"With the minimally invasive surgery we achieve the cure of more than 90% of the small tumors preserving to the maximum the healthy renal tissue".
DR. FELIPE VILLACAMPA
SPECIALIST. UROLOGY DEPARTMENT
Kidney or renal cancer is the third most common urological tumor and accounts for approximately 3% of all tumors in the body.
It appears with maximum frequency between the fifth and seventh decade of life, although it can occur at any age. Regarding sex, it is more frequent in men than in women, in a proportion of 2/1.
Renal cell carcinoma is the most common type of kidney cancer, accounting for over 90% of malignant kidney tumors. Approximately 80% of people with renal cell carcinoma have a clear cell carcinoma.
Most of these tumors are diagnosed in early stages, and cure is possible.
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What are the symptoms of kidney cancer?
The clinical presentation of kidney cancer is highly variable. Currently, most kidney tumors are diagnosed in the course of a routine medical check-up, when the tumor has not yet caused any symptoms.
In less than 10% of cases, we find other symptoms such as abdominal masses, blood in the urine or lumbar pain.
The most common symptoms are:
- None, no symptoms.
- Low back pain (rare).
- Palpable abdominal mass (rare).
- Blood in the urine (rare).
Do you have any of these symptoms?
You may have kidney cancer
What are the causes of kidney cancer?
The causes of kidney cancer are still unknown, although it has been linked to certain genetic diseases, tobacco use and obesity.
Cigarette smoking increases the risk of developing renal cell carcinoma by approximately 40%.
People with Von Hippel-Lindau disease often suffer from several types of tumors. Between 25% and 45% of these patients develop renal cell carcinoma, usually the clear cell type.
What is your kidney prognosis?
The stage of the disease is an indicator of survival. In general, in those patients in whom renal masses below 4 cm are detected and treated surgically, cure rates of over 90% are achieved.
In the event that the mass is large and has extended outside the kidney, there are indicators that signal a worse prognosis. These include:
- High lactate dehydrogenase (LDH) level.
- High blood calcium level.
- Anemia (low red blood cell counts).
- Spread of cancer to two or more distant sites.
- Less than one year from diagnosis to need systemic treatment (targeted therapy, immunotherapy or chemotherapy).
- The person's general condition is unfavorable.
People without any of the risk factors presented above are considered to have a good prognosis, while people with one or two factors have an intermediate prognosis. More than two is considered an unfavorable prognosis.
How is kidney cancer diagnosed?
For the diagnosis of kidney cancer, a detailed clinical history with a complete physical examination must be taken. Usually an imaging test is already available, but an abdominal and thoracic CT scan as well as blood tests are necessary.
With these data it is often possible to offer treatment for the tumor and no further treatment is needed. Occasionally, in order to plan an optimal treatment, MRI, CT angiography or even PET will be necessary.
Biopsy of the renal mass is only recommended in some cases, mainly those in which it may change the therapeutic approach.
How is kidney cancer treated?
Surgery is the standard treatment for tumors located in the kidney, achieving cure rates of over 70%, even over 90% in small tumors.
There are several types of surgery depending on the size of the tumor, but, whenever technically and oncologically possible, we try to remove only the tumor, preserving the rest of the kidney. This technique, partial nephrectomy or lumpectomy, allows not only to cure the tumor, but also to maintain optimal renal function for years after surgery.
The existence in our center of the Da Vinci robot, together with our extensive experience in laparoscopic surgery, allows us to preserve kidneys in technically complex situations that would be more complicated to achieve with other techniques.
In small or very small renal masses, we can apply minimally invasive ablation techniques with different types of energy such as electroporation, radiofrequency or microwaves.
In advanced stages of the tumor, surgery can help to palliate the symptoms caused by the tumor and, in some selected patients, it can be combined with other treatments such as chemotherapy or immunotherapy to improve survival and quality of life.
In patients with metastases, the development of multiple lines of immunotherapy and tyrosine kinase inhibitor treatments in recent years has improved both overall survival and quality of life. The high level of research in this field, in which the Clinic actively participates, has led to the availability of multiple clinical trials that considerably broaden the range of treatment possibilities.
In the case of a diagnosis of urothelial cell carcinoma of the kidney or ureter, they are usually treated by surgery to remove the entire kidney and ureter, as well as the part of the bladder where the ureter joins. Chemotherapy and radiation are often used in addition to surgery. In selected cases, only the affected region may be removed, thus preserving the kidney.
Where do we treat it?
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Thanks to clinical trials, new treatments, immunomodulatory antibodies, are being developed that are showing promising efficacy in kidney cancer patients who have failed previous treatments.
Participating in these trials offers new possibilities for patients by allowing access to the latest therapeutic advances.