Learning About Renal Cancer

Renal malignancies, affecting the vital organs responsible for detoxifying the blood, hold significant importance. According to the GLOBOCAN 2020 report, kidney cancers constitute 1.3% of India's total cancer cases. The incidence stands at 2 per 100,000 males and 1 per 100,000 females.

Notably, 85% of these cases are classified as renal cell carcinomas (RCC). However, these reported figures might be underestimated due to inadequate reporting mechanisms. Anticipated factors like longer lifespans, improved diagnostics, increased awareness, and higher prevalence of risk factors could likely lead to a surge in future incidence.

Risk Factors Associated with RCC

Prominent risk factors encompass advanced age, tobacco consumption, obesity, hypertension, family history of renal cancers, and undergoing dialysis for chronic renal issues. Notably, newer data indicates a decreasing age of onset in India. Certain hereditary syndromes are intertwined with these risk factors.

Underlying Mechanisms

RCC development stems from genetic mutations within kidney cells, prompting abnormal growth and division, eventually culminating in tumour formation. These anomalous cells may detach and metastasize via the bloodstream or lymphatic system to distant body regions.

Clinical Presentation

During the initial stages, tumours often remain inconspicuous and asymptomatic. They are usually incidentally detected through ultrasound scans performed for unrelated reasons. In some cases, patients may experience flank pain, hematuria (blood in urine), diminished appetite, unexplained weight loss, persistent cough, or fatigue.

Diagnostic Approach

In conjunction with routine blood assessments like complete blood count and renal function tests, ultrasound scans provide insights into tumour size and location, as well as the state of the other kidney. Subsequently, contrast-enhanced CT scans are employed, and MRI is occasionally employed for select patients. PET-CT scans are reserved for advanced renal cancer cases, avoiding overuse.

Staging Insights

Renal cancer is categorised into stages. Stages I and II denote localised tumours within the kidney, while Stage III signifies expansion beyond the organ's confines, potentially extending to the inferior vena cava. Stage IV entails widespread metastasis to distant body sites.

Effective Treatment Approaches

For stages I-III, surgical intervention remains the cornerstone, conducted by both an uro-oncology surgery specialist and an oncology surgeon. Tumours up to 4 cm call for partial nephrectomy, accessible through open or robotic surgery. More extensive growth mandates radical nephrectomy, with both open and minimally invasive techniques viable. Aggressive surgical procedures, encompassing vascular structure removal, address locally advanced tumours. In Stage IV, biopsy precedes systemic therapy involving immunotherapy and targeted kinase inhibitor (TKI) treatment, overseen by an oncologist. Kidney removal might be considered before or after this therapy in some Stage IV cases. Oncology treatments are tailored to each patient's unique condition, aiming to control and manage cancer progression.

Empowering Personal Measures

Individuals are encouraged to abandon smoking, maintain a healthy body weight and blood pressure, engage in regular physical activity, adopt a nutritious diet, and undergo routine health check-ups.

If you or a loved one are experiencing any symptoms, book an appointment with Dr. Ganesh Bakshi, Uro Oncology Surgery Specialist at one of the top cancer hospital in Mumbai, P. D. Hinduja Hospital & Medical Research Centre. Contact: 022 6766 8181/022 4510 8181

*Information source: Bombay Times