Especially For Nursing Students

1. Presented by:
Ms. Elizabeth M.Sc (N)
Asst. Professor,
Dept of MSN
NNC, GNSU.

6. It is also called renal
adenocarcinoma. It is a disease
in which malignant cells are
found in the lining of tubules in
the kidney.

9. CAUSES AND RISK FACTORS
• Older age.
• hypertension
• Treatment for kidney failure - People who receive long-term
dialysis to treat chronic kidney failure have a greater risk
• Chemicals exposure - such as cadmium, benzene, organic solvents,
or certain herbicides, asbetos
• Black race
• Lymphoma

12. STAGING OF RENAL CANCER
• Stage I - 7 centimeters in diameter. The tumor is confined to
the kidney.
• Stage II - >7 cm it's still confined to the kidney.
• Stage III - the tumor extends beyond the kidney to the
surrounding tissue and may also have spread to a nearby
lymph node.
• Stage IV- Cancer spreads outside the kidney, to multiple
lymph nodes or to distant parts of the body, such as the bones,
liver or lungs.

16. Tests and diagnosis
• Blood - Hb, HCt (Anaemia), LDH
• Metabolic panel - creatinine, electrolytes, AST, ALT,
alkaline phosphatase, bilirubin, INR, PTT, calcium,
magnesium, phosphate, albumin
• Urine - Microscopic examination, urine cytology

17. Imaging tests.
To visualize a kidney tumor or abnormality. Imaging
tests might include ultrasound, computerized tomography (CT)
scan or magnetic resonance imaging (MRI).
Abdominal/pelvic CT with and without intravenous
contrast
Abdominal MRI if CT suggests thrombus or because of a
contrast allergy or renal insufficiency
Bone scan, if clinically indicated or elevated alkaline
phosphatase
Brain MRI, if clinically indicated
Intra venous Pyelogram
It involves X-raying the kidneys after injects a dye that travels to
the urinary tract, highlighting any tumors.

18. Biopsy - for small (< 3 cm) solid tumours

20. Chemotherapy
• Sunitinib is the first-line standard of care for patients with
good or intermediate prognosis
• Temsirolimus is the treatment option for poor-prognosis
patients.
• Observation can also be considered, as some patients who
have slow-growing asymptomatic disease
• High-dose IL-2 can be considered for extremely selected
patients.
• In patients with advanced or metastatic disease who fail
cytokines or cannot tolerate them, sorafenib is the
preferred treatment

21. Radiation therapy is considered to
control bleeding and pain from the
primary tumour, palliate symptoms
from metastases and stabilize brain
metastases.

22. Surgical
Management
4
6
5
3
2
1 Radical nephrectomy
Simple nephrectomy
Partial nephrectomy
Cryotherapy
Radiofrequency ablation
Arterial embolization

23. Radical nephrectomy
To remove the kidney, adrenal
gland, and surrounding tissue. It also often
removes nearby lymph nodes. It is the
most common surgery for kidney cancer
and can now be done through a small
incision with a laparoscope.

24. Simple nephrectomy -
Only Kidney is removed

25. Partial nephrectomy
To removes the cancer in
the kidney along with some
tissue around it. This procedure is
used for patients with smaller
tumors (less than 4 cm)

26. Cryotherapy - destroying the tumor by freezing it During cryotherapy thin
probes are inserted into the tumor. The probe circulates liquid nitrogen within
the tumor, causing the cells to freeze.

27. Radiofrequency ablation (RFA) -
It use image guidance to place a
needle through the skin into a
kidney tumor. In RFA, high-
frequency electrical currents are
passed through an electrode in the
needle, creating a small region of
heat.

28. Arterial embolization
It involves inserting
material into an artert that leads
to the kidney. This blocks blood
flow to the tumor. This procedure
may be done to help shrink the
tumor before surgery.

29. Prevention
• Quit smoking.
support programs, medications and nicotine replacement
products.
• Maintain a healthy weight.
1. Work to maintain a healthy weight.
2. healthy strategies
• Control high blood pressure.
Lifestyle measures such as exercise, weight loss and diet
changes can help.

30. NURSING MANAGEMENT
• Administer prescribed analgesics as needed by the patient.
• Prepare for nephrectomy as indicated.
• Provide symptomatic treatment for adverse effects of
chemotherapeutic drugs.
• Watch the patient for signs and symptoms of pulmonary,
neurologic, and liver dysfunction.
• Monitor laboratory test results for anemia, polycythemia,
and abnormal blood chemistry.

31. • Watch for adverse effects of radiation or chemotherapy.
• Monitor the patient’s degree of pain and assess the
effectiveness of analgesics.
• Tell the patient what to expect from surgery and other
treatments.
• Explain the possible effects of radiation and drug therapy.
• Stress the importance of compliance with any prescribed
outpatient treatment.
• Encourage the patient to express his anxiety and fears and
remain with him during periods of severe stress and
anxiety.