Kidney cancer • These symptoms should be taken seriously!

Kidney cancer is a malignant tumor disease of the kidney. Compared to other cancers, kidney cancer is relatively rare. Often it is a mere chance finding.

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Cancer: 20 Signs To Take Seriously

Kidney Cancer Symptoms: When To See A Doctor?

Symptoms rarely occur in the early stages of kidney cancer. At first, many people do not notice that a tumor is growing in their kidneys. Doctors often discovered him by chance during an ultrasound examination (sonography) of the abdomen, which they do for a different reason.

The following symptoms are possible with kidney cancer:

Usually these symptoms do not set in until a later stage of kidney cancer. In any case, you should consult a doctor and have the complaints clarified. A blood test can also provide information about a tumor, for example if the number of red blood cells (erythrocytes), the liver values, the blood protein content, the calcium values ​​or certain hormone values ​​are changed.

Causes: How does kidney cancer develop?

Kidney cancer can develop from a variety of tissues. Around 90 percent of all malignant kidney tumors are renal cell cancer. This has its origin in the cells of the fine kidney tubules. Doctors also speak of kidney cancer, kidney carcinoma, renal cell carcinoma or adenocarcinoma of the kidney. Most patients only have one kidney affected.

Lymphomas and sarcomas of the kidneys that originate from the lymphatic system or the muscles are significantly less common. They are more common in children. Wilms’ tumor (nephroblastoma) is a malignant tumor of the kidney that almost exclusively affects children under five years of age.

The exact causes of kidney cancer are not yet known. But there are some risk factors that are linked to the development of the tumor:

• increasing age
• Smoking and passive smoking
• Obesity
• high blood pressure
• lack of physical activity
• high-fat, low-fiber diet
• Insufficient fluid intake
• increased alcohol consumption
• Abuse of painkillers (non-steroidal anti-inflammatory drugs, NSAIDs)

Environmental influences and hereditary risk factors

It has not yet been clearly established whether pollutants such as lead, asbestos, cadmium and aromatic hydrocarbons promote development. Chronic renal failure generally favors malignant kidney tumors, regardless of their cause. For example, taking drugs that damage the kidneys and inflammation of the urinary tract can cause chronic kidney failure. Another risk factor is cystic kidney disease.

In addition, patients who have had a kidney transplant who have to take medication to suppress their immune system (immunosuppressants) have an increased risk of kidney cancer. Only about three percent of kidney carcinomas occur in patients with hereditary diseases, for example as part of the so-called von Hippel-Lindau syndrome. Those affected then develop kidney cancer at a younger age.

Diagnosing kidney cancer

Kidney cancer is often diagnosed at an early stage, when the tumor is still small and has not yet spread. In most cases, kidney cancer can then be treated well. The increased use of ultrasound examinations in medical practices is responsible for this positive development. Doctors discover most kidney tumors by chance during an ultrasound scan.

At the beginning of the kidney cancer diagnosis there is always a conversation between the doctor and the patient, in which they are asked about their medical history (anamnesis). The focus is on symptoms, existing illnesses, the use of medication, cancers in the family, work and lifestyle.

As part of a physical examination, the abdomen is palpated. Doctors can feel swelling that suggests kidney cancer. Swollen lymph nodes or water retention in the legs (edema) can also be indications of kidney tumors.

• The Ultrasound examination of the abdomen and kidneys makes possible changes in the organs visible. The diagnosis of kidney cancer can often be made with the help of ultrasound. A urine test can rule out the possibility of blood in the urine. As part of a blood test, doctors look for abnormal blood values. Among other things, they determine the creatinine level, alkaline phosphatase and inflammation levels (C-reactive protein, CRP). There are no tumor markers that clearly indicate kidney cancer.

• Means Computed Tomography (CT) doctors can assess exactly where the tumor is and how far the kidney cancer has progressed. An alternative is magnetic resonance imaging (MRI, also known as magnetic resonance imaging).

• If there is blood in the urine and a suspected kidney pelvic tumor, one will help X-ray examination of the urinary tract with a contrast medium, the so-called urography. It depicts the kidneys, ureters and bladder.

• Sometimes doctors take one Tissue sample (biopsy) with the help of a fine needle from the suspicious tissue. A pathologist examines the cell material under a microscope. In this way, he usually finds clues as to the tissue from which the tumor developed.

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Kidney cancer therapy – various building blocks against tumors

The treatment is intended to permanently cure the cancer or at least to keep it in check. In the early stages, kidney cancer is often curable and the prospects for survival are good. The therapy depends mainly on how far the kidney cancer has progressed. The size of the tumor and its spread are important, for example whether metastases can be detected in the surrounding lymph nodes or organs such as the lungs or the bones.

Operation for kidney cancer

The operation is considered to be the only treatment method that can permanently cure the cancer. Whether such an intervention is an option depends on whether the tumor is still confined to the kidney or has already metastasized in other organs. In the case of very small kidney tumors, the operation of which would be risky or which would significantly reduce the life expectancy of the patient, doctors sometimes wait and observe the tumor (active waiting).

Depending on the size and location of the tumor, doctors nowadays always try to operate as “kidney-friendly” as possible and to preserve the diseased kidney. Only the tumor is excised, because the kidney can be preserved in small tumors without the patient’s chances of survival deteriorating.

If the kidney tumors are larger or in an unfavorable position, the organ is completely removed. After the operation, the healthy kidney completely takes over the functions of the removed kidney. One can live very well without restrictions even with only one kidney.

Kidney cancer therapy for metastases

In around ten percent of patients, the cancer has spread at the time of diagnosis. The cancer cells have migrated to the surrounding lymph nodes or have infected other organs – the cancer has metastasized. Kidney cancer particularly often spreads to the lungs, liver and bones. A cure for the kidney carcinoma is then often no longer possible.

In patients who are in good general condition, surgeons completely remove the affected kidney. Metastases in the lungs can also be operated on. In principle, a cure is still possible even with metastatic kidney cancer. Daughter tumors in the bony skeleton are operated on and sometimes also irradiated.

Other ways to treat kidney cancer:

• Targeted therapies: In the past few years, new drugs have been approved that are considered a major advancement in kidney cancer treatment. The drugs interrupt certain signaling pathways of the tumor or prevent new blood vessels from forming into the tumor. In doing so, they cut off the oxygen and nutrient supply and starve him. Targeted therapies help with advanced and metastatic kidney cancer.

• Immunotherapy: In recent years, immunotherapy has significantly improved the chances of survival for cancer patients. It does not attack the cancer cells themselves, but targets the immune system. In advanced kidney cancer, the active ingredients interferon alpha or interleukin-2 are used. They stimulate the immune system to attack and eliminate the cancer cells. Checkpoint inhibitors also play an important role among immunotherapies. They attack certain control points of the immune system and also sharpen the immune system.

• Radiotherapy: Radiation is only used if the tumor has already metastasized. Because tumors on the kidneys are not very sensitive to radiation. This form of therapy primarily alleviates the symptoms, but does not lead to a cure.

• Chemotherapy: Chemotherapy is a standard for many cancers. But it hardly helps with kidney cancer. The successes are so small that chemotherapy is usually not used.

• Pain treatment: Advanced kidney cancer can cause considerable pain, which significantly reduces the quality of life. Adequate pain treatment is therefore important. Pain therapy belongs in the hands of an experienced pain specialist.

Cure is possible – metastases worsen the prognosis in kidney cancer

The earlier kidney cancer is discovered, the more treatable it is and the higher the chances of survival. In recent years, life expectancy in kidney cancer has increased. 76 percent of men and 78 percent of women are still alive five years after their diagnosis.

Complete cure through surgery is often possible in people with small kidney tumors. With larger tumors, on the other hand, there is a greater risk that the kidney cancer will recur despite surgery (relapse, relapse). The occurrence of metastases is usually associated with a worse course and a less favorable prognosis.

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