Kidney Cancer
Figure 1. Illustration of a cancerous kidney growth.
What is kidney cancer?
Kidney cancer is a malignant cell growth (a tumour) in the kidneys (Figure 1).
How is kidney cancer diagnosed?
After a kidney mass is detected, your doctor will organise a CT scan to assess whether it is likely to be malignant. Further blood tests and scans such as MRI or bone scans may be done to assess local extent and spread of the tumour.
How is kidney cancer treated?
There are many types of kidney cancer and your treatment and outcome depend on the size, type and location of your tumour as well your general health (especially age, diabetes, high blood pressure, chronic infections, or a kidney disease) and overall kidney function.
If you are diagnosed with localised kidney cancer, your doctor may recommend treating the cancer with one of several ways, including:
Active surveillance (active monitoring with serial scans)
For patients with tumours <4cm
Elderly patients not fit for surgery
Patients with poor kidney function
Partial nephrectomy (removal of tumour only)
For patients with poor kidney function or only 1 kidney
For smaller (<4cm) tumours with favourable location
Radical nephrectomy (removal of whole kidney)
Large (>4-5cm) tumours or where location makes partial nephrectomy difficult
Ablation
Elderly patients not fit for surgery
Patients with smaller (<4cm) tumours with favourable location
Each procedure has its own advantages and disadvantages, which your urologist will discuss with you. If you are in good health, the best chance of cure is surgical removal.
The surgeries may be done with an open cut or via key-hole surgery (laparoscopic or robotic surgery). The goal in this situation is to cure the cancer and prevent further spread in the future. Generally partial nephrectomy is suitable for many tumours less than 4cm depending on their location.
If the kidney tumour has spread to other organs or distant lymph nodes (metastatic disease), it is often incurable and systemic treatment (such as with immunotherapy) may be recommended. The goal is to prolong your survival and prevent complications and symptoms. In some cases, a biopsy is done to get more insight into the specific characteristics of the tumour.