Kidney Cancer Treatment in Delhi, India

• Renal Cell Carcinoma

  Renal cell carcinoma, also called renal cell adenocarcinoma, is the most common type of kidney cancer and accounts for about 90% of cases. It typically manifests as a single tumour in one kidney, but it can also develop as multiple tumours in one kidney or affect both kidneys simultaneously. The most common variant is Clear Cell Carcinoma, followed by Papillary Carcinoma.

• Urothelial Carcinoma

  Urothelial carcinoma, also called transitional cell carcinoma, comprises 5 to 10% of kidney cancer cases. This type of cancer arises from the urothelial cells lining the bladder, renal pelvis, urethra, and uterus.

• Sarcoma

  Sarcoma is a rare form of kidney cancer that begins in the soft tissues of the kidney. Treatment typically involves surgery followed by chemotherapy, as sarcoma cancer has a higher likelihood of recurrence.

• Wilms Tumor

  Wilms tumour is the most common type of kidney cancer in children, accounting for about 1% of kidney cancer cases. It is usually treated successfully with chemotherapy and radiation therapy.

• Lymphoma

  Lymphoma is associated with enlarged lymph nodes, which can also affect the kidneys. It may appear as a tumour in the kidney and is treated using biopsy and chemotherapy.

Kidney cancer does not typically display symptoms in its early stages. However, the following symptoms may manifest as the disease progresses:

• Fever
• Tiredness
• Unexpected weight loss
• Back pain
• Blood in urine
• Loss of appetite
• Bone pain
• High blood pressure
• Anaemia (low red blood cell count)
• Fatigue

It is important to note that kidney cancer symptoms may not be apparent, so it is advisable to consult a doctor if any of the aforementioned symptoms persist.

The exact cause of kidney cancer is still not clear. However, it is believed to develop when there are changes in the DNA of kidney cells. These genetic alterations lead to the rapid growth and multiplication of abnormal cells, which eventually accumulate and form tumours in the kidneys.

Common risk factors that can increase the risk of developing kidney cancer include:

• Advancing age
• Smoking
• Obesity
• Hypertension/ high blood pressure
• Inherited syndromes, such as Hippel-Lindau disease and tuberous sclerosis complex, can predispose individuals to kidney cancer.
• Family History
• Long-Term Kidney Dialysis
• Exposure to paint, dyes and industrial chemicals

Several tests are employed to diagnose kidney cancer:

• Blood and Urine Tests

  Blood and urine samples are collected to investigate the cause of symptoms and examine the levels of various blood cells.

• Biopsy

  A biopsy involves surgically removing a sample of tissue from the kidney to be analysed in a laboratory. This helps determine the type and grade of cancer. However, a biopsy is generally not indicated, and treatment can be commenced based on the imaging findings.

• Imaging Tests

  Ultrasound, X-ray, CT scan, or MRI are used to identify tumours or abnormalities in the kidneys. These tests aid in determining the exact location and size of the tumour besides staging kidney cancer.

Surgery is the most common treatment modality used for kidney cancer. Additional methods may be employed if the cancer has spread to other body parts. The treatment approach depends on factors such as the type of kidney cancer, the patient's overall health, and the extent of the cancer spread.

Surgery

Surgery is the primary method of removing kidney cancer. Following surgical procedures are used based on the extent of the disease:

• Nephrectomy: This involves removing the whole of the affected kidney along with the Gerotas fat, besides some surrounding healthy tissues, such as lymph nodes. 
• Partial Nephrectomy: Also known as kidney-sparing surgery, this procedure involves removing the affected cancerous part of the kidney along with a margin of healthy tissue. It is often preferred if the person has only one kidney, aiming to preserve kidney function and avoid the need for dialysis.

Radiofrequency Ablation

Radiofrequency ablation is a minimally invasive procedure in which needles are inserted into the cancerous part of the kidney through the skin. High-frequency waves are then transmitted through the needles to generate heat, effectively killing the cancer cells surrounding the needles. RFA is generally reserved for small renal masses < 4 cm.

Targeted Therapy

Targeted therapy utilises drugs that specifically target and block abnormalities present within cancer cells. By doing so, these drugs can inhibit the growth and survival of cancer cells.

Immunotherapy

Immunotherapy is a treatment that harnesses the body's immune system to fight against cancer. It involves administering drugs that stimulate the immune system to recognise and attack cancer cells.

Take preventative measures and adopt a healthy lifestyle to reduce the risk of kidney cancer:

• Quit Smoking
• Maintain a healthy weight
• Control Blood Pressure

Kidney cancer can lead to complications such as high blood pressure (hypertension) and an increase in red blood cell count (polycythemia). It can also cause intractable bleeding in urine and a drop in haemoglobin levels. These complications may require additional medical management.

The prognosis for kidney cancer depends on the type and stage of cancer and its spread to other parts of the body. The patient's age and overall health also play a role in determining the prognosis. Early-stage kidney cancer has a better outlook, and timely detection increases the chances of successful treatment and recovery.

Reviewed by Dr. Tushar Aditya Narain, Senior Consultant, Robotic Surgery, Uro-Oncology, Cancer Care / Oncology, Surgical Oncology, Urology on 15-Jun-2023.

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