Kidney Cancer
The kidneys are bean-shaped organs, each about the size of your fist, located behind the abdomen (one on each side of the spine). In adults, the most common type of kidney cancer is renal cell carcinoma, which begins in the solid portion of the kidneys. Another type of kidney cancer, transitional cell carcinoma, forms in the lining of the hollow portion of the kidney. Each year approximately 32,000 new cases are diagnosed and around 12,000 people die from the disease. Although kidney cancer can develop in young adults, the risk increases with age. Other risk factors include smoking, obesity, high blood pressure, exposure to various environmental substances, and certain hereditary diseases.
Kidney cancer seldom causes problems in its early stages. As a tumor grows, it may cause blood in the urine, persistent back pain, or unintentional weight loss. Kidney cancer cells may also spread (metastasize) outside your kidneys to nearby organs as well as to more distant sites in the body. If kidney cancer is detected and treated at an early stage, the chances for a full recovery are good. The two most common ways that these tumors are discovered are by coincidental finding on CT scan and by presence of blood in the urine. The blood in the urine may only be detectable by microscopic analysis (urinalysis), but sometimes it is easily visible.
Treatment Options
When cancer is isolated to the kidney, it is often curable with some type of surgical procedure. This type of cancer does not respond well to non-surgical treatment such as chemotherapy or radiation therapy. Therefore, it is essential to detect and treat the disease effectively before it spreads outside of the kidney. Kidney cancer treatment options are influenced by tumor size, tumor location, kidney function, patient health, patient age, and previous surgery.
Most kidney cancers can be cured by removing the entire kidney (radical nephrectomy) or part of the kidney (partial nephrectomy). Cancer that occurs in the lining of the kidney requires removal of the kidney and the entire drainage tube (nephroureterectomy). Removal of the entire kidney may not be appropriate for patients with one kidney, poor kidney function, or other diseases that might affect kidney function in the future (such as diabetes or high blood pressure). These patients may be better served with removal of part of the kidney (partial nephrectomy) or destruction of the actual lesion (cryoablation of renal mass). Some elderly patients with small tumors do not require any treatment other than careful observation. All of these procedures can be performed with laparoscopic (telescopic) kidney surgery through small “button-hole” incisions.
Robotic Procedures
Partial Nephrectomy
Nephrouterectomy
Laparoscopic Procedures
Radical Nephrectomy
Partial Nephrectomy
Cryoablation of Renal Mass
Nephrouterectomy
FAQs
Q: What information should I bring to my first office visit with Scott D. Miller, MD?
A: Please bring relevant x-ray films (or computer disks) and any pertinent laboratory, radiology, and pathology reports. Completing our patient information forms (available on our website) prior to your arrival will help inform Dr. Scott Miller regarding your medical history, medications and allergies.
Q: What are the risk factors for developing kidney cancer?
A: The most significant risk factors are age, smoking, and certain industrial exposures. In some cases, family history plays a role.
Q: What are the risk factors that raise the chance that my kidney cancer has spread to other areas of the body?
A: The most significant risk factors for having disease outside of the kidney are tumor size and grade. A small amount of disease outside of the kidney, whether close or distant, can be difficult to detect by any type of x-ray test.
Q: Why is a biopsy of a kidney tumor seldom indicated prior to surgery?
A: If a kidney tumor appears suspicious on CT scan, the diagnosis of cancer is highly likely. A needle biopsy of a kidney mass is often unreliable for ruling out cancer. Biopsy may also carry the risk of spreading disease. Although some kidney tumors may be discovered to be benign after removal or other aggressive therapy, the alternative of not treating a malignant tumor is unacceptable.
Q: What is meant by the term “cancer stage”?
A: “Cancer stage” refers to the extent and location of disease, regardless of aggressiveness.
Q: What is meant by the term “cancer grade”?
A: “Cancer grade” refers to the aggressiveness of disease, regardless of extent and location. This determination is made by microscopic examination by the pathologist.
Q: What tests do I need prior to making a treatment choice?
A: Usually a CT scan of the abdomen and a kidney function blood test are the only tests needed to make a decision. In some cases, Dr. Scott Miller may order additional tests to evaluate the extent of the tumor.
Q: Are treatments such as radiation or chemotherapy options for treating my kidney cancer instead of surgery?
A: Radiation and chemotherapy are typically ineffective in the treatment of most types of kidney cancer. A surgical approach is almost always the preferred method. In some cases, even disease outside the kidney is best treated with surgical removal.
Q: How do I keep my kidney(s) healthy?
A: The kidneys are very vascular organs. For that reason, whatever is healthy for the body tends to be healthy for the kidney. The obvious recommendations are exercise, a balanced diet, and management of other medical conditions such as high cholesterol, hypertension, and diabetes. Of course, smoking is detrimental to both kidney and overall health. Although protein restriction is usually unnecessary, seek the advice of a physician prior to starting a high protein diet. A physician can also advise you of any medications to minimize or avoid.
More Information
When cancer is isolated to the kidney, it is often curable with some type of surgical procedure. This type of cancer does not respond well to non-surgical treatment such as chemotherapy or radiation therapy. Therefore, it is essential to detect and treat the disease effectively before it spreads outside of the kidney. Kidney cancer treatment options are influenced by tumor size, tumor location, kidney function, patient health, patient age, and previous surgery.
