Renal cancer, also known as kidney cancer, develops from the cells lining the kidneys. Common risk factors include long term use of pain killers, smoking, and exposure to chemicals. Symptoms include blood in the urine, back pain, weight loss, and pain during urination. Renal cancer is staged based on how far it has spread, from stage I where it is confined to the kidney to stage IV where it has metastasized to other organs. Diagnostic tests include urinalysis, CT/MRI scans, and biopsy. Treatment options include surgery to remove the kidney and surrounding tissue, radiation therapy, chemotherapy, and targeted drug therapies.

1. RenalCancer
Mr. Mahesh Chand
Nursing Tutor

2. • Carcinoma is defined as uncontrolled growth of cells lining
the kidneys and collecting duct, ureter.
• This occurs because of the loss in ability of the body’s
immune system to destroy the cancerous cells, due to their
rapid growth a mass of these cancerous cells aggregate to
form a lump which is identified as tumor these tumors may
or may not be invasive.
• If the formation of tumor is observed in urine collection
system then it is supposed to be renal carcinoma which is
most un common but more often observed in male than in
female.

3. Etiology
• Analgesic (long term usage of pain killers which contain
phenacetin, cocaine etc.
• Tobacco smoking.
• Chemical due to over exposure to chemicals used in
manufacturing of leather goods, plastic, textiles, and rubber.
• Genetic factor may also be a reason for cancer.
• Continuous exposure to heavy metals, dyes, petro chemicals,
coal, tar, asphalt.
• Patients with a history of cancer
• Congenital anomalies in children and infants.
• Sometimes lymphoma and sarcoma in the surrounding areas
may lead to cancer.

4. Signs and symptoms
• Hematuria (blood in urine).
• Persistent back pain.
• Fatigue (loss of consciousness).
• Sudden and unexplained weight loss.
• Nocturia (frequent urination at night).
• Dysuria (feeling of pain, burning or discomfort upon urination).
• Flank pain (pain in upper back or pain in onside of the body between the
upper belly area (abdomen) and the back).
• Dyspareunia (pain during sexual inter course due to medical or physiological
causes).
• Loss of urinary retention.
• Tiredness.
• Anorexia (loss of appetite).
• Hydronephrosis (condition where urine is up held in kidney or ureter).

5. Stages of Cancer
Stage I
• Cancer has formed and has spread from the tissue lining the inside
of the renal pelvis or ureter to the connective tissue layer.
Stage II
• Cancer has spread to the muscle layer of the renal pelvis or ureter.
Stage III
• Cancer has spread rom the muscle layer of the renal pelvis to fat
around the renal pelvis or to tissue in the kidney; or from the
muscle layer of the ureter to fat around the ureter.
Stage IV
• Cancer has spread to at least one of the following:
• a nearby organ.
• the layer of fat around the kidney.
• lymph nodes.
• other parts of the body, such as the lung, liver, or bone.

7. Cancer of the renal pelvis and ureter is also
described as :
• Localized: The cancer is found only in the kidney.
• Regional: The cancer has spread to tissues around
the kidney and to nearby lymph nodes and blood vessels in
the pelvis.
• Metastatic: The cancer has spread to other parts of the body.

8. Diagnostic tests
• History collection and
physical examination
• Urinalysis
• Ureteroscopy
• USG
• CT scan/MRI
• Biopsy
• PET Scan
• Bone scan

9. Treatment
• Nephroureterectomy: Nephroureterectomy is a surgical
technique involving the surgical removal of entire kidney
along with ureter and bladder or only kidney and ureter
irrespective of bladder
• Radiotherapy: Radiation therapy in the treatment of
ureteral cancer usually uses high powered X-rays, seeds or
some radioactive material to shrink or destroy the tumor
• Diathermy: Microwave diathermy uses radiation of high
frequency and short wave length similar to those used in
microwave ovens

10. • Laser surgery: A laser beam (narrow beam of intense light)
is used as a knife to remove the cancer. A laser beam can also
be used to kill the cancer cells. This procedure may also be
called or laser fulguration.
• Chemotherapy: Gemcitabine+ cisplatin.
Methotrexate+ vinblastine+ doxorubicin+ cisplatin.
• Segmental resection: It is also a type of surgical method
which involves the removal of specific effected area in
the body which may be by opening the part of the body
or by laparoscopic techniques.

11. • Breast cancer is cancer that develops from breast tissue.

12. Risk factors
• Risk factors for developing breast cancer include being
female,
• Obesity,
• Lack of physical exercise,
• Drinking alcohol
• Hormone replacement therapy during menopause,
• Ionizing radiation,
• Early age at first menstruation,
• Prior history of breast cancer,
• Family history.

13. Signs
• Signs of breast cancer may include a lump in the breast,
• A change in breast shape,
• Dimpling of the skin,
• Fluid coming from the nipple,
• A newly inverted nipple, or a red or scaly patch of skin

14. Diagnostic test
• History Collection
• Physical Examination
• Breast self
examination
• Mammography
• FNAC

15. Medical mgt
• The selective estrogen receptor modulators (such as
tamoxifen)

16. Surgery
• Mastectomy: Removal of the whole breast.
• Quadrantectomy: Removal of one-quarter of the breast.
• Lumpectomy: Removal of a small part of the breast.
• Radical Mastectomy: Removal of breast tissue, chest
muscle and axillary lymph nodes.

17. References
• Silva AAA, Rodrigues AG, da Silva AA, Silva CAA (2016)
Functional and Morphostructural Evaluation of the Kidneys of
Wistar Rats after the Use of a Protein-Based Food Supplement.
J Nephrol Ther 6: 270.
• Shulkina SG, Smirnova EN, Trushin MV (2016) Interrelation of
Adipokines with Functional State of Kidneys in Patients with
Metabolic Syndrome. Biol Med (Aligarh) 8: 360.
• Kabat-Koperska J, Kolasa-Wolosiuk A, Baranowska-Bosiacka I,
Safranow K, Kosik-Bogacka D, et al. (2015) Influence of
Intrauterine Exposure to Safe and Contraindicated
Immunosuppressive Drugs In Combinations during Pregnancy
on Morphology and Function of Kidneys in Juvenile Wistar
Rats. Clin Exp Pharmacol 5: 196.