Cancer of the Kidney

Cancer of the kidney, also called hypetnephroma or renal cell carcinoma is more common in men than in women. It is difficult to diagnose early and as a result less than 30 per cent of patients can expect to be cured by a combination of surgery and radiotherapy

Symptoms

About two-thirds of patients exhibit symptoms of blood in the urine and/or low, one-sided backache. The other third of patients experience more general symptoms such as fatigue, fever or loss of weight Another late symptom is a lump or mass that can be felt in the area of the kidney.

Diagnosis

When kidney cancer is suspected, several tests can be carried out to confirm it. The most important one is the intravenous pyelogram. For this, iodine-containing dye (which will be concentrated and excreted by the kidneys) is injected intravenously. This will help to show up not only a mass in the kidney, but also how the kidneys are functioning. An ultrasound examination, using sound waves, helps to distinguish between a cystic (and probably benign) mass and a solid, malignant one. Sometimes an arteriogram is performed to discover the blood-supply to the kidney. This involves the injection of a dye into a tube that is passed up an artery in the leg right up into the region of the kidney. By revealing the blood-supply of the cancer, the surgeon gains important information about how to approach the cancer at operation.

Before the best type of treatment can be worked out, one must ensure that the disease has not spread to distant parts of the body. For this, a chest X-ray as well as a bone and liver scan are necessary.

Treatment

If the cancer is found to be localised to the kidney, a nephrectomy (removal of the kidney) together with a removal of the nearby lymph nodes is recommended. Post-operative radiotherapy to the kidney-bed is administered as a routine in more advanced cases.

In patients with metastatic kidney disease, treatment is still disappointing because both drugs and hormones remain ineffective at present.