Renal cell carcinoma

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  • Smoking: Cigarette smoking is a major risk factor. Cigarette smokers are twice as likely as nonsmokers to develop kidney cancer. Cigar smoking also may increase the risk of this disease. Obesity: People who are obese have an increased risk of kidney cancer. High blood pressure: High blood pressure increases the risk of kidney cancer. Long-term dialysis: Dialysis is a treatment for people whose kidneys do not work well. It removes wastes from the blood. Being on dialysis for many years is a risk factor for kidney cancer. Von Hippel-Lindau (VHL) syndrome: VHL is a rare disease that runs in some families. It is caused by changes in the VHL gene. An abnormal VHL gene increases the risk of kidney cancer. It also can cause cysts or tumors in the eyes, brain, and other parts of the body. Family members of those with this syndrome can have a test to check for the abnormal VHL gene. For people with the abnormal VHL gene, doctors may suggest ways to improve the detection of kidney cancer and other diseases before symptoms develop. Occupation: Some people have a higher risk of getting kidney cancer because they come in contact with certain chemicals or substances in their workplace. Coke oven workers in the iron and steel industry are at risk. Workers exposed to asbestos or cadmium also may be at risk. Gender: Males are more likely than females to be diagnosed with kidney cancer. Each year in the United States, about 20,000 men and 12,000 women learn they have kidney cancer.
  • Symptoms: Many kidney tumors go undetected due to the lack of symptoms and are incidentally detected during the medical evaluation of an unrelated problem. Kidney tumors can cause symptoms by compressing, stretching or invading structures near or within the kidney. Symptoms caused by these processes include pain (in the flank, abdomen or back) and blood in the urine (small amounts may not be visible). If cancer spreads beyond the kidney, symptoms depend upon which organ is involved. Shortness of breath or coughing up blood may occur when cancer is in the lungs; bone pain or fracture may occur when cancer in the bone; and neurologic symptoms may occur when cancer is in the brain. In some cases, the cancer causes associated clinical or laboratory abnormalities called paraneoplastic syndromes. These syndromes are observed in approximately 30% of patients with kidney cancer and can occur in any stage. Clinical symptoms include weight loss, loss of appetite, fever, sweats and high blood pressure. Laboratory findings include elevated erythrocyte sedimentation rate, low red blood cell count (anemia), high calcium level in the blood, abnormal liver function tests, elevated alkaline phosphatase in the blood, and high white blood cell count. In many cases, the paraneoplastic syndrome resolves after the cancer is removed. CancerConsultant.com
  • Renal cell carcinoma

    1. 1. Renal Cell Carcinoma The most common type of kidney cancer is Renal Cell Cancer, also called Renal Adenocarcinoma or Hypernephroma.
    2. 2. The Kidneys <ul><li>The kidneys are a pair of organs on either side of the spine in the lower abdoman. Each kidney is about the size of a fist. Attached to the top of each kidney is an adrenal gland. A mass of fatty tissue and an outer layer of fibrous tissue (Gerota’s fascia) enclose the kidneys and adrenal glands. </li></ul>
    3. 3. <ul><li>Smoking: Cigarette smokers are twice as likely as nonsmokers to develop kidney cancer. </li></ul><ul><li>Obesity: People who are obese have an increased risk of kidney cancer. </li></ul><ul><li>High blood pressure: Increases the risk of kidney cancer. </li></ul><ul><li>Long-term Dialysis: Being on dialysis for many years is a risk factor for kidney cancer. </li></ul><ul><li>Von Hippel-Lindau Syndrome: VHL is a rare disease that runs in some families. An abnormal VHL gene increases the risk of kidney cancer. </li></ul><ul><li>Occupation: Coke oven workers in the iron and steel industry are at risk. Workers exposed to asbestos or cadmiumalso may be at risk. </li></ul><ul><li>Gender: Males are more likely than females to be diagnosed with kidney cancer. </li></ul>Renal Cell Cancer Risk Factors
    4. 4. Renal Cell Cancer Symptoms <ul><li>Blood in the urine (making the urine slightly rusty to deep red) </li></ul><ul><li>Pain in the side that does not go away </li></ul><ul><li>A lump or mass in the side or the abdomen </li></ul><ul><li>Weight loss, fever, anemia </li></ul><ul><li>Feeling very tired or having a general feeling of poor health </li></ul>
    5. 5. Background and statistics <ul><li>In the United States, kidney cancer accounts for about 3% of all cancers, with approximately 12,000 kidney cancer deaths each year. </li></ul><ul><li>Kidney cancer strikes more than 28,000 Americans each year—many of whom have no overt symptoms. </li></ul><ul><li>The majority of people with kidney cancer are past the age of 40, and it strikes men twice as often as women. Kidney cancer is usually diagnosed between the ages of 50 and 70, but can occur at any age. </li></ul><ul><li>It is one of the fastest-growing cancers in the United Kindgom. </li></ul><ul><li>There are several genetic factors that predispose people to kidney cancer but this only happens in 5% of the cases. </li></ul>
    6. 6. Treatment <ul><li>Surgery is the standard treatment for contained kidney cancer. Various surgical options may be available to you, depending on tumor size and location within the kidney capsule. Such surgery is performed by a urologic surgeon. </li></ul><ul><li>Radiation and chemotherapy are not very effective in treating kidney cancer. Biologic therapies are used more frequently. </li></ul>
    7. 7. Prognosis <ul><li>In 40% of patients, renal cell cancer will be limited to the kidney and is treated exclusively by surgery, which is curative 90% of the time. </li></ul><ul><li>In the 60% of patients with renal cell cancer that has spread outside the kidney, the disease is generally not curable with surgery and other specialists, such as medical oncologists and possibly even radiation therapists, are involved with treatment. </li></ul><ul><li>According to the most recent follow-ups from patients treated at the Mayo Clinic between 1996 and 1999, 79% of patients who underwent partial nephrectomy were cancer-free, compared to 77% of patients who underwent radical nephrectomy. Furthermore, the incidence of kidney failure was only 11% in the group of patients who underwent partial nephrectomy, compared to 22% in the group who underwent radical nephrectomy. These results suggest that partial nephrectomy is equally as beneficial as radical nephrectomy and reduces the chance of kidney failure. </li></ul>
    8. 8. Prognosis Continued <ul><li>1997 AJCC Pathologic Stage Chance of Cure 5 Years after Surgery </li></ul><ul><li>Open Partial Nephrectomy Open Radical Nephrectomy Laparoscopic Radical Nephrectomy </li></ul><ul><li>T1 N0 M0 (< 4 cm tumor) 91-100% 96-97% 89-100% </li></ul><ul><li>T1 N0 M0 - 95-96% </li></ul><ul><li>T2 N0 M0 - 88% </li></ul><ul><li>1997 AJCC Pathologic Stage Chance of Survival at 5 years with Open Radical Nephrectomy </li></ul><ul><li>T3 N0 M0 40-70% </li></ul><ul><li>T4 N0 M0 0-28% </li></ul><ul><li>N+ 0-33% </li></ul><ul><li>M1 0-20% </li></ul>
    9. 9. Conclusion - Renal Cell Carcinoma <ul><li>Kidney Cancer is not common in US - 28,000 cases vs. overall 1,334,100 in 2003 (2.09%) </li></ul><ul><li>Caught early - chances of survival and cure are excellent (91 - 100%) </li></ul><ul><li>Radiation and Chemotherapy are not very effective for Kidney Cancer (M+ 0 - 20% : N+ 0 - 33%) </li></ul><ul><li>One Man’s Pathology Report gives interesting detail - he is yet to pass his 5 year mark but doing well </li></ul>

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