Renal Cell Cancer

Overview

Renal cell carcinoma (cancer), RCC, is the primary cancer of the kidney, which develops from the epithelium of the proximal convoluted tubule (PCT), which functions in urine transport. It spreads to other tissues and organs in stages (stages I -IV). 

It is more likely that 85% of renal cancer cases are renal cell carcinomas. It’s widespread among adults, especially in men above 50-70 years. Therefore, it is generally rare. 

Common symptoms are fever, high blood pressure, weight loss, pain in the flank etc. Typical therapy is surgery (either partial or complete). Surgical treatment is best applicable when it has not metastasised to other organs and the chances of survival are strong.

The specific cause of RCC is not known. On the other hand, there are risk factors associated with the ailments. Examples are old age, renal stones, polycystic kidney disease, sickle cell anaemia, fatness, chronic renal failure, tuberous sclerosis etc. Some of the risk factors are hereditary diseases. 

In addition, it’s a scientific fact that exposure to certain chemical elements and compounds is a risk factor for RCC, e.g. certain herbicides, cadmium and trichloroethylene.

Key Facts

• Renal cell cancer begins in the proximal convoluted tube in the renal cortex.
• With time, it begins spreading to other tissues and organs, starting from the blood vessels.
• Hereditary diseases, chemicals, and drug abuse can trigger its onset.
• Symptoms are fever, distress, sleep disorders, hypertension etc.
• Symptoms may be silent and only be stumbled upon during diagnosis for other suspected conditions.
• The primary treatment is nephrectomy. However, other treatment plans may be considered, given the stage of its manifestation and the specific purpose of those treatments.

Symptoms

Symptoms of renal cell cancer are often noticed by three cardinal signs, namely, haematuria, pain between the rib cage and hip bone, and abdominal swelling. Sadly, it’s widespread that renal cell carcinoma arises without symptoms-silent manifestation. Therefore, patients with RCC often discover this malady upon medical examination of another illness. For some persons, the carcinoma had already spread across other tissues and organs at this point.

General symptoms are:

• Blood in the urine (haematuria)
• Pain in the lower abdominal region
• Feeling sick
• Weight loss
• High blood pressure 
• Anaemia-as the result of declining erythropoietin.
• Absence of appetite
• Increased production of red blood cells
• Testis venous drainage enlarges (pampiniform plexus)
• Distress and sleep disturbance
• Fever

Diagnosis

As a standard medical practice, the doctor will first record the patient’s medical history and perform a physical examination to detect apparent symptoms. A couple of diagnoses and lab tests can be carried out to underpin the investigation thus:

• Renal Function Test

For RCC, renal functions can be confirmed by blood analysis. The blood count is taken for different blood cells. Electrolyte function in the bloodstream is studied. Creatinine clearance is performed. All of these are used to detect abnormal conditions like anaemia.

• Urinalysis

A urine sample is collected for lab observation. This diagnosis can trace any speck of blood in the urine (haematuria) 

• Imaging Diagnosis

Imaging methods (MRI, Ultrasound, CT scan) can be used to obtain clear images of the organs to trace tumour cells. For a CT scan, a complementary dye is used. The impaired kidney can’t take this dye; hence this is a notable sign.

• Kidney Biopsy 

Via biopsy, a small sample of kidney cells can be extracted with a needle. This tissue sample is studied to detect tumour cells.

Causes

The precise cause of renal cell carcinoma is medically unknown. But several factors may give rise to it. These risk factors include certain unhealthy habits, diseases and carelessness. They include:

• Smoking and drug abuse lifestyle. The longer people live with this habit, the greater the risk of renal carcinomas. Drug substances may have genetic alteration potentials.
• Continuous dialysis therapy may elope to RCC.
• Obese individuals are at greater risk of developing RCC.
• People from families with a medical history of RCC are prone to develop the condition.
• People with histories of hereditary diseases like polycystic kidney disease, renal stone, anaemia, Von Hippel-Lindau disease (VHL) etc., are at risk of developing RCC.
• An individual who might have gone through therapies in the past that employ radiation is at risk of developing RCC.

From the angle of biogenetics, Renal cell cancer manifests from the genetic alteration of oncogenes and tumour suppressor cells. These alterations are the results of gene cloning and are commonly diagnosed in patients with a history of RCC-associated risk factors (hereditary diseases), as listed earlier.

Signs like hypertension occur because the tumour cells continually secret renin.

Prevention

Although the precise cause of renal cell carcinoma is locked in the dark and shadows, preventive measures, which include certain lifestyles, can be adopted and dutifully practised.

• Abolish the habit of smoking and drug abuse intake.
• Diabetes management
• Watch for high blood pressure 
• Reduce obesity

Typical Treatment

When RCC is confirmed upon diagnosis, the doctor will approve one of the below-explained treatment routines/measures. 

Each treatment plan has its practical purpose and efficiency. This will depend on the nature of cancer, i.e. the size of the area affected if it has begun spreading. Therefore, the following are examples of treatments for renal cell cancer. 

• Surgical Treatment – Nephrectomy

Most kidney cancer cases usually end in surgery as the best option. A nephrectomy is carefully carried out based on the nature of cancer. Although surgery is for both affected areas and metastasised cases, other therapeutic measures can be approved to underpin the effect of surgery.

1. Partial Surgery – partial nephrectomy

For partial surgery, the surgical team only aims to remove the tumour. Some kidney tissues may fall along. This could be preferable to a complete nephrectomy. 

2. Complete Surgery (nephrectomy) 

This involves the complete removal of the affected area, including related tissues. The entire kidney and other structures can be lost by this method. On the other hand, everyday living after this procedure may demand dialysis. Also, negligence may lead to further complications.

• Immunotherapy

This is earnest to be considered at the early stage of RCC. For this technique, the immune system is made to recognise and fight cancer cells. Tumours usually have a secret substance that makes them unrecognisable by the immune system

• Radiotherapy

Radiation technologies like X-rays are high-power energy sources employed for treating cancer. The rays are professionally directed to exterminate tumour cells, reducing their symptoms. 

It’s very effective for metastasised tumours.

• Ablation Techniques 

Ablation techniques include cryoablation-freezing and radio-frequency ablation. It is quite suitable for small size cancer-early stage. For cryoablation, specific cold gas, with the assistance of imaging techniques, is directly administered to the tumour to dissolve it. For radiofrequency ablation, electric current is instead utilised.

• Specific Medication 

Certain medicines can be specifically administered to target some spreading cancer cells. By this means, the drug kills the tumour cells as directly administered.

Conclusion

It’s clear at this point that renal cell cancer is common in old age, and its primary cause is unknown. Although rare, certain risk factors may trigger its onset. Therefore, a regular medical check-up is recommended when some symptoms surface. It might be easier to spot it earlier, and surgery may offer a reasonable survival rate, i.e. before RCC metastasis.