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RENAL CANCER created by KIRAN K. KARETHA

Detailed presentation on renal cancer covering risk factors, types, clinical signs, staging, diagnostic methods, and management including surgery, chemotherapy, immunotherapy, and targeted therapy.

Health & Medicine◦
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For Nursing Students•
RENAL CANCER • PRESENTED BY: • MS. KIRAN K. KARETHA • M.SC (N), MSN (CCN)
INTRODUCTION • Kidney cancer is one of the most common cancers of the urinary system. • It occurs more frequently in males than females and is usually diagnosed between 50 and 70 years of age. • Due to the widespread use of imaging techniques, many kidney tumors are now detected incidentally at an early stage.
DEFINITION • Renal cancer is a malignant tumor that originates in the cells of the kidney, most commonly from the renal tubular epithelium. • It is characterized by uncontrolled growth of abnormal cells that may invade surrounding tissues and spread to distant organs.
RISK FACTORS • The exact cause of kidney cancer is unknown; however, several factors increase the risk: • Cigarette smoking • Obesity • Hypertension • Chronic kidney disease
CONTI.. • Long-term dialysis • Family history of kidney cancer • Occupational exposure to chemicals (cadmium, asbestos, petroleum products)
TYPES • 1. Renal Cell Carcinoma (RCC) • Accounts for 85–90% of cases. • Originates from renal tubular cells.
CONTI.. • 2. Transitional Cell Carcinoma • Arises from the renal pelvis. • Similar in behavior to bladder cancer.
CONTI.. • 3. Wilms Tumor • A childhood kidney cancer. • Usually occurs before 5 years of age.
CONTI.. • 4. Renal Sarcoma • Rare tumor arising from connective tissue of the kidney.
CLINICAL MANIFESTATIONS • Classical Triad • Hematuria (blood in urine) • Flank pain • Palpable abdominal mass
CONTI.. • Other Manifestations • Weight loss • Fever • Fatigue • Anorexia
CONTI.. • Hypertension • Night sweats • Anemia • Lower limb edema
STAGES • Stage I (T1, N0, M0) • Characteristics • Tumor is 7 cm or smaller in greatest dimension. • Cancer is confined to the kidney. • No lymph node involvement. • No distant metastasis.
CONTI.. • Stage II (T2, N0, M0) • Characteristics • Tumor is larger than 7 cm. • Cancer remains confined to the kidney. • No lymph node involvement. • No distant metastasis.
• Stage III • TNM Classification • T3, N0, M0 OR • T1–T3, N1, M0 • Characteristics • Cancer has spread to: • Major veins (renal vein or inferior vena cava), OR
CONTI.. • Perirenal tissues, OR • Regional lymph nodes. • No distant metastasis.
CONTI.. • Stage IV • TNM Classification • T4, Any N, M0 OR • Any T, Any N, M1 • Characteristics • Cancer has: • Extended beyond Gerota's fascia, OR
CONTI.. • Invaded nearby organs, OR • Spread to distant organs.
CONTI.. • Common Sites of Metastasis • Lungs (most common) • Bones • Liver • Brain • Adrenal glands
Stage Tumor Status Lymph Nodes Metastasis Stage I ≤ 7 cm, confined to kidney N0 M0 Stage II > 7 cm, confined to kidney N0 M0 Stage III Invades major veins/perirenal tissues or regional nodes N1 may be present M0 Stage IV Beyond Gerota's fascia or nearby organs Any N M1 may be present SUMMARY TABLE
DIAGNOSTIC EVALUATION • 1. History and Physical Examination • Smoking history • Family history • Assessment of symptoms
CONTI.. • 2. Laboratory Investigations • Urinalysis • Detects hematuria. • Complete Blood Count (CBC) • May show: Anemia
CONTI.. • Renal Function Tests • Serum creatinine • Blood urea nitrogen (BUN) • Liver Function Tests • Evaluate metastatic involvement.
CONTI.. • 3. Imaging Studies • Ultrasonography • CT Scan • MRI
CONTI.. • Chest X-ray • Detects lung metastasis. • Bone Scan • Performed if bone pain is present.
MANAGEMENT OF RENAL CANCER (KIDNEY CANCER) • Management depends on the stage of cancer, tumor size, patient's age, overall health, and presence of metastasis.
CONTI.. • Surgical Management • 1. Partial Nephrectomy (Kidney-Sparing Surgery) • Only the tumor and a small margin of healthy kidney tissue are removed, while the rest of the kidney is preserved.
CONTI.. • 2. Radical Nephrectomy: Complete removal of the affected kidney along with surrounding tissues. • Structures Removed • Entire kidney • Perirenal (surrounding) fat • Sometimes adrenal gland • Nearby lymph nodes (if involved)
CONTI.. • 3. Cytoreductive Nephrectomy • Removal of the primary kidney tumor even when cancer has already spread to other parts of the body.
CONTI.. • 4. Lymph Node Dissection (Lymphadenectomy) • Surgical removal of affected nearby lymph nodes.
CONTI.. • Chemotherapy • Limited effectiveness in Renal Cell Carcinoma. • Used mainly for rare non-RCC tumors. • Common Drugs • Gemcitabine • 5-Fluorouracil
CONTI.. • Immunotherapy • Stimulates the immune system to attack cancer cells. • Immune Checkpoint Inhibitors • Nivolumab • Pembrolizumab • Ipilimumab
CONTI.. • Targeted Therapy • Targeted drugs block pathways responsible for tumor growth and blood vessel formation. • Common Drugs • Sunitinib • Pazopanib • Cabozantinib • Axitinib
CONTI.. • Radiation Therapy in Renal Cancer • In Renal Cell Carcinoma (RCC), radiation therapy is not the first-line treatment because RCC cells are relatively resistant to conventional radiation. The primary treatment is usually partial nephrectomy or radical nephrectomy. • Therefore, radiation therapy is mainly used for palliation (symptom relief) and treatment of metastatic
RENAL CANCER created by KIRAN K. KARETHA