What Is Kidney Cancer?

Today, let's discuss about kidney cancer.

Understanding kidney cancer, also known as renal cell cancer, begins with knowing it starts in kidney cells. Renal cell carcinoma (RCC) is the most common type, accounting for about 90% of cases. Usually, only one kidney is affected, but sometimes both kidneys can be involved, though this is rare.

There are also less common types to be aware of:

• Urothelial carcinoma, also called transitional cell carcinoma, can start where the kidney and ureter connect in the ureter or renal pelvis. Doctors usually treat it similarly to bladder cancer.
• Wilms tumour is predominantly found in younger children, although it remains rare.

In Singapore, kidney cancer constitutes one to two percent of all cancer cases. It's predominantly diagnosed in individuals over 50, with nearly two-thirds of cases occurring in those aged 65 and above.

Early recognition and understanding of symptoms are key to effective management and treatment.

Kidney Cancer Symptoms

Many times, kidney cancer doesn't show obvious signs. Surprisingly, about two-thirds of cases are discovered while checking for other health issues. When found this way, the cancer is often in its early stages. However, for the remaining third, the disease is typically found at a later, more advanced stage.

Some signs to watch for are:

• Blood in the urine
• Feeling a lump in your belly
• Persistent side pain
• Unexplained weight loss or loss of appetite
• Anaemia (low red blood cell count)

These signs may indicate kidney cancer, but they could also be from other, less serious conditions. For instance, blood in urine is often due to a bladder infection or kidney stone. Not to be confused with kidney stone symptoms. Nonetheless, if you experience any of these symptoms, it's crucial to see a doctor for proper evaluation and treatment if necessary.

Kidney Cancer Causes

In many cases, doctors can't pinpoint a single cause for kidney cancer, but they've identified some risk factors:

• Smoking - Smokers are about twice as likely to develop kidney cancer as non-smokers.
• Working with specific chemicals - People who work with substances like aniline dye or heavy metals face higher risks.
• Exposure to certain substances like trichloroethylene, found in some cleaning products and solvents, can increase the risk.
• Obesity is another risk factor.
• End-stage kidney diseases that require dialysis can increase the likelihood of kidney cancer.
• Regular use of mild painkillers like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin over a long time.
• There's also a hereditary aspect to kidney cancer. Less than five percent of cases are linked to faulty genes passed down through families. Conditions like Von Hippel-Lindau (VHL) syndrome, tuberous sclerosis, Birt-Hogg-Dube syndrome, and hereditary non-VHL clear cell and papillary renal cell cancer can put individuals at higher risk.

Kidney Cancer Diagnosis:

If kidney cancer is suspected based on your medical history and examination, they may order medical tests to confirm the diagnosis. These tests may include some of the following:

• Urine Tests: Check for blood in the urine, which can be a sign of kidney cancer.
• MRI / Ultrasound / CT scans: These imaging tests provide detailed pictures of the kidneys, helping to detect any tumours or other abnormalities.
• Cystoscopy / Ureterostomy / Renoscopy: For cancers affecting the lining of the urinary tract, a thin, flexible tube with a camera attached may be inserted through the urethra to examine the urinary tract and kidney. This procedure allows doctors to visualise any abnormal changes and identify suspicious masses. If any abnormalities are found, a biopsy may be performed to confirm the diagnosis.

Treatment for Early Kidney Cancer

When it comes to treating kidney cancer early, there are a few options, depending on how far the cancer has progressed:

• Surgery: This is the most common treatment for kidney tumours if the patient is fit for surgery.
• Radiofrequency Ablation: This is a less invasive procedure that uses heat to destroy cancer
• Active Surveillance: Some patients with very small kidney tumours may simply be monitored closely with kidney scans to track any changes in the tumour's size or behaviour.

Note: Radiofrequency ablation and active surveillance are often considered for elderly patients with multiple health issues who may not be suitable candidates for surgery.

Treatment for Advanced Kidney Cancer

For some patients who are diagnosed late with kidney cancer that has spread to other parts of the body, a combination of kidney removal surgery and systemic therapy has proven to be effective, even in advanced cases.

Treatment options for these patients may include:

• Targeted therapy: This involves using medications that target specific pathways in cancer cells to inhibit tumour
• Immunotherapy: These drugs help stimulate the body's immune system to fight against cancer
• Chemotherapy: Involves administering anti-cancer drugs either orally (by mouth) or through injections into the body. It is typically utilised to treat advanced kidney cancer that remains unresponsive to other forms of treatment.

Life After Treatment

After kidney cancer treatment, many people can continue living normally with one healthy kidney. Most kidney cancer patients don't end up with kidney failure requiring dialysis. Your doctor will discuss the risks of reduced kidney function after surgery, which can depend on factors like diabetes, high blood pressure, and age.

Seek Expert Guidance for Kidney Cancer

When facing kidney cancer, understanding your treatment options is crucial. If you or a loved one is navigating kidney cancer treatment in Singapore, consider reaching out to our senior specialist doctors at OncoCare Cancer Centre.

For information on how your health insurance may cover kidney treatments, visit our insurance enquiries page.

“Expert knowledge means better care for cancer”

Contributed by:

Dr Akhil Chopra

MBBS (Delhi)

American Board Certified (Int Med)

American Board Certified (Hematology)

American Board Certified (Med Oncology)