National Kidney Month: Kidney Cancer Awareness

March isn't just National Kidney Month. It's also Kidney Cancer Awareness Month, spotlighting one of the most common cancers for both men and women. Renal cancers often go without symptoms in the early stages, but routine screening is not available. Knowing your family history and risk levels is an important step in making sure you spot potential signs or even have imaging tests done if you're at high risk for the disease. Awareness of your risk can help you spot the disease in the crucial early stages.

The Facts About Kidney Cancer

Kidney cancer, including all types of kidney and renal pelvis cancers, is among the 10 most common cancers for both men and women. Diagnosis rates have risen since the 1990s, but this is likely attribute to better diagnostic technologies like CT scans.

• The average age of diagnosis is 64.
• 1 in 46 men will develop kidney cancer; the lifetime risk for women is 1 in 83.
• Over 73,000 new cases of kidney cancer are expected to occur in 2019.
• In 1 of 4 cases, the cancer has spread by the time the kidney cancer is discovered.

Survival rates for kidney cancer vary by stage, with a 5-year relative survival rate of 75% for all stages combined. By stage:

• Localized (no signs of cancer outside the kidneys): 93%
• Regional (the cancer has spread to nearby structures of lymph nodes): 69%
• Distant (the cancer has spread to other parts of the body such as the lungs, brain, or bones): 12%

Risk Factors

Your likelihood of developing different types of kidney or renal cancers may be affected by a number of factors. These include:

• Smoking: increases your likelihood of developing renal cell carcinoma (RCC). Can gradually reduce if you stop smoking.
• Obesity: increases your likelihood of developing RCC.
• Family History: a family history of RCC may indicate a genetic predisposition or similar circumstances, and it increases your likelihood.
• Genetic Predisposition: a number of inherited conditions, including heriditary RCC, familial renal cancer, and Cowden disease.
• Gender: men are twice as likely to get RCC.
• Race: those of African, American Indian, or Alaska Native descent are more likely to get RCC.
• Advanced Kidney Disease: especially those requiring dialysis.
• Workplace Exposure: the metal cadmium, some herbicides, and some solvents have been linked to kidney cancer.
• High Blood Pressure: increases likelihood of RCC, although it is still being determined whether this is due to the condition or certain medications.

Symptoms

Many early kidney cancers do not cause signs or symptoms, so screening is important. But larger cancers or more advanced ones may cause:

• Hematuria: blood in the urine.
• Lower back pain on one side, unrelated to injury.
• A mass or lump on the side or lower back.
• Persistent fever, unrelated to infection or other sickness.
• Anemia: low red blood cell counts.
• Fatigue or tiredness.
• Loss of appetite.
• Weight loss, not caused by dieting.

These symptoms do not always indicate kidney cancer. Many other, benign diseases such as kidney stones or a bladder or urinary tract infection, could explain many of these symptoms. If you're experiencing any of these symptoms, however, you should schedule an appointment with a doctor for screening. Early detection is always key.

Treatment

As with most cancers, the best course of treatment will be determined by the stage and spread of the disease. Some common treatments include:

• Surgery: A partial nephrectomy, or removal of part of the kidney, is usually the preferred method of treating smaller and accessible tumors. A radical nephrectomy is the removal of the entire kidney. Nearby lymph nodes may also be removed, especially if they are enlarged.
• Cyrotherapy: the use of extreme cold to kill the tumor.
• Radiofrequency Ablation (RFA): high-energy radio waves to heat the tumor and destroy cancer cells.
• Arterial Embolization: blocking the artery that feeds the kidney with the tumor, causing the kidney and tumor to die.
• Targeted Therapies: drugs that block proteins in cancer cells or growth of blood vessels that nourish cancers. Findings indicate this is especially effective on kidney cancers.
• Immunotherapy: boosting the body's immune system or spurring an immune response to fight cancer cells.
• Active Surveillance: Doctors may choose to watch small tumors for evidence of growth before proceeding with surgery, especially with frail or elderly patients.
• Radiation Therapy: Largely used as palliative care in later stage case, as kidney cancers aren't very sensitive to radiation.
• Chemotherapy: Largely used for cancer that has spread beyond the kidney, as kidney cancer cells don't respond well to chemo.