Urology

What is a risk factor? A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors. Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors. But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What are the different types of kidney cancer?

Kidney cancer affects more than 30,000 people in the US, with the most common type called renal cell cancer. The information contained on this page refers to renal cell cancer.

What are the risk factors for renal cell cancer?

The exact cause of renal cell cancer is unknown. However, there are certain risk factors that are linked to it. These risk factors, according to the American Cancer Society, are as follows:

• smoking
  Smoking doubles the risk of kidney cancer.

• asbestos
  Studies show a link between exposure to asbestos and kidney cancer.

• cadmium
  There may be a link between cadmium exposure and kidney cancer. Cadmium may increase the cancer-causing effect of smoking.

• family history
  Family history of kidney cancer increases a person's risk.

• gender
  Men are twice as likely to develop renal cell cancer than women.

• von Hippel-Lindau syndrome
  This is a disease caused by a gene mutation that increases the chances of renal cell cancer.

• tuberous sclerosis
  Patients who have this disease are more likely to develop renal cell cancer.

• diet
  A high-fat diet increases a person's risk of kidney cancer.

• obesity
  Obesity increases a person's risk of kidney cancer.

• long-term dialysis
  Patients who have been on dialysis for a long time may develop kidney cysts, which may be one cause of renal cell cancer.

What are the symptoms of renal cell cancer?

The following are the most common symptoms of renal cell cancer. However, each individual may experience symptoms differently. Symptoms may include:

• blood in the urine
• rapid, unexplained weight loss
• low back pain (not caused by an injury)
• loss of appetite
• swelling of ankles and legs
• mass or lump in the belly
• fatigue
• recurrent fever (not caused by a cold or the flu)
• high blood pressure (less frequently)
• anemia (less frequently)
• unrelieved pain in the side

The symptoms of renal cell cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

How is kidney cancer (renal cell cancer) diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for kidney cancer may include the following:

• blood and urine laboratory tests

• intravenous pyelogram (IVP) - a series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.

• renal angiography (Also called arteriography.) - a series of x-rays of the renal blood vessels with the injection of a contrast dye into a catheter, which is placed into the blood vessels of the kidney, to detect any signs of blockage or abnormalities affecting the blood supply to the kidneys.

• other imaging tests (to show the difference between diseased and healthy tissues), including the following:
  
  
  • computed tomography scan (Also called a CT or CAT scan.) - a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary x-ray.
    
    
  • magnetic resonance imaging (MRI) - a non-invasive procedure that produces two-dimensional view of an internal organ or structure, especially the brain and spinal cord.
    
    
  • ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.

Based on results of other tests and procedures, a biopsy may be needed. A biopsy is a procedure in which a sample of the tumor is removed and sent to the laboratory for examination by a pathologist. Biopsy is the only sure way to diagnose cancer.

Treatment for kidney cancer:

Specific treatment for kidney cancer will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• surgery
  Surgery to remove the kidney is called a nephrectomy and it is the most common treatment for kidney cancer. The following are different types of nephrectomy procedures:
  
  
  • radical nephrectomy - the whole kidney is removed along with the adrenal gland, tissue around the kidney, and, sometimes, lymph nodes in the area.
    
    
  • simple nephrectomy - only the kidney is removed.
    
    
  • partial nephrectomy - only the part of the kidney that contains the tumor is removed.
    
    

  The remaining kidney is generally able to perform the work of both kidneys.

• radiation therapy (Also called radiotherapy.)
  Radiation therapy uses high-energy x-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.

• biological therapy (Also called immunotherapy.)
  Biological therapy is a treatment that uses the body's own immune system to fight cancer.

• chemotherapy
  Chemotherapy is the use of drugs to kill cancer cells.

• hormone therapy
  Hormone therapy is used in a small number of patients with advanced kidney cancer to try to control the growth of cancer cells.

• arterial embolization
  Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow. It may also be used before an operation to make surgery easier, or to provide relief from pain when removal of the tumor is not possible.