Kidney Cancer Symptoms and Treatment – Dr. Kadir Tepeler

Kidney Cancer

The kidneys are organs located on both sides of our spine and their main task is to produce urine and remove harmful substances from the body. In the middle part of the kidneys, there is the artery that brings blood to the kidney, the vein that carries the blood away, and the main pool (pelvis) where the urine produced is collected.

As with all tumors, kidney tumors occur as a result of uncontrolled proliferation of cells. The proliferating cells can form a mass and spread to the surrounding tissue and distant organs.

Renal tumors usually (85%) originate from kidney cells (renal cell carcinoma). Tumors originating from the cells lining the urinary tracts in the kidney (transitional cell carcinoma) are less common. Apart from these, there are also rarer types of tumors.


What are the Risk Factors?

  • Smoking: It doubles the risk of kidney cancer
  • High blood pressure: Hypertension patients are at higher risk
  • Gender-age: The risk is 1.5 times higher, especially in men, and is common over the age of 40.
  • Long-term use of painkillers: Some drugs can trigger the formation of cancer in the kidney
  • Dialysis: Long-term dialysis increases kidney cancer formation.
  • Family history: Some types of kidney cancer show genetic inheritance
  • Exposure to chemicals: Asbestos, benzene and some pesticides are carcinogenic

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Is Cancer So Malicious in Kidney Cysts?

Particularly in advancing ages, we frequently encounter fluid-filled, thin and regular-walled structures that do not contain calcification in the kidney, which we call simple cysts.

Simple cysts are not cancer. Cysts usually do not cause any complaints in the patient and do not require treatment. When the centrally located ones grow, they can cause complaints by putting pressure on the urinary canals and veins. Those located in the outer part of the kidney may enlarge and cause fullness and pain. In these cases, surgery may be required to remove the cysts.

There are also cysts with thick walls, which we call complicated cysts, with calcification (calcification) on the wall, containing tissue as well as fluid, and have the potential to become cancerous.

More detailed imaging methods (contrast-enhanced tomography or MRI) are used to differentiate these complicated cysts from simple cysts. Complicated cysts are treated like kidney tumors (requiring surgery).

What is Angiomyolipoma (AML)?

It is the most common benign tumor of the kidney, consisting of fat, muscle and vascular structures. It is 4 times more common in women. They generally do not spread elsewhere. When their size increases (greater than 4 cm), they can bleed spontaneously. While small-sized AMLs are followed, surgery or embolization (occlusion-closure of the vessels in the mass with drugs by angio) is performed for larger-sized AMLs.

What Symptoms Do Kidney Tumors Give?

Kidney tumors are usually detected by ultrasound or tomography performed for another reason. The patients do not have any complaints in the early stages. As the disease progresses, they cause some complaints:

  • Bleeding in the urine (visible or detected by urinalysis)
  • Abdominal bloating
  • Loss of appetite - fatigue - weight loss
  • flank pain
  • anemia, pallor
  • swelling in the legs

How is Kidney Cancer Diagnosed?

More detailed investigations should be performed in patients who are found to have a mass in the kidney during the investigation of their complaints or incidentally by ultrasound. For this purpose, MRI (magnetic resonance imaging) or medicated tomography (contrast-enhanced CT) is taken.

In patients with kidney cancer, lung (thorax) tomography is also taken due to the possibility of spreading. With these imaging methods, information is obtained about the size of the mass, its location, its relationship with the main vessels and urinary canals, whether it has spread to another place or to neighboring organs (spleen, liver, pancreas, adrenal gland or lymph nodes), and the structure of the mass. Staging is also done with imaging methods, but tomography or MRI cannot definitively differentiate the mass from benign or malignant.

Definitive distinction of the tumor as benign or malignant is possible only by pathological examination of the surgically removed mass.

Kidney Cancer Treatment

The main treatment for kidney tumors is surgery. The basic principle is to remove the tumorous kidney tissue and to protect the healthy and non-cancerous kidney tissue. This surgery is called partial nephrectomy, that is, removal of tumor kidney tissue. Unfortunately, we perform radical nephrectomy surgery, in which the kidney is removed together with the fatty tissue around it, in tumors that have grown excessively, have involved the renal vessels, and are numerous in the kidney.

Partial or radical nephrectomy surgery can be performed with open or closed (laparoscopic or robotic) methods. Laparoscopic and Robotic surgery provides advantages such as shorter hospital stay, less painkiller use, faster return to work and social life, and less scarring compared to open surgery. Laparoscopic radical nephrectomy is currently accepted as the standard treatment.

Chemotherapy can be applied in kidney tumors that are not suitable for surgery or metastatic (spread to distant organs).

Tumors originating from the cells lining the urinary tract in the kidney (transitional-transitional cell) are called collecting system tumors (transitional cell carcinoma). In the treatment of these tumors, the connection of the kidney, urinary canal (ureter) and urinary canal to the bladder (urinary bladder) is surgically removed. This surgery is called radical nephro-ureterectomy.

How is Post-Operation Follow-up Performed?

As a result of the pathological examination of the tissue removed after the operation, the type, type, stage and grade of the tumor are revealed. Our patients are followed up at regular intervals with blood and imaging methods such as CT / MRI / USG, guided by these pathology results.

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