By – Dr. Sanjeev Gulati, Principal Director – Nephrology & Kidney Transplant, Fortis Escorts Heart Institute
Kidney cancer or Renal cell carcinoma is the most common type of kidney cancer in adults. It accounts for approximately 85% of neoplasms arising from the kidney. his disease is characterized by a lack of early warning signs, diverse clinical manifestations and resistance to radiation and chemotherapy. In recent years, multiple agents have been developed for the systemic treatment of metastatic disease. Although the optimal treatment strategy continues to evolve, three agents that target angiogenesis (sunitinib, bevacizumab/interferon, and pazopanib) and a mammalian target of rapamycin (mTOR)–targeted therapy (temsirolimus) are approved as front-line agents.
For selected patients, cabozantinib or combination therapy with nivolumab plus ipilimumab are also used as first-line treatments. Finally, high-dose interleukin-2 (IL-2) and axitinib can be used in selected patients.
Kidney cancer is most common in people between the ages of 65 and 74. The risk of kidney cancer increases with age.
Signs and symptoms
Renal cell carcinoma may remain clinically occult for most of its course. Only 10% of patients present with the classic triad of flank pain, hematuria, and flank mass.
Other signs and symptoms include the following:
• Weight loss
• Night sweats
• A varicocele, usually left sided, due to obstruction of the testicular vein
The exact cause of kidney cancer isn’t known, but there are certain risk factors that may increase your chances of getting the disease. These include:
– High blood pressure
– Family history
– Radiation therapy
– Gene changes (mutations
– Long-term dialysis treatment
– Tuberous sclerosis complex
– Von Hippel-Lindau disease (VHL
The treatment approach to renal cell carcinoma (RCC) is guided by the probability of cure, which is related directly to the stage or degree of tumor dissemination. More than 50% of patients with early-stage RCC are cured, but the outcome for stage IV disease is poor.