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Understanding kidney cancer

This year [2008], about 54,000 people will find out they have renal cell carcinoma (RCC), the most common type of kidney cancer. RCC begins in the tissues that filter blood and produce urine. Generally striking between ages 50 and 70, RCC affects nearly twice as many men as women. Experts believe smoking may be directly responsible for 40 percent of kidney cancer. Asbestos and cadmium exposure may increase risk, and some people are born with a genetic predisposition to kidney cancer.

What are the symptoms?

Blood in the urine is one of the first signs of kidney cancer and should always be checked by a doctor. The blood may be visible or discovered during urinalysis, a routine urine test. Kidney cancer may also cause dull back or side pain, fatigue, decreased appetite, weight loss or fever. Sometimes the cancer is discovered when a doctor feels a suspicious lump during a checkup.

Several tests are used to confirm kidney cancer. An intravenous pyelogram, or IVP, is a special X-ray of the kidneys, ureter and bladder. And CT scans and MRIs let doctors see cross sections of the kidneys. Once a tumor is identified, a biopsy may be necessary.

How is it treated?

Treatment depends on the location and size of a tumor and whether it has spread. Doctors must also take a person’s general health into account. If caught in a very early stage, surgery to remove all or part of the affected kidney, called nephrectomy, is the most effective treatment. If the cancer is more widespread, a radical nephrectomy—complete removal of the kidney, the adrenal gland and the fat immediately surrounding the kidney—is usually performed. Often, nearby lymph nodes are also removed. Radiation may be done before surgery to shrink tumors and after surgery to destroy remaining cancer cells.

If the cancer is too advanced to be treated surgically or if a patient cannot withstand surgery, radiation alone may be used to shrink tumors and relieve pain. Doctors may also use a procedure called arterial embolization, in which the artery that supplies blood to the cancerous kidney is clogged. In addition, researchers are at work refining various forms of immunotherapy and gene therapy for kidney cancer.

If you or a loved one is diagnosed with kidney cancer, it’s important to understand and to carefully weigh the risks and benefits of available treatment options, including experimental procedures.