Kidney cancer

How common is kidney cancer?

Renal cell carcinoma or renal adenocarcinoma accounts for 3% of malignant neoplasms occurring in adults. It is the most common renal tumour with a rate of up to 85%.

Who are more likely to get kidney cancer?

Most cases of kidney cancer occur in the fifth and sixth decade of life. Although cases have been described at younger ages, the disease rarely occurs below the age of 40. Men have a higher risk of kidney cancer. The incidence of kidney cancer varies around the world. The lowest rates of the disease are found in Asia and Africa, while the highest rates are found in Caucasians

Are there any symptoms indicative of kidney cancer?

Kidney cancer can be asymptomatic or present with a variety of symptoms. In recent years, cases of kidney cancer are increasingly being discovered incidentally, due to the widespread use of ultrasound and CT and MRI. 25-40% of tumours are found incidentally. Quite often (40-60%) blood is found in the urine, either as macroscopic haematuria (red urine) or microscopic haematuria (red blood cells in a urinalysis). Back pain or palpable mass is seen in only 10-15% of cases. In 1/3 of cases, symptoms such as dyspnoea, cough, weight loss and diffuse bone pain are the first manifestation and occur in case of metastatic disease.

What tests does a patient with suspected kidney cancer undergo?

The main diagnostic methods include ultrasound, CT and MRI. These tests are also used to check other organs in the chest and abdomen where metastases may be found. Bone scintigraphy is a test to check whether the disease has spread to the bones.

How is kidney cancer diagnosed?

The definitive diagnosis of the disease is made by histological examination through biopsy of the tumour. Depending on the extent of the disease, the biopsy is performed either surgically or percutaneously by puncturing the lesion under a CT scanner.

What are the treatments available today?

In the early stages of the disease the treatment of choice is surgical cancellation. More specifically, if the cancer is found only in the kidney, surgery is the most commonly used treatment and offers the possibility of a cure. There are other invasive methods, other than surgery, that are used to treat localized disease. These are minimally invasive techniques (percutaneous or laparoscopic cryo- or thermo-therapy) where, using special instruments placed on the tumour through small incisions in the body, the tumour is destroyed by the application of high or low temperatures.

Do all kidney cancer patients receive the same treatment?

The treatment strategy to be followed for each patient is individualized and depends on various factors related to the stage of the disease, age and the patient’s general health status.

What options are available if the disease cannot be treated surgically?

In extensive disease a combination of treatments may be needed. Metastatic kidney cancer is usually resistant to chemotherapy and radiotherapy, but responds well to immunotherapy, biological agents and targeted therapies. In particular, targeted therapies, which are the result of knowledge of the genetic and molecular basis of cancer, have become predominant in the treatment of metastatic kidney cancer and have the advantage over standard chemotherapy in that they target only the cancer cells, leaving normal cells in the body unaffected. In addition, immunotherapy plays a key role in the treatment of metastatic kidney cancer.