Currently, among all tumors of the kidneys order 90-95 per cent was for renal cell carcinoma, which is also often referred to as renal adenocarcinoma, hypernephroma, tumor cells with light. Remaining tumors – sarcomas and Wilms’ tumor are much rarer. Given the prevalence of renal cell carcinoma in the structure of the kidney tumor, then it will follow him.
Why there is kidney cancer?
To say why there is renal cell carcinoma is difficult to say why there is cancer of the kidney in a specific patient, is impossible. There is evidence that people employed in the manufacture of aniline dyes, kidney cancer occur much more frequently. In this regard, some carcinogens, are formed in the manufacture of aniline dyes, was accused of a carcinogenic effect on the kidneys. These carcinogens are accused of involvement in the emergence of bladder cancer. Increased risk of disease observed in patients with Hippel-Lindau disease, horseshoe kidney, polycystic and acquired cysts, which are accompanied by a high content of nitrogenous substances in the blood (uremia). Last condition is the result of insufficient kidney function.
Symptoms of kidney cancer
There are three symptoms of kidney cancer, about which patients generally go to the doctor – hematuria, education and pain in the stomach. Hematuria is literally translated from Latin as "blood in the urine.Distinguish microhematuria and gross hematuria. In microhematuria elements of blood in the urine can be seen only under a microscope. Naturally, the study performed in the laboratory. Urine, however, remains the ordinary color. In gross hematuria the urine becomes red from the blood. While this can be seen without a microscope. Most often, hematuria appears against a background of full health, with that characteristic of renal cancer, hematuria often is not accompanied by pain (this is more typical of renal colic with urolithiasis). After his appearance hematuria may quickly disappear. In this case it may be repeated quite a different time – a few days, months, and sometimes a year or two. There is bleeding due to tumor growth, which destroys the fabric of the kidney, rich blood vessels. Of them, and poured out blood. Blood clots may roll in, which in turn can cause renal colic, similar to that which occurs when urolithiasis.
The tumor gradually increased in size, which leads to the appearance of a second symptom – the appearance of a certain tumors in the stomach. Kidneys with the tumor can be palpated through the abdomen.Often thin patients notice their own kidney in the early stages. More frequently, only the discovery of the kidney during the inspection of the abdomen not to say an early stage tumor.
If untreated, the tumor beyond the capsule of the kidney and germinates neighboring structures – the fatty tissue, blood vessels. As a result of compression of the nerve endings may receive pain. Only 10-15 percent of cases the pain appears in the early forms of kidney cancer. In most cases, the pain indicates a common tumor. The tumor grows its surrounding blood vessels and thus may be violated current venous blood from the trunk veins of the abdominal cavity – the inferior vena cava. In men, such a breach can lead to varicocele – expand the veins of the spermatic cord.
The pain may be the result of metastasis – the emergence of new foci of growth in other organs. Kidney cancer metastasizes to almost all organs and tissues. Most metastases are detected in the lungs, liver, bones.
Sometimes renal cell carcinoma can appear unusual symptoms. This tumor can produce hormones or biologically active substances. As a result, may develop a significant increase in the number of red blood cells, a significant increase in the level of calcium in the blood, high blood pressure, abnormal liver function, etc.
Diagnosis
Diagnosis is based, of course, the complaints of the patient, as well as on data from general clinical examination, and research methods (clinical blood analysis, clinical analysis of urine, etc.). Currently, the main methods of instrumental diagnosis of kidney cancer is an ultrasound of the abdominal cavity, urography (X-ray study of the kidneys with contrast agents), radionuclide scanning, and computed tomography and magnetic resonance imaging. The last two methods can accurately establish the incidence of tumors. Mandatory inspection of the patient with suspected renal cell carcinoma is a lung X-ray, and radiography of the pelvis and chest. If you suspect a metastatic lesion of bone necessary to carry out radionuclide bone scans, which allows you to specify the presence of metastases in the bones.
Treatment
Main method of treatment for kidney cancer is surgical. Operative intervention in almost all cases, whenever possible. During the operation, performed removal of the kidney, as well as adipose tissue, which surrounds it and ureter (radical nephrectomy). Currently designed and organ-preserving surgery in cancer of the kidney. They are held in the early stages of tumor in cases where the patient can not remove a kidney. Thus we are not talking about the prevalence of the process. It is about where the remaining kidney can not assume all responsibility for the allocation of metabolic products from the body. Such operations involve removal of only part of the kidney. As shown by research, long-term results of operations differ little from operations to remove kidney (nephrectomy). However, since the organ operations there is a higher risk of local recurrence.
Five-year survival rate of patients after radical nephrectomy in the first stage is 70-80 per cent. If the tumor affects the inferior vena cava, after the operation 5 or more years of living about 40-50 percent of patients (2 stage). With involvement of the renal vein (Stage 2) Five-year survival rate is 50-60 percent. If the process was involved fatty tissue surrounding the kidney (3 stage), the survival rate is 70-80 per cent. Any damage to regional lymph nodes (3-4 phase) 5-year survival rate ranges from 5 to 20 percent. In the presence of sprouting tumor to neighboring organs or the presence of distant metastases, 5 year survival rate is no more than 5 percent.
Currently, most scientists recognize the utility of the operation with single distant metastasis of kidney cancer. As the results of research, such operations improve the quality of life of the patient and prolong his life.
Popularity: unranked [?]
