Kidney Cancer

What is kidney cancer?

cancer-riñon Kidney cancer is a malignant cell growth that occurs in the kidneys and accounts for about 3% of all cancer diagnoses worldwide. Its medical name is renal cell carcinoma (RCC).

"Kidney cancer" is a general term, as there are many variants of kidney tumors and different stages of the disease. Its treatment will depend on the specific characteristics of the tumor.

In recent years, thanks to imaging tests such as ultrasound of the urinary tract and CT scans, the number of early stage diagnoses has increased, leading to higher survival rates. Likewise, survival rates for renal cancer have also increased, partly due to improved treatments both in the early stages (surgery) and in more advanced stages (targeted systemic treatments). Nephron-sparing surgery (or partial nephrectomy) allows only the tumor to be removed, preserving most of the organ and providing the patient with a better quality of life in the long term. We can affirm that more than 90-95% of patients will be cured with surgery alone when the tumor is diagnosed at a localized stage.

In terms of epidemiology, renal cancer is more common in men than in women and most people are diagnosed between the ages of 60 and 70.

At ROC Clinic we have all the technology available in the market to treat kidney cancer such as the Da Vinci robot, laparoscopy and ablative treatments, among others.

What are kidneys and what are they for?

The kidneys are two organs of the urinary system that are bean-shaped and about the size of a fist. They are located just below the rib cage (ribs), on either side of the spine.

These organs are essential for life and are mainly responsible for eliminating excess water, salt and waste substances through urine. The kidney filters the blood that reaches it through the renal artery and, once filtered, returns to the bloodstream through the renal vein. The result of filtration is urine, which accumulates in the center of each kidney, in an area called the renal pelvis, and from there flows into the bladder - where it is stored - through ducts called ureters.

They also have other important functions, such as regulating the balance of the body's internal environment (homeostasis) and manufacturing hormones such as erythropoietin, which regulates the production of red blood cells, and renin, which regulates blood pressure.

Types of malignant kidney tumors

There are several types of malignant renal tumors which, as a whole, are known as renal cell cancer. The most common are clear cell tumor (70-80%), followed by papillary tumor (10-15%) and chromophobe tumor (3-5%). The subtype of cell carcinoma will determine, among other factors, which treatment to employ.

Clear cell renal tumor. When examined in the laboratory, these cells appear very pale or clear due to a high glycogen and lipid content, presenting a nested growth pattern. It arises from proximal tubular epithelial cells in the renal cortex.
Papillary cell kidney tumor. These cancer cells form small finger-like projections called papillae in some part or most of the tumor. These cells absorb certain dyes and appear pink when viewed under a microscope.
Chromophobe cell renal tumor. The cells of these cancers are also pale, but are larger and have different characteristics. It originates in the intercalated cells of the distal tubular epithelium and manifests macroscopically as a solid, well-defined, multilobulated tumor. It is a tumor of variable biological behavior, less aggressive than conventional clear cell carcinoma.

Types of benign kidney tumors

A tumor in the kidney can also be benign, i.e. non-cancerous. The most common are oncocytomas and angiomyolipomas.

Oncocytoma is radiologically indistinguishable from renal cancer, so it is usually diagnosed after surgical removal. The most common treatment options for these tumors are partial nephrectomy and active surveillance.
Angiomyolipoma (AML) is a benign tumor and is more likely to occur in women. It is usually diagnosed after an ultrasound, CT or MRI scan, or if the tumor bleeds and causes symptoms. Although AML is a benign tumor, the risk of spontaneous bleeding into the kidney increases if it continues to grow. Surgery or embolization is recommended if the AML is large (more than 4-5 cm), you are a woman younger than 45 years old, the tumor causes symptoms, it is difficult for you to get to your doctor in an emergency because you live far from a hospital, or you have limited mobility. Generally, an AML is removed with a partial nephrectomy, but in some cases it may be necessary to remove the entire kidney. Radical nephrectomy is recommended in cases of severe bleeding from the tumor.

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Kidney Cancer

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Kidney Cancer

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How do you know if a cyst in the kidney is malignant?

To know if a kidney cyst is malignant, it is important to perform a series of studies and medical evaluations. The most common steps to determine the nature of a kidney cyst are: Renal ultrasound: ultrasound can show the shape and size of the cyst, as well as the presence of any suspicious features, such as irregular walls or inhomogeneous fluid. Computed tomography (CT): If the cyst has suspicious features on ultrasound, a CT scan may be done to obtain more detailed images. This helps to identify if there are solid masses within the cyst or changes in the cyst walls that suggest malignancy. Magnetic resonance imaging (MRI): is useful to better characterize the cyst and may provide additional information about its composition. This is particularly useful if there is doubt after the CT scan. Bosniak classification: The Bosniak classification system is used to categorize renal cysts based on their appearance on imaging and help determine the risk of malignancy. Biopsy: In some cases, if the cyst is suspected to be malignant or if imaging tests are inconclusive, a renal biopsy may be performed to obtain a sample of the tissue and examine it under the microscope. In general, benign kidney cysts do not cause symptoms. However, if a cyst becomes large, it may cause pain in the back or abdomen. If the cyst is malignant, there may be additional symptoms such as blood in the urine, unexplained weight loss or fatigue.

What is the prognosis of kidney cancer?

In general, in patients with renal tumors under 4 cm that are treated surgically, cure rates of over 90% are achieved. If the mass is large and has spread outside the kidney, the prognosis is worse, especially if any of the following factors are present: anemia, high lactate dehydrogenase level, high blood calcium level, spread to two or more distant sites, or if the person's general condition is unfavorable.

Is kidney cancer curable?

Kidney cancer is curable in early stages. It is key that, once kidney cancer is treated, the patient is followed closely. In advanced stages of the tumor, surgery can help palliate symptoms and, in selected patients, can be combined with other treatments such as chemotherapy or immunotherapy to improve survival and quality of life.

What is the best treatment for kidney cancer?

Surgery is the standard treatment, achieving cure rates of over 90% in small tumors. There are various types of surgery depending on the size of the tumor, but whenever possible, the aim is to remove only the tumor, preserving the rest of the kidney and renal function.

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