Lidney cancer

Malignant tumors from kidney tissue cells are detected in 2-3% of cases from the total number of registered oncological diseases. People in the age range from 40 to 60 years are more prone to risk, and women get sick twice as often as the male part of the population.

Kidney cancer: risk factors

The causes of the disease have not yet been discovered, but there are some patterns that increase the likelihood of risk, such as:

• violation of the optimal balance of sex hormones, in particular estrogens;
• hereditary factors, which are manifested by the presence of family forms of the disease;
• occupational damage - there is a connection with the development of tumors in people working in factories with coke compounds, asbestos, aromatic amines;
• long-term course of inflammatory kidney diseases. Presence of benign formations or congenital malformations in a person's anamnesis;
• obesity - it increases the risk by 20%;
• smoking, which increases the probability of kidney cancer by one and a half times;
• among the female part of the population, after removal of the uterus, the risk of developing an oncological process in the kidney tissue increases twofold.

Varieties and metastasis

Neoplasms are morphologically divided into several forms:

• clear cell kidney cancer - survival in this type, as in other types, depends on the degree of the disease. This is a growing tumor that has a high level of blood supply. It is observed in 60-65% of cases;
• the chromophobic form, or the papillary form, develops from the cells of the renal pelvis, is diagnosed in 7-14% of cases;
• squamous cell carcinoma of the kidney originating from the cortical part of the collecting tubules. The frequency of detection varies between 4-10%;
• oncocytic form, found in 2-5% of cases.
• cancer of the collecting ducts is an oncological process that develops from the cells of the renal tubules of Bellini, it is diagnosed with a frequency of 1-2%.

Metastasis of a kidney tumor occurs in two ways:

• system of lymphatic vessels, from where metastases can penetrate into the lymph nodes surrounding the gates of the kidneys, located around the abdominal aorta, the inferior vena cava, and pararectally. In rare cases, they can penetrate into the lymph nodes of the mediastinum and neck;
• blood vessels, as a result of which tumor cells enter the tissues of many organs and systems.

Kidney cancer: stages

In addition to pathomorphological classification, there is a division of kidney cancer by stages of development. The classification of the stage of the oncological process, developed by Robson in 1969, will be the most acceptable for a wide range of people, according to which:

• Stage I is characterized by the growth of the tumor exclusively within the kidney, without disruption of its capsule;
• in stage II, the process covers the renal capsule, but does not go beyond it;
• Stage III can be manifested in two ways: the appearance of metastases in local lymph nodes or the spread of the tumor process to the tissues of the renal and (or) inferior vena cava;
• Stage IV is diagnosed if metastases are detected in distant organs.

Kidney cancer: symptoms

For a long period of time, the oncoprocess proceeds in a latent form, without manifesting itself in any way. The first symptoms may appear only after 3-5 years, and in 30% of cases, the tumor process is diagnosed due to the symptoms that arise from the fact that distant organs are affected by metastases.

Clinical signs of the disease can be divided into two main groups: urological and neurological. Others manifest themselves:

• reduced tolerance to physical exertion;
• increased sweating;
• a rise in body temperature, mainly in the evening;
• pronounced swelling of the legs;
• unmotivated high blood pressure associated with an increase in the level of angiotensin (this substance is increasingly produced due to weakened blood circulation in the kidney tissue, as it is partially removed by a kidney tumor).

With the progression of the disease, the paraneoplastic syndrome comes to the fore - a complex of clinical and laboratory symptoms that indirectly indicate the presence of an oncological process. These include:

• increased erythrocyte sedimentation rate in the general blood test;
• prolonged and constantly high temperature;
• increased number of erythrocytes;
• increased level of calcium in the blood;
• non-metastatic hepatomegaly.

Urological signs are manifested by three classic symptoms:

• hematuria - an admixture of blood in the urine. Kidney cancer is characterized by its manifestation against the background of complete well-being, discharge in the form of worm-like clots (in the shape of the ureters) is often observed. Hematuria can vary in intensity and duration, it often stops on its own and may recur without treatment of the underlying pathology;
• pain sensations in the region of the projection of the kidneys, which are observed in half of the patients and are characterized by a feeling of heaviness and discomfort in the area of ​​the kidneys. Due to blockage of the ureter with a blood clot, the phenomenon of renal colic may occur;
• tumor-like kidney - a bumpy and dense neoplasm that can be palpated in 20% of patients.

Urological symptoms of kidney cancer, as a rule, are delayed - approximately one-third of patients with these signs show metastases.

Kidney tumor diagnosis

Laboratory studies play an important role in the diagnostic process, as they can indirectly lead to a diagnosis or become an additional confirming factor in its formulation. With the help of analysis, you can find out such important indicators as:

• the degree of kidney function, which can be established using the level of creatinine and urea in a biochemical blood test;
• imbalance of micro- and macroelements, in particular calcium level;
• high rate of sedimentation of erythrocytes and their increased number due to the development of paraneoplastic syndrome;
• hidden hematuria (when evaluating urine analysis), since not in all cases it can flow clearly and be noticed by the naked eye.

Research using instrumental methods plays a decisive role, as they help to visualize the pathological process in the kidney tissue.

A frequently used visualization method is an ultrasound screening test, which has a high diagnostic value, because more than 40% of malignant kidney neoplasms that are symptomatic are found already at the ultrasound stage. This method does not cause harm, is quick to perform, and does not require unpleasant or painful manipulations. Conducting a dopplerographic study is especially valuable because it allows you to determine how much the tumor process has spread along the course of adjacent vessels.

Classical x-ray methods with the use of special medical contrast agents are also used to diagnose a kidney tumor. These include:

• excretory urography - it displays changed contours, deformation of the pelvic-pelvic system due to tumor growth;
• renal arteriography - determination of filling defects of renal arteries by the type of "puddles" and "lakes", this method can also be used for preoperative preparation;
• cavography - examination of the inferior vena cava with the introduction of a contrast agent into it. It is used to determine tumor growth in the vessel wall and lumen.

Research with a magnetic resonance device and a computer tomography are also relevant, which give a very accurate picture, and additionally allow to identify the structures of the body affected by metastases.

It is necessary to distinguish kidney tumors from such pathologies as:

• intra-abdominal neoplasms;
• abscess, kidney carbuncle;
• paranephritis;
• tuberculous kidney damage;
• urolithiasis;
• pseudotumors;
• polycystic disease;
• hydronephrosis

Kidney cancer: treatment

Operative treatment of kidney oncology can be divided into radical and symptomatic. The first type of operations includes:

• extended radical nephrectomy – complete removal of the organ with the inclusion in the scope of surgical intervention of removal of the upper third of the ureter, adrenal gland, seminal vein and local lymph nodes;
• organ-preserving nephrotomy - it is used in the initial stages of cancer: the kidney is removed, operated on at a low temperature, and reverse transplantation is performed.

Palliative surgical intervention is a simple nephrotomy - removal of the tumor in the maximum possible volume. This leads to a decrease in patient suffering.

In addition, such treatment methods are used as:

• chemotherapy is an extremely ineffective method for kidney cancer, it is used as a palliative form of therapy or in combination with other methods;
• hormone therapy - blocking of estrogens with the help of special antagonist drugs, which can inhibit tumor development;
• active immunotherapy - stimulation of the growth and reproduction of special immunocompetent cells. It is also used as a palliative measure;
• radiotherapy is also ineffective, so it is used as symptomatic therapy.

If doctors recognized kidney cancer in time, the prognosis after removal is extremely favorable. As the condition worsens, the chances become much lower.

It is important to know: even if a successful operation was performed and surgeons radically removed the kidney cancer, metastases can appear even decades after surgery.

Prevention

Although there are no special measures that prevent the development of the disease, it is possible to reduce the likelihood of cancer by taking into account some points. Importantly:

• overcome or prevent harmful habits in your life, monitor your weight, engage in physical education and follow a proper diet;
• maintain the level of arterial blood pressure within normal limits;
• conduct annual examinations, and if necessary, consult a urologist.

It is important to remember that kidney cancer is curable in the first stages, so it is necessary to detect the disease early and fight it effectively. In case of suspicion, it is necessary to visit a specialist.