Kidney cancer is a kind of malignancy starts in epithelium of uriniferous tubule and can happens in any parts of renal parenchyma. Normally it grows slow, except some special cases. The primary tumor in kidney can develop step by step to encroach on the tissues and organs around or metastases to other distant organs through lymphatic vessels or veins.
Kidney cancer is a most common malignancy in urinary system, whose incidence accounts for 3%-6% of all malignant tumors. With a ratio about 2：1 between male and female patients, it may occur in various ages and mostly happens in an age range of 50-70.
There are many factors affecting the survival rate of kidney cancer. Generally, the survival rate for the patients who have removed kidney within 5 years is 35%～40%, when for 10 years is 17%～30%. Since the prognosis of kidney cancer is hard to estimate that metastases may occur 20 - 30 years or even longer after nephrectomy.
Although the incidence of kidney cancer is high, the exact cause of it is still unknown. It may be a combined result of many risk factors.
1) Smokers. The risk is high for those people who have been smoking without filter for more than 30 years to develop kidney cancer.
2) Obesity and high blood pressure. These are the two risk factors leading to male kidney cancer.
3) Occupation. The incidence and death rate of kidney cancer would increase in those people involved in printing, coke, dry-clean and petrochemical processing.
4) Radiation. The people who have been exposed in some weak radiation for long would increase the risk of taking kidney cancer.
5) Heredity. The ones whose family members have suffered from kidney cancer get a higher incidence.
6) Food and drugs. According to researches, high intake of milk product, animal proteins and fat, low intake of vegetables and fruits are the risk factors of kidney cancer.
1. Absence of obvious symptoms. Currently above 40% cases are clinically found in physical checkup or other occasional examinations and do not present any obvious symptoms or physical signs. The prognosis normally is good if a kidney cancer patient from early stage takes treatments early. That is why most specialists suggest regular physical checkup.
2. Typical local symptoms. Hematuria, lumbar pain and abdominal tumor are thought to be the three main symptoms of kidney cancer. When these occur in a patient normally it is indicating the cancer is in late stage, though this condition happens rarely. Actually only one or two of these three symptoms would develop in most patients.
1) Bloody urine. Visible or microscopic bloody urine may present in about 40% patients. When the severe bloody urine or blood clots forms, a patient develops renal colic, urodynia, difficulty of urination or even urine retention.
2) Tumor. Kidney is deep in retroperitoneum, where cannot reach through abdominal touch. Only when a tumor is big enough or is in the inferior pole of kidney can be touched. Abdominal lumps can be touched in around 10~40% patients. Sometimes it can be the only symptom of kidney cancer.
3) Lumbar pain. When a tumor is big enough to increase the tension of renal capsule or when tumor encroaches on tissues around would cause constant dull pain in lumber, which incidence is around 20%～40%. When related symptoms occur should a patient come to doctor for consultation and treatments without delay.
3. Systematic symptoms. 10%~40% patients would develop paraneoplastic syndrome, which would present as high blood pressure, anemia, weight loss, cachexia, fever, erythrocytosis, and abnormality of liver functions and so on.
4. Metastatic symptoms. About 10% patients come to hospital for the occurrence of metastatic symptoms like bone pain, fracture, cough, hemoptysis and other symptoms.
As the symptoms of kidney cancer vary greatly that once above symptoms occur, a patient should consult professional doctors and has related examinations in time.
1. Imaging examinations
1) X-ray. Irregular enlargement of lesions in kidney and blurring image of psoas major muscle can present on plain scan of lumbar. The films of pyelography normally show the images of suppressed renal pelvis or renal calices, disfiguration or torsion.
2)Ultrasound scan can specifically distinguish the solid tumor and kidney cysts, additionally, it can show the range of the caner, any encroachment on the organs around, if metastases in liver and spleen, etc.
3) CT scan mostly is used to diagnose occupying lesions in kidneys, identify kidney cyst and solid tumor, whose accuracy can reach 95%. Apart from this, it can objective and precisely comment on tumor size, appearance, density, bleeding, post operative tumor necrosis and liquefaction, infiltration or metastases in peripheral tissues.
4) NMR zeugmatographic imaging(MRI)which can clearly reveal the solid tumor of kidney and distinguish tumor from identify kidney cysts.
2. Pathological examination
Kidney puncture biopsy can get the pathological diagnosis early.
Treatment would be different as kidney cancer patients in different stages. And a doctor would plan out the treatment according to the physical condition of a patient. Clinically, the treatments now apply to kidney cancer are various, for instance, surgery, radiotherapy, targeted therapy, immunotherapy, chemotherapy or a combination of those treatments.
There are many methods of surgery for kidney cancer, such as radical radical nephrectomy, partial nephrectomy and so no. If a patient condition allows, radical nephrectomy is one of the best methods.
Ar-He cryotherapy is a treatment develops fastest and matures in past few years. It performs under the guide of CT to inject Argon air and helium air alternatively to freeze and heat the tumor, so as to kill the cancer cells.
3. Radiofrequncy ablation
It is a good choice in treating kidney cancer. Under the guide of imaging devices, it kills cancer cells rapidly by performing radiofrequency inside tumor through percutaneous puncture. Because it operates only through a small trauma and a patient recovers fast after operation that it can relieve the symptoms and improve the living quality of a patient.
4. Radiothearpy and chemotherapy
The therapeutic effect of general radiotherapy and chemotherapy is unconfirmed in the past. Currently Modern Cancer Hospital Guangzhou starts “minimally invasive and target therapy”, by which can locally perform radiotherapy and chemotherapy within tumor.
Immunotherapy combines with other therapies can effectively improve therapeutic effect through interferon, transfer factors and so no.
Through years’ exploration and development, traditional Chinese medicine (TCM) can regulate the balance of body and strengthen the resistance against tumor. It can perform through the whole treatment of kidney cancer. As a treatment based on syndrome differentiation, combines with other therapies, TCM can reduce toxicity and enhance efficacy. TCM takes therapeutic effect on depressing cancer and helps to improve living quantity even applies alone. Additionally, there are acupuncture, injection therapy, Chinese traditional manipulation, qigong and other therapies, which can help to relive the symptoms and improve the therapeutic effect.
Practice proves that the clinic team services composed by multiple disciplines like oncosurgery, oncology, pathology, imageology and anesthesia doctors as well as professional nurses, can provide patients with most effective, most suitable and most economic treatment plan, and also can greatly improve the therapeutic effect of treating cancer patients.
“One station” medical system constructed by Modern Cancer Hospital Guangzhou combining multiple disciplines, can perform comprehensive diagnosis and treatment for patients under the condition of without adding patients’ burden. Therefore, on one hand, it can provide all-round and heartfelt medical services, and on the other hand, it improves medical efficiency and level. There are many channels can be applied to conduct the communication between patients and doctors, like online consultation, email, telephone conversation, and face-to-face consultation. All these consultation services can effectively help patients to fight the cancer. While the medical team faced by the patients includes doctors, nurses, dietitians, interpreters and so on to meet various demands in different level of different countries. Patients would be more confident under the unobstructed communication environment to cooperate the hospital to diagnose and treat the diseases.
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