Renal cancer: Symptoms, risk factors; importance of early diagnosis in treatment

Renal cancer: Symptoms, risk factors; importance of early diagnosis in treatment

Renal cell carcinoma, also known as renal cancer, is also the most common types of kidney cancer found in adults. Here's all you need to know about this condition, from symptoms to treatment.

KEY HIGHLIGHTS

• Renal cell carcinoma is the most common type of kidney cancer found in adults
• The primary investigations for renal cancer are CT scan/MRI of the abdomen, PET-CT whole body, bone scan, and routine blood tests
• The success rate and survival depend on how soon treatment is started and whether the cancer has spread to other parts of the body or not

New Delhi: Renal cell carcinoma (RCC), also known as renal or kidney cancer, is one fast-growing cancer. Renal cell carcinoma, which is also the most common type of kidney cancer found in adults, is a condition in which cancer cells are present in the lining of tubules in the kidney. Renal cancer can be diagnosed in anyone, although it’s often detected in men between the ages of 50 and 70. Young children are more likely to develop Wilms’ tumour, a kind of kidney cancer that most often affects those between ages three and four. 

The primary investigations for renal cancer are CT scan/MRI of the abdomen, PET-CT whole body, bone scan, and routine blood tests. The success rate and survival depend on how soon treatment is started and whether the cancer has spread. Early diagnosis and getting medical help in time can increase the chances of recovery.

Signs and symptoms of renal cell carcinoma

Renal cancer rarely causes signs or symptoms in its early stages. However, as the condition progresses, the person may experience the following symptoms:

1. Blood in the urine 
2. A lump in the abdomen 
3. Persistent pain in your back or side, near the kidneys 
4. Loss of appetite 
5. Unexplained weight loss 
6. Fatigue 
7. Vision problem 
8. Excessive hair growth (in women)

Stages of renal cell carcinoma 

If a person has been diagnosed with renal cancer, more tests will be conducted to find out whether and where the cancer cells have spread within the kidneys or to other parts of the body. This is called staging. Kidney cancer is grouped into four stages:

1. Stage I indicates that the cancer tumour is less than 7cm and is present in the kidney only. 
2. Stage II indicates that tumour larger than 7cms and still present in the kidney only. 
3. Stage III indicates that cancer has spread to nearby lymph nodes and structures. 
4. Stage IV is the most advanced form and the last stage of the disease - here, cancer has metastasized to the lymph system or other organs like liver, bones and even brain.

Renal cell carcinoma in India 

Unfortunately, in India, the disease gets diagnosed in the later stage (Stage 4 only) due to which the survival rate is poor, said Dr Ajay Sharma, an oncologist and a member of American Society of Clinical Oncology. Screening of asymptomatic individuals is not recommended because of the low prevalence of RCC in general population. Doctors may recommend people with a high risk of the disease. Candidates for screening include those with inherited conditions (VHL syndrome, TS), end-stage renal disease, etc. 

Prognostic factors of patients with RCC depend on the stage of the disease, tumour type (clear cell, papillary, chromophobe), tumour grade, tumour necrosis, performance status, paraneoplastic syndromes, added Dr Sharma.

Causes and risk factors for renal cell carcinoma 

Doctors don’t really know what causes renal cancer, however, they believe that kidney cancer develops when there is a change in the structure of DNA in kidney cells. These changes or mutations trigger the cells to grow and divide rapidly, eventually producing tumour cells. This type of cancer often spreads to the lungs and surrounding organs.

The risk factors for renal cell carcinoma are –

• Smoking 
• Hypertension 
• Obesity 
• Older age 
• Acquired cystic disease of the kidney 
• Occupational exposure 
• Use of analgesics - although the evidence is mixed Family history of kidney cancer 
• Treatment fo kidney failure

It becomes imperative to opt for routine check-ups annually, especially after the age of 45 since the risk for renal cancer increases as a person gets older. If diagnosed early, the treatment and survival rate can be better with improved outcomes. One would assume that life after diagnosing RCC is painful, but such is not the case always.

Treatment for renal cell carcinoma 

There are two main types of treatment for renal cancer -- surgical and non-surgical, which includes various therapies like chemotherapy and targeted therapy and immunotherapy.

The definitive treatment for localised RCC is surgery with varied options which is curative. There is no clear role for treatment after surgery outside formal clinical trials. However, stringent follow-ups are required to detect early recurrence. Chemotherapy is required in less than 5 per cent of patients with non-clear cell tumour type. 

Needless to say, these were the options available until now. Today, the latest advancements include immunotherapy. Immunotherapy is a type of treatment that uses a patient’s immune system to fight cancer. Doctors said immunotherapy is safer than other treatment options - it does not have side effects with better results compared to other forms of treatment available until now.