Kidney cancer
Encyclopedia
Kidney cancer is a type of cancer
that starts in the cells in the kidney
.
The two most common types of kidney cancer are renal cell carcinoma
(RCC) and urothelial cell carcinoma (UCC) of the renal pelvis
. These names reflect the type of cell from which the cancer developed.
The different types of kidney cancer (such as RCC and UCC) develop in different ways, meaning that the diseases have different outlooks (or prognosis
), and need to be staged
and treated in different ways.
In addition to renal cell carcinoma and renal pelvis carcinoma, other, less common types of kidney cancer include:
Rarely, some other types of cancer and potentially cancerous tumors that more usually originate elsewhere can originate in the kidneys. These include:
Cancer in the kidney may also be secondary, the result of metastasis from a primary cancer elsewhere in the body.
. Most cancers in the renal tubule are renal cell carcinoma and clear cell adenocarcinoma. Most cancers in the renal pelvis are transitional cell carcinoma.
and/or blood in the urine (or hematuria
). Other symptoms may include tiredness, loss of appetite, weight loss, a high temperature and heavy sweating, and persistent pain in the abdomen However many of these symptoms can be caused by other conditions, and there may also be no signs or symptoms in a person with kidney cancer, especially in the early stages of the disease.
In the United States in 2008, there were around 54,390 new cases of kidney cancer and 13,010 deaths from the disease. 2005. In the UK, 8,757 people were diagnosed with kidney cancer in 2008, and the disease caused 3,848 deaths.
The most recent estimates of incidence of kidney cancer suggest that there are 63,300 new cases annually in the EU25. In Europe, kidney cancer accounts for nearly 3% of all cancer cases.
In the UK kidney cancer is the eighth most common cancer in men (5,377 new cases diagnosed in 2008), and the ninth most common cancer in women (3,380 new cases in 2008), giving a male:female ratio of over 3:2. The number of cases of kidney cancer in men in the UK has doubled from 7 per 100,000 to 14.8 per 100,000 between 1975-1977 and 2006-2008. In women the rates have more than doubled over the same period, rising from 3.2 to 7.5 per 100,000.
The incidence of kidney cancer is also increasing in the United States. This is thought to be a real increase, not due only to only to changes in the way the disease is diagnosed.
; being infected with hepatitis C
; and previous treatment for testicular cancer
or cervical cancer
.
There are also other possible risk factors such as high blood pressure, which are being investigated by scientists.
and radiotherapy, as kidney cancers often do not respond to these treatments.
If the cancer has not spread, it will usually be removed by surgery. Sometimes this involves removing the whole kidney, which is called nephrectomy
. But surgery is not always possible - for example the patient may have other medical conditions that prevent it, or the cancer may have spread around the body and doctors may not be able to remove it.
If the cancer can't be cured with surgery, sometimes doctors may use other techniques such as cryotherapy
(freezing the tumour away) or radiofrequency ablation
(burning the tumour away). However these are not yet used as standard treatments for kidney cancer. Other treatment options include biological therapies (drug treatments that use natural substances from the body) such as torisel, nexavar and sutent, the use of immunotherapy including interferon
and interleukin-2.
In Wilms' tumor
(a type of kidney cancer that affects children), chemotherapy, radiotherapy and surgery are the accepted treatments, depending on the stage of the disease when it is diagnosed. Other rare forms of kidney cancer are not discussed here.
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
that starts in the cells in the kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
.
The two most common types of kidney cancer are renal cell carcinoma
Renal cell carcinoma
Renal cell carcinoma is a kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products. RCC is the most common type of kidney cancer in adults, responsible for approximately 80% of cases...
(RCC) and urothelial cell carcinoma (UCC) of the renal pelvis
Renal pelvis
The renal pelvis or pyelum is the funnel-like dilated proximal part of the ureter in the kidney.In humans, the renal pelvis is the point of convergence of two or three major calyces...
. These names reflect the type of cell from which the cancer developed.
The different types of kidney cancer (such as RCC and UCC) develop in different ways, meaning that the diseases have different outlooks (or prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
), and need to be staged
Cancer staging
The stage of a cancer is a description of the extent the cancer has spread. The stage often takes into account the size of a tumor, how deeply it has penetrated, whether it has invaded adjacent organs, how many lymph nodes it has metastasized to , and whether it has spread to distant organs...
and treated in different ways.
Types
- Squamous cell carcinomaSquamous cell carcinomaSquamous cell carcinoma , occasionally rendered as "squamous-cell carcinoma", is a histologically distinct form of cancer. It arises from the uncontrolled multiplication of malignant cells deriving from epithelium, or showing particular cytological or tissue architectural characteristics of...
- Juxtaglomerular cell tumorJuxtaglomerular cell tumorJuxtaglomerular cell tumor is a rare kidney cancer that typically secretes renin. It involves the juxtaglomerular cells. It often causes hypertension, in adults and children, although among causes of hypertension it is rare. Its malignant potential is uncertain.-History:Juxtaglomerular cell tumor...
(reninoma) - AngiomyolipomaAngiomyolipomaAngiomyolipoma are the most common benign tumour of the kidney and are composed of blood vessels, smooth muscle cells and fat cells. Angiomyolipoma are strongly associated with the genetic disease tuberous sclerosis, in which most individuals will have several angiomyolipoma affecting both kidneys...
- Renal oncocytomaRenal oncocytomaA renal oncocytoma is a tumour of the kidney made up of oncocytes, a special kind of cell.-Presentation:An oncocytoma is an epithelial tumor composed of oncocytes, large eosinophilic cells having small, round, benign-appearing nuclei with large nucleoli.-Pathophysiology:Renal oncocytoma is thought...
- Bellini duct carcinomaBellini duct carcinomaBellini duct carcinoma is a type of kidney cancer that originates in the duct of Bellini of the kidney. It is rare, accounting for 1-3% of all kidney cancers. It is also recently described; a 2002 review found just 40 case reports worldwide...
- Clear-cell sarcoma of the kidneyClear-cell sarcoma of the kidneyClear cell sarcoma of the kidney is a rare type of kidney cancer. Clear cell sarcoma can spread from the kidney to other organs, most commonly the bone, but also including the lungs, brain, and soft tissues of the body....
- Mesoblastic nephromaMesoblastic nephromaCongenital mesoblastic nephroma is a type of kidney tumor that is usually found before birth by ultrasound or within the first 3 months of life. It contains fibroblastic cells , and may spread to the other kidney or to nearby tissue...
- Wilms' tumorWilms' tumorWilms' tumor or nephroblastoma is cancer of the kidneys that typically occurs in children, rarely in adults.Its common name is an eponym, referring to Dr. Max Wilms, the German surgeon who first described this kind of tumor....
, usually is reported in children under the age of 5. - Mixed epithelial stromal tumor
Rarely, some other types of cancer and potentially cancerous tumors that more usually originate elsewhere can originate in the kidneys. These include:
- Clear cell adenocarcinomaClear cell adenocarcinomaClear cell adenocarcinoma or mesonephroma is a rare type of adenocarcinoma. It usually affects cells in the female genital tract. Vaginal clear cell adenoma is common in women in their late teens and early 20's whose mothers took diethylstilbestrol during pregnancy.Some of these cancers may not...
- Transitional cell carcinomaTransitional cell carcinomaTransitional cell carcinoma is a type of cancer that typically occurs in the urinary system: the kidney, urinary bladder, and accessory organs. It is the most common type of bladder cancer and cancer of the ureter, urethra, and urachus...
- Inverted papillomaInverted papillomaAn inverted papilloma is a type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract . When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such...
- Renal lymphomaLymphomaLymphoma is a cancer in the lymphatic cells of the immune system. Typically, lymphomas present as a solid tumor of lymphoid cells. Treatment might involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and can be curable depending on the histology, type, and stage...
- TeratomaTeratomaA teratoma is an encapsulated tumor with tissue or organ components resembling normal derivatives of all three germ layers. There are rare occasions when not all three germ layers are identifiable...
- CarcinosarcomaCarcinosarcomaCarcinosarcoma is a malignant tumor that is a mixture of carcinoma and sarcoma ....
- Carcinoid tumor of the renal pelvis
Cancer in the kidney may also be secondary, the result of metastasis from a primary cancer elsewhere in the body.
Location within the kidney
Kidney cancer originates in the kidney in two principal locations: the renal tubule and the renal pelvisRenal pelvis
The renal pelvis or pyelum is the funnel-like dilated proximal part of the ureter in the kidney.In humans, the renal pelvis is the point of convergence of two or three major calyces...
. Most cancers in the renal tubule are renal cell carcinoma and clear cell adenocarcinoma. Most cancers in the renal pelvis are transitional cell carcinoma.
Signs and symptoms
The most common signs and symptoms of kidney cancer are a lump in the abdomenAbdomen
In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...
and/or blood in the urine (or hematuria
Hematuria
In medicine, hematuria, or haematuria, is the presence of red blood cells in the urine. It may be idiopathic and/or benign, or it can be a sign that there is a kidney stone or a tumor in the urinary tract , ranging from trivial to lethal...
). Other symptoms may include tiredness, loss of appetite, weight loss, a high temperature and heavy sweating, and persistent pain in the abdomen However many of these symptoms can be caused by other conditions, and there may also be no signs or symptoms in a person with kidney cancer, especially in the early stages of the disease.
Epidemiology
Around 208,500 new cases of kidney cancer are diagnosed in the world each year, accounting for just under 2% of all cancers. The highest rates are recorded in Northern America and the lowest rates in Asian and African regions.In the United States in 2008, there were around 54,390 new cases of kidney cancer and 13,010 deaths from the disease. 2005. In the UK, 8,757 people were diagnosed with kidney cancer in 2008, and the disease caused 3,848 deaths.
The most recent estimates of incidence of kidney cancer suggest that there are 63,300 new cases annually in the EU25. In Europe, kidney cancer accounts for nearly 3% of all cancer cases.
In the UK kidney cancer is the eighth most common cancer in men (5,377 new cases diagnosed in 2008), and the ninth most common cancer in women (3,380 new cases in 2008), giving a male:female ratio of over 3:2. The number of cases of kidney cancer in men in the UK has doubled from 7 per 100,000 to 14.8 per 100,000 between 1975-1977 and 2006-2008. In women the rates have more than doubled over the same period, rising from 3.2 to 7.5 per 100,000.
The incidence of kidney cancer is also increasing in the United States. This is thought to be a real increase, not due only to only to changes in the way the disease is diagnosed.
Risks and causes
Factors that increase the risk of kidney cancer include smoking, which can double the risk of the disease; faulty genes and certain inherited conditions; a family history of kidney cancer; being obese; having kidney disease that needs dialysisDialysis
In medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure...
; being infected with hepatitis C
Hepatitis C
Hepatitis C is an infectious disease primarily affecting the liver, caused by the hepatitis C virus . The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years...
; and previous treatment for testicular cancer
Testicular cancer
Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system.In the United States, between 7,500 and 8,000 diagnoses of testicular cancer are made each year. In the UK, approximately 2,000 men are diagnosed each year. Over his lifetime, a man's risk of...
or cervical cancer
Cervical cancer
Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...
.
There are also other possible risk factors such as high blood pressure, which are being investigated by scientists.
Treatment
Treatment for kidney cancer depends on the type and stage of the disease. Usually treatment doesn't involve chemotherapyChemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
and radiotherapy, as kidney cancers often do not respond to these treatments.
If the cancer has not spread, it will usually be removed by surgery. Sometimes this involves removing the whole kidney, which is called nephrectomy
Nephrectomy
Nephrectomy is the surgical removal of a kidney.-History:The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelberg. Simon practiced the operation beforehand in animal experiments...
. But surgery is not always possible - for example the patient may have other medical conditions that prevent it, or the cancer may have spread around the body and doctors may not be able to remove it.
If the cancer can't be cured with surgery, sometimes doctors may use other techniques such as cryotherapy
Cryotherapy
Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo meaning cold and the word therapy meaning cure...
(freezing the tumour away) or radiofrequency ablation
Radiofrequency ablation
Radio frequency ablation is a medical procedure where part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from the high frequency alternating current to treat a medical disorder...
(burning the tumour away). However these are not yet used as standard treatments for kidney cancer. Other treatment options include biological therapies (drug treatments that use natural substances from the body) such as torisel, nexavar and sutent, the use of immunotherapy including interferon
Interferon
Interferons are proteins made and released by host cells in response to the presence of pathogens—such as viruses, bacteria, or parasites—or tumor cells. They allow communication between cells to trigger the protective defenses of the immune system that eradicate pathogens or tumors.IFNs belong to...
and interleukin-2.
In Wilms' tumor
Wilms' tumor
Wilms' tumor or nephroblastoma is cancer of the kidneys that typically occurs in children, rarely in adults.Its common name is an eponym, referring to Dr. Max Wilms, the German surgeon who first described this kind of tumor....
(a type of kidney cancer that affects children), chemotherapy, radiotherapy and surgery are the accepted treatments, depending on the stage of the disease when it is diagnosed. Other rare forms of kidney cancer are not discussed here.
In children
The majority of kidney cancers reported in children are Wilms' tumors. These tumors can begin to grow when a baby is still developing the womb, and may not cause problems until the child is a few years old. Wilms' tumor is most common in children under the age of 5, but can rarely be diagnosed in older children or in adults. It is still not clear what causes most Wilms' tumors. The most common symptoms are swelling of the abdomen and blood in the child's urine.External links
- Clinically reviewed kidney cancer information for patients, from Cancer Research UKCancer Research UKCancer Research UK is a cancer research and awareness charity in the United Kingdom, formed on 4 February 2002 by the merger of The Cancer Research Campaign and the Imperial Cancer Research Fund. Its aim is to reduce the number of deaths from cancer. As the world's largest independent cancer...
- UK kidney cancer statistics from Cancer Research UKCancer Research UKCancer Research UK is a cancer research and awareness charity in the United Kingdom, formed on 4 February 2002 by the merger of The Cancer Research Campaign and the Imperial Cancer Research Fund. Its aim is to reduce the number of deaths from cancer. As the world's largest independent cancer...