Kidney cancer begins when healthy cells in 1 or both kidneys change and grow out of control, forming a mass called a renal cortical tumor.

Kidney Cancer Treatment In Malaysia



 

Types of kidney cancer

There are several types of kidney cancer:

Renal cell carcinoma

Renal cell carcinoma is the most common type of adult kidney cancer, making up about 85% of diagnoses.

Transitional cell carcinoma

This is also called urothelial carcinoma. It accounts for 10% to 15% of the kidney cancers diagnosed in adults.

Sarcoma

Sarcoma of the kidney is rare and develops from the soft tissue of the kidney or the capsule or surrounding fat.

Wilms tumor

This is most common in children and is treated differently than kidney cancer in adults.

Lymphoma

Lymphoma is associated with enlarged lymph nodes in other parts of the body, including the neck, chest, and abdominal cavity. In rare cases, kidney lymphoma can appear as a lone tumor mass in the kidney and may include enlarged regional lymph nodes.

 

Types of kidney cancer cell

The most common types of kidney cancer cells are listed below:

Clear cell

About 70% of kidney cancers are made up of clear cells. Clear cells range from slow growing to fast growing. Clear cell kidney cancer is particularly responsive to immunotherapy and targeted therapy.

Papillary

Papillary kidney cancer develops in 10% to 15% of patients.

Sarcomatoid features

Each of the tumor subtypes of clear cell, chromophobe, and papillary in kidney cancer can show highly disorganized features under the microscope, also described as sarcomatoid which suggest a very aggressive form of kidney cancer.

Medullary/collecting duct

This is a rare and highly aggressive cancer that is more common in black people and is highly associated with having the sickle cell trait.

Chromophobe

Chromophobe is uncommon and may form indolent tumors.

Oncocytoma

This is a slow-growing type of kidney cancer that rarely, if ever, spreads.

Kidney cancer: Risk factors and prevention

The following factors may raise a persons risk of developing kidney cancer.

Smoking
Smoking is believed to cause about 30% of kidney cancers in men and about 25% in women.
Exposure to cadmium
Some studies have shown a connection between exposure to the metallic element cadmium and kidney cancer.
Gender
Men are 2 to 3 times more likely to develop kidney cancer than women.
Chronic kidney disease
People who have decreased kidney function but dont yet need dialysis may be at higher risk for the development of kidney cancer.
Race
Black people have higher rates of kidney cancer.
Long-term dialysis
People who have been on dialysis for a long time may develop cancerous cysts in their kidneys.
Age
Kidney cancer is typically diagnosed between the ages of 50 and 70.
Family history of kidney cancer
People who have first-degree relatives, such as parents, brothers, sisters, or children, with kidney cancer have an increased risk of developing the disease. This risk increases if a number of extended family members have been diagnosed with kidney cancer, including grandparents, aunts, uncles, nieces, nephews, grandchildren, and cousins, and if these family members were diagnosed before the age of 50, had cancer in both kidneys, and/or had more than 1 tumor in the same kidney.
Nutrition and weight
Research has often shown a link between kidney cancer and obesity.
High blood pressure
Men with high blood pressure, also called hypertension, may be more likely to develop kidney cancer.
Inherited kidney cancer
Although kidney cancer can run in families, inherited kidney cancers are uncommon, occurring about 5% of the time. Finding a specific genetic syndrome in a family through genetic testing can help our oncologists at Onco Life Centre devise an appropriate cancer screening plan and, in some cases, help determine the best treatment options. Genetic conditions that increase a persons risk of developing kidney cancer include Von Hippel-Lindau syndrome, Hereditary non-VHL clear cell renal cell carcinoma, Hereditary papillary renal cell carcinoma, Birt-Hogg-Dub syndrome, Hereditary leiomyomatosis and renal cell carcinoma.

 

Treatment overview

Our oncologists at Onco Life Centre can discuss your treatment options and recommendations based on several factors, including the type, cell type, and stage of cancer, patient preferences and overall health.

Kidney cancer is most often treated with surgery, targeted therapy, immunotherapy, or a combination of these treatments. Radiation therapy and chemotherapy are occasionally used. Patients with kidney cancer that has spread often receive multiple lines of treatments.

 

Surgery

If the cancer has not spread beyond the kidneys, surgery to remove the tumor, part or all of the kidney, and possibly nearby tissue and lymph nodes, may be the only treatment necessary. The types of surgery used for kidney cancer include the following procedures.

  • Radical nephrectomy

    Surgery to remove the tumor, the entire kidney, and surrounding tissue is called a radical nephrectomy. If nearby tissue and surrounding lymph nodes are also affected by the disease, a radical nephrectomy and lymph node dissection is performed.

  • Partial nephrectomy

    A partial nephrectomy is the surgical removal of a tumor. This type of surgery preserves kidney function and lowers the risk of developing chronic kidney disease after surgery.

  • Laparoscopic and robotic surgery (minimally invasive surgery)

    During laparoscopic surgery, the surgeon makes several small incisions rather than the 1 larger incision in the abdomen to completely remove the kidney or perform a partial nephrectomy.

  • Radiofrequency ablation (RFA)

    Sometimes surgery is not recommended because of tumor characteristics or the patients overall health. RFA is the use of a needle inserted into the tumor to destroy the cancer with an electrical current.

  • Cryoablation

    Cryoablation is the freezing of cancer cells with a metal probe inserted through a small incision. The metal probe is placed into the cancerous tissue.

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

  • Anti-angiogenesis therapy

    This type of treatment focuses on stopping angiogenesis, which is the process of making new blood vessels. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to starve the tumor. Talk to our Oncologists about FDA approved anti-angiogenesis drugs that have been shown to slow down tumor growth for people with metastatic renal carcinoma.

  • Tyrosine kinase inhibitors (TKIs)

    Clear cell kidney cancer has a mutation of the VHL gene that causes the cancer to make too much of a certain protein, known as vascular endothelial growth factor (VEGF). VEGF controls the formation of new blood vessels. Drugs called TKIs help block VEGF and other chemical signals that promote the development of new blood vessels. Please call to talk to our Oncologists about FDA approved TKIs, which are indicated for use in treatment for clear cell kidney cancer.

  • mTOR inhibitors

    The FDA has also approved drugs that target a certain protein that helps kidney cancer cells grow, called mTOR. Studies show that these drugs slow kidney cancer growth.

Immunotherapy

Immunotherapy, also called biologic therapy, is designed to boost the bodys natural defenses to fight cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.

A type of immunotherapy, called checkpoint inhibitors, works by taking the brakes off the immune system so it is better able to destroy the cancer. These drugs use antibodies directed at specific molecules found on the surface of immune cells, such as programmed death-1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4).

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells ability to grow and divide.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Although chemotherapy is useful for treating most types of cancer, kidney cancer is often resistant to chemotherapy. However, researchers continue to study new drugs and new combinations of drugs.

Radiation Therapy

Radiation therapy is the use of high-energy x-rays to destroy cancer cells. Most often, radiation therapy is used when the cancer has spread to help ease symptoms, such as bone pain or swelling in the brain. The most common type of radiation treatment is called external-beam radiation therapy. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Another type of radiation therapy is stereotactic radiosurgery, which is designed to direct the radiation therapy to a specific area without damaging nearby tissue.

Patients and their families have opportunities to talk about the way they are feeling with our oncologists, nurses, counselors, or join our psychosocial program and support group at Onco Life Centre.

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