14 Jul 2011

Renal cell carcinoma

Renal cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer – kidney

Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.
Causes, occurrence, and risk factors
Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ages 50 - 70.
The exact cause is unknown.
The following may increase your risk of kidney cancer:
    Dialysis treatment
    Family history of the disease
    High blood pressure
    Horseshoe kidney
    Polycystic kidney disease
    Von Hippel-Lindau disease (a hereditary disease that affects blood vessels in the brain, eyes, and other body parts)
    Abdominal pain and swelling
    Back pain
    Blood in the urine
    Swelling of the veins around a testicle (varicocele)
    Flank pain
    Weight loss
Other symptoms that can occur with this disease:
    Cold intolerance
    Excessive hair growth in females
    Pale skin
    Vision problems
Cipher and tests
The health care provider will perform a physical exam. This may reveal:
    Mass or swelling of the abdomen
    A varicocele in the male scrotum
Tests include:
    Abdominal CT scan
    Blood chemistry
    Complete blood count (CBC)
    Intravenous pyelogram (IVP)
    Liver function tests
    Renal arteriography
    Ultrasound of the abdomen and kidney
    Urine tests
The following tests may be done to see if the cancer has spread:
    Abdominal CT scan
    Abdominal MRI
    Bone scan
    Chest x-ray and CT scan
    PET scan
Action - Treatment
Surgery to remove of all or part of the kidney (nephrectomy) is recommended. This may include removing the bladder, surrounding tissues, or lymph nodes. A cure is unlikely unless all of the cancer is removed with surgery.
Hormone treatments may reduce the growth of the tumor in some cases.
Chemotherapy is generally not effective for treating renal cell carcinoma. However, the drug interleukin-2 (IL-2) may help a small number of patient. It tells the body’s own immune system kill the cancer cells. It is very toxic.
Other chemotherapy drugs have been used, but patients generally do not live long once the disease has spread outside the kidney.
Newer medicines to treat kidney cancer include:
    Sorafenib (Nexavar)
    Sunitinib (Sutent)
    Temsirolimus (Torisel)
    Bevacizumab (Avastin)
Radiation therapy usually does not work for renal cell carcinoma so it is not often used.
    Barjorin D. Tumors of the kidney, bladder, ureters, and renal pelvis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:Chap 2007.
    National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Kidney Cancer. 2011. Version 1.2011. [PubMed]

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