Renal Cell Cancer or Hypernephroma is a serious pathological condition of the kidney. Renal cell cancer originates from small renal tubules of the kidney. Kidney tubule functions as a filtering apparatus of the body. The survival rate of the advanced renal cell carcinoma or cancer is usually five years. Renal cell carcinoma is often resistant to radiation and chemotherapy treatment. In this article, we will discuss in detail about the various causes, symptoms, and treatment options for Renal Cell Cancer.
How Do We Define Renal Cell Cancer Or Hypernephroma?
- Renal Cell Cancer is also known by the name of Hypernephroma.
Cancer of Proximal Convoluted Tubule-
- The cancer of the kidneys stems from the lining of proximal convoluted tubule.
- Renal symptoms are caused by abnormalities of electrolytes, metabolites and water retention.
- Capillaries surround the tubule. Capillaries are integrated with proximal tubule. The excessive electrolytes, metabolites and water are filtered in proximal convoluted tubule from capillary blood.
- Most of the electrolytes and water are reabsorbed into blood.
- Excessive water and unwanted metabolites are discharged as urine.
- Renal Cell Cancer or Hypernephroma is one of the commonest forms of cancer of the kidneys and constitutes for more than 75% of cases of kidney cancer.G
Fatal Cancer Growth-
- Renal Cell Cancer or Hypernephroma is also termed to be one of the most lethal tumors of the Genitourinary System.
- Non-metastasize cancer is treated by removal of kidney.
- Survival rate is over 5 years in over 65% of the cases.
- Renal Cell Cancer is resistant to chemotherapy and radiation treatment, thus metastatic spread is often difficult to treat.
Incidental Asymptomatic Renal Cell Tumor-E, F
- The disease is asymptomatic during initial stage and diagnosis is delayed until cancer is spread in distant organ.
Causes Of Renal Cell Cancer Or Hypernephroma
- Age Factor-
- It is usually known to occur in adults in the age range of 50-70.
- Hereditary Factor-
- The exact cause of Renal Cell Cancer/Hypernephroma is unknown.
- Family history of Renal Cell Cancer/Hypernephroma
- Hereditary is one of the causes not yet eliminated.
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)-
- Long-term use of NSAIDs is associated with cancer of the kidney.
- Occupational Hazards-
- Exposure to chemicals- asbestos, cadmium, lead, chlorinated solvents and petrochemicals.
- Several years of dialysis may be triggering the cancerous activities of the renal cells.
Risk Factors Of Renal Cell Cancer Or Hypernephroma
- Horseshoe Shaped Kidney
- Polycystic Renal Disease
- Tobacco abuse and
Symptoms Of Renal Cell Cancer Or Hypernephroma
Nonspecific Symptoms of Renal Cell Cancer Or Hypernephroma-
- Weakness and fatigue
- Loss of weight
- Loss of appetite
Specific Symptoms of Renal Cell Cancer Or Hypernephroma-
- Moderate to severe flank pain often radiates to lower back
- Severe abdominal pain, intensity becomes severe following abdominal examination.
- Abdominal Mass
- Abdominal mass is felt during examination on right or left side of the umbilicus.
- Urine Discoloration
- Urine may be dark brown or red because of bleeding from cancer in to renal tubule.
Increased Erythropoietin Secretion
- Deep vein thrombosis
Decreased Erythropoietin Secretion
- Pale skin
Increased Angiotensin Secretion
- Vision problems
- Night sweating
Diagnosis Of Renal Cell Cancer Or Hypernephroma
- Frank Blood in urine
- Bacteria in urine
- Complete Blood Cell Count (CBC)-
- White Blood Cell Count- Elevated, if renal cell cancer is associated with kidney or bladder infection.
- Red Blood Cell Count- Elevated, secondary to increased erythropoietin secretions.
- Platelet Count- Elevated, secondary to increased secretion of erythropoietin hormone.
- Decreased hemoglobin results in anemia secondary to decreased secretion of erythropoietin in few cases.
- Erythrocyte Sedimentation Rate (ESR)-
- ESR is elevated.
- Kidney Function Test-
- Blood urea nitrogen- Elevated
- Creatinine- Elevated
- Liver Enzyme Test- (Elevated If Cancer is Metastasized in Liver)
- Aspartate Aminotransferase (AST)- Elevated
- Alanine Aminotransferase (ALT)- Elevated
Findings of Image Studies-
- Solid mass is observed around or within kidney tissue.
- Irregular margin of the tumor is observed.
- Renal mass may be cystic or calcified.
- Lymph node tumor mass
- Spread of tumor in renal vein.B
- Metastatic Tumor- Vertebral column, lungs, brain, thyroid,C liver and abdominal organs.
Following Image Studies Are Performed-
- CT Scan
- Renal Arteriography
- Intravenous Pyelogram
- Microscopic study is performed to diagnose renal cell carcinoma.
Treatment For Renal Cell Cancer or Hypernephroma
The recommended treatment for Renal Cell Cancer or Hypernephroma usually is nephrectomy or excision of the kidney. This may entail removal of the bladder, adjacent tissues, and lymph nodes. A definite cure for Renal Cell Cancer/Hypernephroma is quite unlikely unless and until the cancerous cells are completely removed from the body. In some cases, hormone treatments are used to make the tumor shrink. As stated above, Renal Cell Cancer/Hypernephroma does not respond to usual form of chemotherapy or radiation therapy.
Choice Of Treatment For Renal Cell Cancer Or Hypernephroma Are As Follows-
Surgery for Renal Cell Cancer or Hypernephroma-
- Radical Nephrectomy-
- Removal of kidneyD
- Removal of lymph node and adjacent soft tissue.B
- Laparoscopic Nephrectomy
- Laparoscopic surgery
- Kidney is removed.
- Lymph node close to kidney is removed.
- Partial Nephrectomy-
- Solitary well localized tumor with no sign of metastasis is partially removed by performing partial kidney excision.
- Radiofrequency Ablation A
- Several Radiofrequency needles are inserted under CT guidance in to the renal cell cancer mass.
- The tip of the needle heated with radiofrequency waves to 80 to 900 C and tumor mass is ablated (destroyed).
- Cryoprobe is inserted into tumor mass and cooled to -700 F. The freezing of the tumor causes tissue destruction.
Chemotherapy For Renal Cell Cancer or Hypernephroma
- Several chemotherapy medications have been tried.
- Results are not encouraging.
Immunotherapy For Renal Cell Cancer or Hypernephroma
- Activation of Immune System-
- Immune system is activated so white blood cells attacks tumor cells.
Treatment of Pain
- Mild to moderate pain is treated with non-steroidal anti-inflammatory drugs (NSAIDs)
- Severe to very severe pain is treated with opioids.
- Antibiotics are selected after blood test to find out antibiotic sensitivity test.
Prognosis Of Renal Cell Cancer Or Hypernephroma
Solitary Tumor Not Metastasized- Survival rate is over 80% for 5 years or longer.
Tumor Associated With Metastasis- The prognosis of Renal Cell Cancer/Hypernephroma is dependent on the extent of the metastasis as usually this condition is diagnosed after the tumor has metastasized to other organs in the body. The chances of survival invariably increase if the diagnosis is made early and the tumor has not spread.
Complications Of Renal Cell Cancer or Hypernephroma Are:
- Excessive calcium in the body
- Elevated RBC count
- Liver dysfunction
The stress of the illness can be decreased by leaps and bounds if the affected individual contacts a support group, the members of which share common experiences.
A. Long-term outcomes in healthy adults after radiofrequency ablation of T1a renal tumours.
Ma Y1, Bedir S, Cadeddu JA, Gahan JC.
BJU Int. 2014 Jan;113(1):51-5.
B. Renal cell carcinoma metastases to the thyroid gland-8 cases reported.
Iesalnieks I1, Trupka A, Raab M, Glockzin G, Woenckhaus M, Schlitt HJ, Agha A.
Thyroid. 2007 Jan;17(1):49-52.
C. Renal cell carcinoma with renal vein and inferior vena caval involvement: clinicopathological features, surgical techniques and outcomes.
Parekh DJ1, Cookson MS, Chapman W, Harrell F Jr, Wells N, Chang SS, Smith JA Jr.
J Urol. 2005 Jun;173(6):1897-902.
D. Clinical outcome of surgical resection for renal cell carcinoma.
Hara I1, Hara S, Miyake H, Muramaki M, Hikosaka S, Gotoh A, Fujisawa M, Okada H, Arakawa S, Kamidono S
Jpn J Clin Oncol. 2002 Aug;32(8):291-5.
E. Renal cell carcinoma: prognostic significance of incidentally detected tumors.
Tsui KH1, Shvarts O, Smith RB, Figlin R, de Kernion JB, Belldegrun A.
J Urol. 2000 Feb;163(2):426-30.
F. Clinical analysis of incidentally found renal cell carcinomas.
Tsukamoto T1, Kumamoto Y, Yamazaki K, Miyao N, Takahashi A, Masumori N, Satoh M.
Eur Urol. 1991;19(2):109-13.
G. Clinical profile and epidemiological changes of clear cell renal carcinoma during 12 years in our health area.
[Article in English, Spanish]
Lorenzo-Gómez MF1, Padilla-Fernández B, Antúnez-Plaza P, Gracía-Criado FJ, Mirón-Canelo JA, Silva Abuín JM
Arch Esp Urol. 2012 Nov;65(9):823-9.