Kidney cancer treatment

Kidney cancer is a malignant neoplasm that develops in one of the departments of the organ. The tumor consists of atypical cells that divide rapidly and chaotically, can be carried by blood and lymph throughout the body, provoking the development of metastases - new foci of the disease. Despite the possibility of early diagnosis, in approximately a third of patients, kidney cancer is detected in the late stages.

In Ukraine, kidney cancer is diagnosed in 5,000 people annually. It most often develops in people over 65 years of age, but cases of the disease are often found at a young age. Kidney cancer occupies a special place in the statistics of childhood oncological diseases - in some countries its frequency reaches 40% of all malignant neoplasms.

Oxford Medical has created all the conditions for accurate diagnosis and effective treatment. We employ some of the best oncologists and surgeons in Kyiv and Ukraine with many years of experience, who are familiar with all modern methods of cancer treatment, including targeted and immunotherapy.

Surgical treatment is performed in a high-tech surgical hospital with two operating rooms, an intensive care unit and intensive care wards. Operations are performed using both classical and minimally invasive techniques.

To make an appointment for a consultation, call our contact center or write to the chat on the website.

Depending on the nature of the cells that make up the tumor, several types of kidney cancer are distinguished:

• clear cell;
• chromophilic, or papillary;
• chromophobic;
• oncocytic;
• collecting duct.

Clear cell cancer (renal cell or adenocarcinoma) is the most common - up to 80-90% of tumors. Most often it develops from the epithelial cells of the proximal tubules, less often the structure also includes cells of the collecting tubules.

Each type of cancer has its own characteristics, in particular, a different tendency to metastasize. All this is taken into account when drawing up a treatment program.

Also of particular importance is the classification of cancer according to the stage of development.

In total, 4 stages are distinguished:

• Stage 1 - the diameter of the tumor is less than 7 cm, it is localized in one kidney and does not go beyond its boundaries;
• Stage 2 – the tumor penetrates the renal capsule, has a size of more than 7 cm;
• Stage 3 – the tumor grows beyond the kidney, and can affect the renal or inferior vena cava, as well as metastasize to the lymph nodes;
• Stage 4 – the tumor penetrates into adjacent organs, metastases may appear throughout the body.

Kidney cancer, like other neoplasms, is not detected in the early stages. The patient may not have symptoms for 3, and sometimes 5 years. The disease can be detected at this stage only when undergoing regular preventive examinations or consulting a doctor for another reason. However, it is at stages 1 and 2 that oncology is best treated.

The state of health worsens, as a rule, at stages 2-4, when the size of the tumor increases, and it begins to affect the functionality of the kidneys or affects neighboring organs and gives metastases.

These symptoms are non-specific, that is, they are characteristic not only of kidney cancer, but also of other diseases. To find out their cause, you should consult a doctor and undergo the examinations that he will prescribe (blood tests, urine tests, ultrasound, etc.).

The development of kidney cancer is mainly associated with genetic predisposition, lifestyle and environmental influences.

The main risk factors are:

• heredity;
• kidney disease;
• prolonged hemodialysis;
• hypertension;
• work in chemical plants;
• smoking;
• obesity;
• age over 50-60 years;
• male gender;
• removal of the uterus.

As cancer develops, it affects both the affected organ and the entire body as a whole. The tumor can cause kidney dysfunction and lead to chronic failure. It can also spread to adjacent organs: the adrenal glands, bladder, reproductive system, etc.

In addition, oncology is characterized by metastasis. Malignant cells can be transported by the bloodstream and lymph, settle in different parts of the body and cause the development of new foci.

A neoplasm can be diagnosed using instrumental diagnostics: ultrasound, X-ray or computed tomography. However, to determine its type, a biopsy is required - taking a sample of cells and conducting a histological analysis. It is the most accurate method of diagnosing cancer.

In addition, it is important to assess the size of the tumor, find out whether it has grown beyond the kidney and whether there are metastases in other parts of the body. Making an accurate diagnosis requires a whole range of studies.

The patient may be prescribed:

• laboratory tests of blood and urine (general, biochemistry, for hormones, tumor markers, etc.);
• Ultrasound of the kidneys;
• X-ray, CT or MRI of the kidneys with contrast;
• Ultrasound of the abdominal cavity and pelvis;
• CT of the chest;
• CT of the brain and other examinations.

Computed tomography of other parts of the body is necessary to detect metastases. It is a more accurate examination than X-rays and ultrasound, as it involves layer-by-layer scanning of the body. CT allows you to diagnose tumors as small as 1 mm.

X-rays, CT scans, or MRI with contrast are also used to determine the size of the tumor and its involvement of blood vessels and adjacent organs.

The doctor develops an individual examination program based on the patient's medical history, symptoms, and other features.

Treatment of cancer requires a comprehensive approach.

National and international protocols provide for:

• surgical treatment;
• radiotherapy;
• chemotherapy;
• targeted therapy;
• immunotherapy.

Depending on the size of the tumor and the presence of metastases, an individual treatment program is developed for the patient. It may include surgery, radiotherapy or chemotherapy, which can be performed before and after removal of the kidney tumor, and other treatment measures.

The kidneys are a paired organ. If cancer has affected only one kidney, it is often recommended to remove it. After that, the second kidney usually copes with the increased load, allowing the patient to lead a full life.

There are 3 types of surgical interventions:

• resection of the kidney - an organ-preserving operation that involves the removal of only the tumor inside the organ;
• nephrectomy - removal of the kidney;
• nephrectomy with removal of adjacent organs - a radical operation that removes not only the kidney, but also the surrounding tissues affected by the tumor (adrenal glands, lymph nodes, etc.).

Resection of the kidney is the simplest operation, but it is effective only for a small tumor that does not extend beyond the organ. Removal of the kidney is required in more complex cases and for inconveniently located tumors, when resection is impossible.

In case of advanced cancer, radical nephrectomy is performed, that is, the kidney, nearby lymph nodes, adrenal glands and other tissues into which the tumor has grown are removed.

Operations are performed:

• laparoscopically - through several punctures in the abdominal cavity;
• laparotomy, or open method – through a longitudinal incision in the kidney area.

Laparoscopic operations are usually performed during kidney resection and nephrectomy. This is a minimally invasive technique that allows the tumor to be removed through several small punctures using special equipment. As a result, damage to healthy tissues is reduced and the rehabilitation period is shortened.

Laparotomy is required for difficult-to-locate tumors that have spread to neighboring organs.

Patients for whom surgery is contraindicated are sometimes subjected to cryoablation or radiofrequency thermoablation. These procedures involve exposing the tumor to extremely low or high temperatures that cause cell death.

Most often, in addition to resection or removal of the kidney, patients are also prescribed conservative treatment. It is used for metastases, as well as to prevent the recurrence of cancer. During surgery, it is very difficult to guarantee that all malignant cells have been removed. However, the preservation of even a few of them can lead to relapse. To reduce the risk, radiation, chemotherapy, targeted and immunotherapy are used. The patient may be prescribed a complex of several methods.

In addition, other drugs are prescribed that help relieve pain and other symptoms of the disease.

The effectiveness of cancer treatment directly depends on when the diagnosis was made. The earlier the tumor is detected, the more chances the patient has to defeat the disease.

For stage 1 and 2 cancer, the prognosis is favorable. Most patients manage to completely defeat the disease. At stage 3, the prognosis is determined as satisfactory. The tumor is usually amenable to surgical treatment. At stage 4, extensive metastasis is noted, which significantly reduces the effectiveness of treatment. In such cases, many patients are recommended only palliative care, which helps to reduce symptoms and alleviate the painful condition.