What is Kidney cancer?
A growth of malignant cells in the kidney resulting in the formation of a tumour. Kidney cancer like other urogenital cancer is on the rises but the reason is partially due to improved medical technology with increase in detection of smaller and early stage renal cell cancer. It was used to say that 50% of renal cell cancer associated with spread when diagnosed but this is changing due to increase use of abdominal ultrasound in detecting intra-abdominal tumour.
If the lesion is small and there is no systemic effect, surgery will be the main modality of treatment especially when the lesion is small and focal, partial removal of the lesion with a clear margin will cure the patient. Lifelong follow up is necessary to detect recurrence
However, if the lesion is too big and more than 5cm then removal of the whole kidney is necessary (radical nephrectomy) because there may be synchronous lesion elsewhere in the same kidney and the part that left behind may not worth to do a partial as there is more blood loss. The removal of the whole kidney will be unavoidable when there is a healthy contralateral kidney.
Nowadays, minimal invasive surgery will be the operation of choice as the patient will have less pain, smaller scar and shorter hospital stay without affecting the outcome
Radiotherapy has very little effect on the primary cancer especially when it is big. However, radiofrequency treatment may be effective for lesion less than 2 cm especial when the patient is not fit for surgery
If the cancer have spread beyond the confined of the kidney to the lungs, brain and one, then chemotherapy especially the target focos-chemotherapy will have some effect on kidney cancer and the patient has 30-40% partial response with the control of the cancer.