Kidney Cancer (Kidney Cancer) is a malignant disease caused by abnormal cell division within the kidney tissue, resulting in a malignant tumor that can spread to nearby organs or metastasize through the bloodstream and lymphatic system to other organs such as the lungs, bones, liver, or brain. If not detected early, it may affect treatment and reduce survival chances.
How many types of ‘Kidney Cancer’ are there?
There are several types of kidney cancer, but the most common in adults are
- Renal Cell Carcinoma
This is the most common type in adults, accounting for about 90% of all kidney cancers. This cancer originates from the kidney’s filtering units. Patients in this group often come with incidental findings of a mass or cyst. If there are no obvious symptoms and the mass or cyst is not detected early, patients may present to the doctor at an advanced stage. - Transitional Cell Carcinoma originates from the tissue lining the urinary tract. It appears as a polyp or may be found as a large mass in the lining of the renal pelvis. Patients in this group often present with ‘blood in the urine’.
Risk factors for kidney cancer?
Several factors are associated with the development of kidney cancer, including
- Smoking significantly increases the risk of developing kidney cancer.
- Obesity and overweight Certain hormones altered in obesity may stimulate the growth of abnormal cells.
- High blood pressure is a risk factor for both kidney disease and kidney cancer.
- Genetic or hereditary abnormalities such as Von Hippel-Lindau (VHL) syndrome, Birt-Hogg-Dube (BHD) syndrome, Tubulous sclerosis (TS)
- Exposure to certain chemicals such as asbestos, cadmium
- Chronic kidney disease or end-stage renal failure especially in patients on long-term dialysis or those found to have kidney cysts.
- Detection of certain types of kidney cysts such as those with thick walls, irregular borders, or containing solid components within the cyst.
‘Symptoms of Kidney Cancer’ that should not be ignored!
In the early stage, most kidney cancer patients do not have clear symptoms because the tumor is small, causing no awareness or symptoms. Patients usually visit the doctor when symptoms become obvious, such as
- Blood in the urine, even without pain during urination
- Unexplained back or flank pain
- Palpable mass or swelling in the abdominal area
- Easy fatigue, weight loss, loss of appetite without known cause
- Chronic low-grade fever without known cause
- In some cases, high blood pressure or abnormal anemia may occur
Observing symptoms from the beginning is very important because it can help doctors diagnose the disease at an early stage
Diagnosis of Kidney Cancer
Starts with history taking and physical examination, along with additional tests including
- Ultrasound: to detect abnormal masses in the kidney
- Computed Tomography of the kidney (CT KUB) or Magnetic Resonance Imaging (MRI): to examine the details of the mass and assess the extent of spread
- Blood tests: to evaluate kidney function and indicators of abnormalities
- Urine tests: to detect blood or abnormal substances
- Biopsy: in some cases where imaging results are inconclusive
Treatment approaches
‘Kidney cancer treatment’ depends on the stage of the disease, cell type, and overall health of the patient. The main treatments include
- Surgery
- Partial Nephrectomy: suitable for small tumors or patients who need to preserve the affected kidney
- Radical Nephrectomy: for cases with large tumors or tumors close to major blood vessels
- Immunotherapy stimulates the immune system to fight cancer cells, suitable for patients with advanced or metastatic disease
- Targeted Therapy uses drugs that specifically act on cancer cells, reducing effects on normal cells
- Active Surveillance is treatment by close monitoring. This may be suitable for patients with small tumors and high surgical risk to avoid unnecessary surgery. The cancer must be a slow-growing type, and monitoring is done by periodic CT scans.
Preventing kidney cancer starts with us!
- Quit smoking immediately
- Maintain a healthy weight within standard range
- Control blood pressure appropriately
- Exercise regularly
- Eat nutritious food and reduce consumption of processed meats
- Have annual health check-ups, especially for those with a history of kidney disease or family members with kidney cancer
Kidney Cancer Screening
Currently, there is no clear guideline for kidney cancer screening, but due to the increasing incidence of kidney cancer and most patients being asymptomatic until diagnosed at an advanced metastatic stage,
which has a significantly lower survival rate compared to early detection, screening may be considered for patients with the above risk factors, especially those with chronic kidney disease, patients on renal replacement therapy, patients with a history of genetic diseases related to kidney cancer, patients with a family history of kidney cancer, and patients found to have kidney masses or cysts.
Initial screening includes urine examination and ultrasound or additional imaging such as computed tomography of the kidney (CT KUB) or magnetic resonance imaging (MRI) when more detailed and accurate assessment of abnormalities is needed.
As mentioned above, ‘kidney cancer’ may be asymptomatic in the early stages, but symptoms that occur can be important warning signs. Annual health check-ups, especially in high-risk groups, play a crucial role in early detection, which increases the chances of curative treatment. If you have abnormal symptoms or concerns about kidney health, you should promptly see a specialist for accurate evaluation and appropriate care.
Dr. Sitthiphat Thirasatyapitak
Nephrologist and Kidney Transplant Specialist
Phyathai 2 Hospital
