in an X-ray department.

If the cancer has spread

Treatments can curb the disease

If the kidney cancer has spread, the disease is very serious, but there are opportunities to curb the disease with the help of various treatments. It is most common for the cancer to spread to the lungs. But it can also be spread to the liver, brain or skeleton.

Several specialists usually cooperate in deciding which treatment is best. Sometimes the cancerous tumor in the kidney is removed, but not always. If there are any single metastases in the lung, liver or brain they can also in some cases be removed.

Targeted drugs

If the cancer has spread to several parts of the body, you can get a new type of drug called targeted. There are several different types of targeted drugs, most commonly called tyrosine kinase inhibitors. They interfere with the ability of the cancer cells to grow and divide by reducing the formation of blood vessels and thereby reducing the nutrient supply to the cancer cells. This allows the tumors to shrink or grow more slowly.

Today there are various medical targeted drugs. The most common treatment is with tablets. One example is taking the medication in the form of tablets every day, often for four weeks. After the four-week course, a two-week break is made. Then a new treatment course begins. How long the treatment lasts depends on how the body responds to the treatment and how troublesome side effects you get. You can also get some targeted drugs like a syringe once a week. If the treatment has no effect on the cancer tumor, another medication can help.

You get the drug in consultation with a cancer doctor, either at a urology clinic or an oncologist’s clinic. Although the treatment does not make you get rid of the cancer, it can make you feel better and can live longer with the disease.

Common side effects

The targeted drugs can cause side effects such as diarrhea, fatigue and nausea. Sometimes, eczema-like changes can occur on palms and soles of the feet. If the side effects become too cumbersome, you can get medicines to suppress them. It is also possible to reduce the dose or to make the stay between the courses longer. The side effects disappear when you stop taking the medicine.

How the drug treatment affects the kidney cancer is checked with regular x-rays.

radiotherapy

Radiation therapy can be used to relieve the pain that metastases can cause. Radiation therapy is otherwise usually not effective against the kidney cancer itself.

When the disease can no longer be stopped

The disease can be so severe that it is no longer possible to curb the cancer. In this situation there are many different treatments to relieve the pain and other problems. Often they are cared for at home. There are also special clinics in the country where you can be cared for by staff who specialize in caring for people with severe cancer at the end of life.

How is life affected by cancer?

Regular checks

When you have received treatment for kidney cancer, for example surgery, you usually have to go for regular checks. How often and how long depends on how extensive and severe the kidney cancer is.

If you have not had problems with the kidneys earlier in life, the body is usually able to function normally, even if one kidney has been removed. You can live as before but be careful about using medicines that can affect or damage the healthy kidney you have left.

To recover mentally

There are many different events and situations in life that can cause you to feel great mental stress, for example if you go through a serious illness. In different ways you can try to recover mentally. Some may want to discuss the disease frequently with their friends, others may want to keep this to a smaller circle. But you have to recover in the way that corresponds to who you are as a person. For many, the illness and time of treatment means stopping, re-evaluating and changing things in one’s life.

People in close proximity are often good support, but it may not always be enough. It may also be that you have no one to talk to. You should never hesitate to contact the healthcare provider if you feel you need help.

You can turn to the clinic where you have received care or a health center to get help, for example to a curator. Some clinics and health centers also have psychologists that you can meet for calls. Here you can read more about different types of cancer advice and support 

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