Renal cell carcinoma (RCC) is known by many names: hypernephroma, renal adenocarcinoma, renal cancer, or simply, kidney cancer. The kidneys are bean-shaped organs that filter the blood and help us get rid of excreta, urine, and other waste from the body. When renal cell carcinoma affects the body, there is a growth of cancer cells in the lining of the tubules of the kidney(s).
If left untreated, renal cell carcinoma can spread quickly to other organs, such as the lungs and bones. Renal cell carcinoma is the most common type of kidney cancer in adults. It can be detected early when the cancer is small and is confined only to the kidneys. It is more common in men between the ages of 50 and 70.
Causes and Risk Factors of Renal Cell Carcinoma
The exact cause of RCC is not known to the medical community. It begins with a change in the kidney genes, but the exact trigger for this change is unknown.
The following factors are known to increase the risk of RCC:
Smoking: Smoking regularly can increase the risk of developing RCC. Even if you quit, the risk levels are hard to bring down to the level of a non-smoker.
Family history of RCC: A strong family history of RCC can predispose you to RCC.
Obesity: An obese person is more likely to develop RCC due to hormonal changes in the body.
Chronic drug abuse: The use of certain prescribed over-the-counter medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) used to treat arthritis and medications for fever and pain relief such as acetaminophen, are also associated with an increased risk.
Hypertension: High blood pressure can also increase the risk of RCC, irrespective of medicines taken to manage blood pressure.
Gender: The incidence of RCC is higher in men than women.
Von Hippel-Lindau disease: It is a genetic condition where cysts and tumors are formed in various organs.
Renal Cell Carcinoma Symptoms
RCC often goes unnoticed because no symptoms are seen in the early stages. The following symptoms can be noticed with the progression of the disease:
A mass or lump in the abdomen or lower back
Hematuria or the passage of blood in the urine
Unexplained weight loss
Loss of appetite
Fatigue or tiredness
Persistent fever without infection/fever of unknown origin
Excessive hair growth (in women)
If you notice any of these signs or symptoms persistently, we recommend booking an appointment with your doctors, so they can examine and test.
Renal Cell Carcinoma Stages
The stage of the tumor is determined on the basis of the size and extent of the tumor, its spread to the nearby lymph nodes, and its spread to distant sites, also known as metastasis.
Stage I tumor is only in the kidney.
Stage II tumor is larger than Stage I but contained to the site of the kidney.
Stage III tumor is when the tumor has spread into the tissue around the kidney into veins or lymph nodes but not to distant sites.
Stage IV tumor is when it possibly grows into the adrenal gland on top of the kidney and/or to distant lymph nodes.
Renal Cell Carcinoma Diagnosis
Usually, doctors will begin by recording your family and personal history. This will be followed by a physical exam to observe symptoms such as swellings, lumps, and enlarged veins.
If the doctor deems it necessary, they will order more tests, which may include:
Complete blood count
CT scan / PET CT Whole body
Ultrasounds for abdomen and kidney ultrasounds
Biopsy, in which a small piece of kidney tissue is sent to the path lab.
If RCC is detected, further tests will be done to assess the spread. This process is called staging and will determine the course of treatment.
Renal Cell Carcinoma Treatment
The course of renal cell carcinoma treatment depends on the stage of cancer. A variety of treatment modes can be combined for a holistic treatment plan.
Surgery is the main stage of treatment. Surgery can include different surgical procedures. Partial nephrectomy involves the removal of part of the kidney. A nephrectomy surgery involves the removal of the whole kidney. A radical nephrectomy is performed when cancer has spread to the surrounding tissues, lymph nodes, and adrenal gland. Surgery can be done by open / minimally invasive technique - Robotic surgery being the latest & the best modality.
These two modelisations are used in palliative settings.
Radiation therapy is given externally or internally to kill the cancer cells.
Chemotherapy is the use of drugs to kill cancer cells through intravenous injection.
Immunotherapy or biological therapy
Researchers to find new ways of cancer treatment are constantly being tested to assess their efficacy. If a clinical trial is considered a good fit or viable option for your treatment, your medical team will share this option.
Care management for Renal Cell Carcinoma
The sooner we detect RCC, the better chances you have for a full recovery. Despite the best treatment, you might experience poor kidney function or require external, long-term care like dialysis or drug therapy. In any case, palliative and long-term care management resources are available.
Frequently Asked Questions
1. Can renal cell carcinoma be hereditary?
Most cases of renal cell carcinoma are sporadic; a small percentage of cases can be hereditary. Individuals with a family history of renal cell carcinoma or certain genetic conditions may have a higher risk of developing the disease.
2. Are there alternative treatments available for renal cell carcinoma in Delhi?
In addition to conventional treatments such as surgery, radiation therapy, and targeted therapy, alternative treatments like immunotherapy and clinical trials may be available for certain patients with renal cell carcinoma in Delhi. It is best to consult with a healthcare provider for personalised treatment recommendations.
3. Can renal cell carcinoma be diagnosed through imaging tests alone?
Imaging tests such as CT scans, MRIs, and ultrasounds can provide valuable information for diagnosing renal cell carcinoma. However, a definitive diagnosis typically requires a biopsy, where a sample of the kidney tissue is obtained and examined under a microscope to confirm the presence of cancer cells.
4. Is renal cell carcinoma more common in men or women?
Renal cell carcinoma is slightly more common in men than women, with men comprising around two-thirds of all cases. However, the incidence of renal cell carcinoma can vary depending on factors such as age and geographical location.
5. Can lifestyle changes help reduce the risk of developing renal cell carcinoma?
While the exact causes of renal cell carcinoma are not fully understood, maintaining a healthy lifestyle can potentially reduce the risk. This includes regular exercise, a balanced diet, avoiding tobacco and excessive alcohol consumption, and managing underlying health conditions.
6. Can renal cell carcinoma occur bilaterally in both kidneys?
Yes, although rare, renal cell carcinoma can occur in both kidneys simultaneously or develop in the remaining kidney after the initial treatment of the first kidney. Close monitoring and follow-up are crucial to detect any potential recurrence or new tumours.
7. Can renal cell carcinoma cause paraneoplastic syndromes?
Yes, renal cell carcinoma can sometimes produce substances that cause paraneoplastic syndromes, which are a group of signs and symptoms unrelated to the direct effects of the tumour. These syndromes may affect various body systems and can contribute to the overall clinical presentation of the disease.
8. What is the cost of renal cell carcinoma treatment in Delhi?
The cost of renal cell carcinoma treatment in Delhi can vary depending on several factors, including the stage of the disease, the treatment approach, the hospital facility, and additional services required. It is best to consult with a healthcare provider or the hospital for an accurate estimate of the costs involved.