Clear cell renal carcinoma
The vast majority of kidney cancer cases are of this type. About 70% to 90% of cases are renal clear cell carcinoma. The cells affected by this disease originate in the tube that filters the blood inside the kidney. The disease rarely affects both kidneys at the same time.
Papillary carcinoma is responsible for up to 15% of kidney cancers. It often blocks the channel through which urine passes and causes pain. It is also an extremely aggressive version of the disease and spreads quickly throughout the body.
Chromophobic renal carcinoma
Unlike the previous version, chromophobic renal carcinoma is one of the least aggressive. It takes its name because it does not appear in any color in the imaging exams and its diagnosis requires the use of a dark blue or purple dye, since it does not react with other colors. It is responsible for 5% of the cases of the disease.
A rare type of kidney cancer, cancer of the collecting ducts appears in the so-called Bellini’s Tube . This structure is the final portion of the collecting ducts , which after collecting impurities from the blood, fuse in a tube that sends them to the bladder with water, forming the urine. Only 1% of cases are represented by this type of cancer.
Also rare, sarcomatoids are aggressive and have characteristics similar to clear cell carcinoma. It makes up 1% of kidney cancer cases.
Cancers are divided into stages ranging from 0 to IV. Each of them indicates a point in the development of the disease. In stage 0 the cancer is still small and well located while in most cases a stage IV cancer is already spread throughout the body and the patient does not have much time to live.
In a stage 0 cancer, some cells multiply in a disorderly manner, creating a small tumor limited to their initial area, not yet having infiltrated any tissue.
That is, the cancer did not come from where it was born and at this stage the cure is usually complete and simple, and is usually done through surgical removal of the tumor.
In stage I, the cancer is isolated, limited to a part of the body, but already has some infiltration in the initial tissue. To be considered stage I, he must not have compromised the lymphatic system.
The tumor is called stage II when it compromises the lymphatic system or reaches other tissue. For example, in the case of the kidneys, if it is infiltrated in more than one part of the organ. At this stage the tumor is still well located, but it is advancing .
In stage III, the tumor is already considered advanced in its location. In order to be classified at this stage, it is necessary to involve the lymphatic system and more than one tissue.
Stage IV is the last stage of cancer. It is defined by metastases . When tumor cells manage to enter the bloodstream and infiltrate other parts of the body, the cancer is said to have metastasized and is spread throughout the body.
At this stage the cure is very difficult and the treatment is usually palliative, seeking to guarantee quality of life for the person.
It is important to note that stages II and III can be confused if this classification is applied to all types of cancer. Each type of cancer is different and the criteria for the differentiation of stages II and III can vary.
The causes of all cancer are genetic mutations in the cancer cell, which differs from other cells in the body and begins to reproduce in a disorganized and wrong way.
The change can happen in the genes that coordinate the cell’s reproduction or in the genes that lead the cell to death. The genetic defect can cause cell reproduction to be incorrect, as well as cell death. The result of this is the tumor.
The reason for the mutations cannot always be discovered, however they can be inherited or acquired .
Inherited genetic mutation
The inherited genetic mutation happens when the DNA alteration was genetically inherited from the parents.
Common mutations that can lead to kidney cancer are the mutation of the VHL gene, which causes the genetic disorder of von Hippel-Lindau, and the FLCN gene, which causes Birt-Hogg-Dube syndrome.
These changes are inherited and increase the chances of kidney cancer.
Acquired genetic mutation
Most cancers are caused by changes that genetic acquired . This means that they happen during the patient’s life. Several factors can cause these changes.
For example, in skin cancer, exposure to UV rays alters the DNA of cells in the epidermis. In lung cancer, the tar smoked alters the DNA of the lung cells.
Carcinogenic chemicals increase the chances of cell mutation in any part of the body. Cigarettes, for example, do not only affect the lung. It causes effects throughout the body and is a factor that can lead to cancer in any part of it.
However, most mutations are random and not necessarily the result of external influence. That is why the rate of cancer in the elderly is higher. They lived longer, which, in addition to increasing the influence from the outside, increases the chances of random mutations occurring in the cells.
Cancers can affect anyone at any time. However, some factors can increase a person’s chances of developing kidney cancer. Are they:
Advanced age increases the chances of developing any type of cancer, including kidney cancer.
Especially after age 50, men are more likely than women to develop kidney cancer. The natural production of estrogen, the female hormone, is believed to protect women from this specific type of tumor.
Tobacco and its carcinogenic substances do not only affect the places that the smoke touches. Lung, mouth and throat cancers are the most associated with smoking, but the whole body is negatively affected by the substance and any cell can mutate due to tobacco.
Obesity and hypertension
Obesity and hypertension increase the chances of developing several types of cancer, including kidney cancer. Doctors are not sure why, but obesity is believed to cause hormonal changes.
In the case of hypertension, there is doubt as to whether the cause of cancers related to it is the disease itself or the medications for it.
Renal failure can cause mutations in the patient’s kidney, as can treatments.
People who have family members who have had kidney cancer are more likely to develop the disease if the mutation is genetically inherited.
Von Hippel-Lindau disease
This is a rare genetic disease that increases the chances of developing malignant and benign tumors, including kidney cancer.
The reason is not known, but black people have a slightly higher chance of developing kidney cancer.
Cancer of the lymphatic system increases the chance of other cancers, including kidney, as this system passes through the entire body.
Kidney cancer is an often silent disease. The three main symptoms of the disease rarely appear together, which makes suspicion difficult. The triad of kidney cancer symptoms consists of:
- Blood in the urine;
- Abdominal pain;
Less than 10% of patients experience all three symptoms at the same time.
However, there are other signs besides these three. Are they:
Kidney cancer can lead to anemia , as some types of it are linked to iron consumption. The patient feels tired and weak.
Fever for no apparent reason
The fever is the result of his immune system struggling and he tries to beat the cancer. The fever arises without seeming to have a reason.
Cancer causes poor appetite and weight loss. Several types of cancer reduce appetite, as well as hamper the ability to eat, depending on its stage. Some are also able to absorb nutrients.
Volume in the abdomen
When the tumor grows, it may be possible to feel it in the belly through pressure.
Elevation in the level of calcium in the blood may be a sign of kidney cancer. This is because the kidneys have a reduced ability to filter calcium if they are affected by cancer.
How is the diagnosis made?
Kidney cancer is a silent disease and is often diagnosed while being tested for other things. It often appears on imaging exams, which can be redone to investigate:
Computed tomography , X-ray and ultrasound are imaging tests that can find a tumor or kidney cancer. However, they are not always enough to accurately identify what you are dealing with. It may be a benign tumor or an aggressive and growing cancer. Therefore, more tests may be needed.
Biopsy is not always used, but it is an effective and accurate method for the diagnosis of kidney cancer. To perform this examination, a piece of the tumor is removed and then examined in the laboratory under a microscope. Its cells are identified and it can be classified.
Is there a cure?
Yes, kidney cancer can be cured . But wait a minute! It is not that simple. Let’s talk a little bit about this cure. This applies to any type of cancer.
The treatments for cancer are varied and when completed, signs of the disease are sought. When no signs of cancer cells are found, the cancer is said to be in remission .
In theory, he is cured, but care must be taken. Cancer begins as a single altered cell that multiplies until there is a tumor. This means that if a single cancer cell escapes, there is a risk that it will multiply again.
The tests we can do can find a lot, but there are around 10 trillion cells in the human body. 10 000 000 000 000. There are 13 zeros. To get an idea of how big that number is, 10 trillion seconds is 316 880 years .
In practice, this means that it is impossible to check each cell to find remnants of the cancer that may have escaped into the bloodstream or entered some hidden corner in the organ it affects. Remission means that there is no more evidence of the disease.
If someone has already had cancer, the chances of him coming back are higher and he can do it at any time. A single cell that has escaped can take root in another part of the body and start to multiply, creating another tumor. It is also possible that the same cause of the first cancer leads to a second shortly thereafter.
That is why it is important that, after the treatment is completed, routine examinations are done to find possible recurrences , the return of cancers. This often happens in the same place where it was previously, but this is far from the norm and new cancer can appear anywhere.
Cancer is considered cured when it remains in remission for five years, without developing again. If that happens, your chances of developing another cancer are basically the same as before you had the first tumor. Only then is the patient considered completely cured.
But getting there is not easy. You need to go through treatment first.
What is the treatment?
There are several ways to treat kidney cancer. It is often necessary to have several treatments together to make sure – or almost – that all cancer cells have been eliminated.
Depending on the stage of the tumor, treatment may vary or new methods may be added. Only the doctor can indicate each type of treatment for the patient’s particular case.
Surgery is one of the main means of treating kidney cancer. Nephrectomy removes a piece of the kidney or the entire organ. There are two types:
In this case, the surgery removes only a piece of the kidney, seeking to remove the tumor entirely, preserving as much of the organ as possible.
It is usually used for tumors smaller than 4 cm, although it is possible to apply this surgery to larger cancers when its format allows.
This surgery removes the kidney entirely, but does not remove the adrenal glands. There are doctors who argue that simple nephrectomy is more risky than radical, but there is no evidence that radical is actually more efficient. In principle, it represents a greater safety margin.
In radical nephrectomy, the affected kidney is removed entirely, along with the adrenal gland and nearby lymph nodes. This surgery is used when the tumor is large and the cut seeks to remove a safe area, trying to ensure that no cancer cells remain in the patient’s body. The adrenal glands do not always need to be removed, but they are when the tumor is large or at the upper pole of the organ, which facilitates the cancer’s contact with them.
It is possible that a kidney transplant is necessary after surgery of this type. It is still possible to live without a kidney. However, it is a necessary organ and if the remaining kidney function is compromised in any way, there may be a case of kidney failure.
Cryotherapy and radiofrequency
These two types of treatments are similar, although somewhat opposed. The Cryotherapy involves freezing the tumor use for destruction while the radio uses heat waves to eliminate it.
Both methods involve the insertion of a needle that performs the process in the tumor. They are used only in some special situations. The advantage of these methods is that they are very invasive, unlike nephrectomy.
Radiotherapy and chemotherapy
Unlike most cancers, the kidney does not respond well to radiotherapy and chemotherapy. These treatments can still be used, especially in stage IV cancers, seeking to reduce symptoms in a palliative manner and when the patient’s condition permits. However, it is common for these two treatments, in the case of kidney cancer, to be replaced by immunotherapy.
Immunotherapy consists of stimulating the immune system, which helps to attack and destroy the tumor. Immunotherapy with cytokines , a type of molecule that is involved in triggering immune responses, has positive responses in the treatment of kidney cancer. However, it is common to have severe side effects, including:
- Extreme fatigue;
- Decreased blood pressure;
- Accumulation of fluid in the lungs;
- Breathing difficulty;
- Kidney damage;
- Intestinal bleeding;
- Diarrhea or abdominal pain;
- High fever and chills;
- Mental changes.
Other drugs can be used to treat kidney cancer. For example, drugs that inhibit Angiogenesis are used to treat kidney cancer with metastasis in other distant organs. These drugs prevent the creation of new blood vessels, preventing the irrigation of new tumors.
Since kidney cancer has a low cure rate, testing for new drugs or treatments can be considered.
The drugs for kidney cancer are several, with several different functions that seek to cure the tumor. Here are some of the active ingredients of these drugs:
- Interleukin-2 ;
- Interferon-alpha ;
- Nivolumab ;
- Bevacizumab ;
- Everolimus .
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Living with cancer is a challenge. Receiving the diagnosis is already difficult. The disease is linked to death and especially considering kidney cancer survival rates, it scares a lot and can leave a patient groundless.
In addition, treatments are expensive and difficult. The patient may need a lot of support to go through all of this.
Regardless of the severity of the cancer, people with this diagnosis always face death, often for the first time.
Therefore, psychological support is essential for this patient, helping him to accept the diagnosis and helping with the treatment. Depending on the case, the patient’s family may also need this type of support.
Pay attention to medical instructions
During cancer treatment, following the doctor’s instructions is essential to increase the chances of a cure. Avoiding behaviors that hinder treatment or feed the tumor can make everything better.
Alcohol, cigarettes, unbalanced food, all of these must be reviewed and eliminated from the person’s life.
Sometimes there is nothing to do. Cancer may not respond to treatment or come back and take over the body and, unfortunately, medicine can do nothing more to save a life. It is a terrible thing, but a reality.
For these cases, palliative care exists . They aim to make the end of the patient’s life as human as possible, with quality of life and with as little pain as possible.
They may involve pain medication and psychological treatment.
Getting the news that you have cancer is not easy. Knowing that kidney cancer has low cure rates makes it worse. But it is possible to look with optimism for the future and treatment can save lives.
Cancer prognosis is usually given based on the survival rate . This is an estimate of the patient’s chances of living at least five years after the cancer diagnosis.
This number is used, as it is not possible to accurately predict someone’s survival after that time. Even in less than five years, forecasts are inaccurate.
It is the same number of years used to define the cure for cancer after going into remission.
It is important to note that survival rates are usually based on patients who had the same condition in previous years. Therefore, it is possible that recent improvements in treatment technologies and techniques may improve the prognosis, making it more favorable.
The survival rate is calculated based on the stage of the cancer at the time of diagnosis, but that is not all that defines the number. Age, general health status and how the disease responds to treatment influence the prognosis and each case is different.
Knowing the stage of the cancer is very important for the prognosis. The chances of survival are different for each stage. This table shows the survival rate for each stage in the five years following diagnosis.
||% of survival
It is possible to see that only 8% diagnosed in stage IV survive five years or more. Stage IV of any cancer is quite dangerous, as it means that there has been metastasis and the disease is spread throughout the body.
In the case of kidney cancer, in particular, it is extremely difficult to deal with metastases (which can be anywhere in the body such as the brain, lungs and bones) as this type of tumor does not respond well to more widespread treatments such as chemotherapy.
A kidney tumor is rarely found in the early stages and its symptoms usually appear only in the most advanced ones. Therefore, it is common for it to become large and cause several complications. In addition, the lack of treatment can also bring several difficulties.
The biggest problem related to any type of cancer is metastasis . It is what differentiates stage III from IV. When metastasis occurs, the tumor spreads to the rest of the body. Tumor cells travel through the lymphatic system and bloodstream, depositing themselves in other tissues in the body. It can be anyone: brain, lungs, even bones.
A metastatic cancer is extremely dangerous because several tumors start to appear, leading the person, little by little, to death.
It kills by causing bleeding, cachexia (severe weight loss due to disease), by preventing nutrients from reaching healthy cells, or even by taking too large parts of the organs, making them insufficient and preventing them from exercising their function.
A kidney tumor can cause severe organ damage, just like any cancer. These injuries can lead to serious bleeding.
Cancer causes pain in the region it affects. In the case of kidney cancer, a large tumor can put pressure on the abdomen, hurting and damaging the region. When there is metastasis, the regions affected by them can also be painful when the tumor grows.
A kidney tumor can consume a large part of the organ, leading to kidney failure. This causes the kidney’s filtration function to be decreased or completely stopped. Likewise, metastases can cause failure of other organs such as the lungs, liver or any other affected organ.
How to prevent
A curious and counter-intuitive fact: in the last few decades, the number of cancer cases has increased and this is a good sign. Do you know why? Because that means that life expectancy is increasing.
It means that people are failing to die because of other diseases. Tuberculosis , flu, infections, many other diseases can be cured and now more people live long enough to develop cancer.
The longer you live, the greater the chances of a cell mutating when it reproduces, the greater the chances of cancer. Definitely preventing cancer is not exactly possible, but it is possible to delay it as much as possible.
Most cancers are caused by environmental influences. Genetics is responsible for between 10% and 20% of cases. The rest is the environment. Some behaviors can be modified in people’s lives to reduce the chance of cancerous development.
What to avoid?
Smoking causes about 90% of lung cancer cases. His main victims are the airways, but that does not mean that he has no other victims. The smoking affects negatively the whole body and can cause cancers in other organs such as the kidneys. Avoiding it greatly decreases the chances of cancer.
Obesity is one of the main risk factors for kidney cancer. Having a healthy and balanced diet can prevent obesity and reduce the risks of this disease. Eating fruits and vegetables, as well as controlling hypertension, can also reduce the chances of kidney cancer.
Contact with large amounts of solvents such as cadmium and organic solvents such as ketones increases the risk of developing kidney cancer and avoiding them can reduce the chances of the disease appearing.
Can I live with just one kidney?
Yes, it is possible to live with just one kidney. The second kidney takes on the role of both. Although possible, kidney cancer rarely affects both kidneys at the same time. However, in these cases, a transplant may be necessary. The same applies if the health status of the other kidney is impaired by any other condition.
Will I have to do exams forever?
Tests to check for relapses are recommended for five years after remission. Other tests after this period can be done as a guarantee, since having cancer once means that, in some way, you have this predisposition, whether genetic or environmental.
I will die?
This question is not that simple and the prognosis of cancer varies from case to case. Talk to your doctor and ask about the specifics of your case. Only he will know how to answer these questions.