Kidney
Cancer
By: Zoe Chinn
Kidney Cancer is when a kidney cell creates a “bad cell” or a cell that is not like the others. then that cell reproduces more “bad cells” and that creates a tumor eventually. The kidney controls your blood pressure by making a hormone called Renin. It also makes sure your body has enough Red Blood Cells. The kidney does this by making another hormone called Erythropoietin. Erythropoietin tells the bone marrow to make more red blood cells to spread out the oxygen throughout the body. A fun fact about the Kidney is that a human body only needs one Kidney to function. Amazingly so, some people have no Kidneys, but have to rely on a medical procedure called Dialysis. Dialysis uses a machine that filters your blood the same way a Kidney would. The average age people are when they get diagnosed is 64, and it is uncommon if someone gets diagnosed before the age of 45. The risk at getting Kidney Cancer is higher in men than women, but the chances of getting it are 1 in 63 for someone's lifetime. Kidney Cancer is one of the top 10 most common cancers in both men and women.
One of the causes for Kidney Cancer is a change in a person's DNA/genes. This is when a “bad cell” is created (paragraph 1). Also some conditions/diseases increase the risk or crate Kidney Cancer. These diseases/conditions are Von Hippel-Lindau disease, Hereditary Papillary Renal Cell Carcinoma (HPRCC), Hereditary Leiomyoma Renal Cell Carcinoma, Birt-Hogg-Dube (BHD) syndrome, Familial Renal Cancer, and Hereditary Renal Oncocytoma. Other risk factors include Smoking, Obesity, hypertension, workplace exposures (organic solvents, cadmium, some herbicides, and particularly trichloroethylene.
Kidney Cancer has four stages. They use T, N, and M to decide what stage the cancer is. T represents tumor size, N represents spreading to Lymph Nodes (part of the immune system), and M represents spread to distant organs. In stage one cancer the tumor is seven centimeters across or smaller and is located only in the Kidney (T1), the tumor has not spread to Lymph Nodes (N0), and there is no spread to distant organs (M0). Stage two Kidney Cancer is when the tumor is larger than seven centimeters across but is still only located in the Kidney (T2), there is still no spread to Lymph Nodes (N0), and there has been no spread to distant organs (M0). In stage three cancer the tumor has spread into a major vein or into tissue surrounding the Kidney, but has not spread into the Adrenal Gland (on top of the Kidney) or beyond the Gerota´s Fascia (it is located around the Kidney) (T3), there is still no spread to Lymph Nodes (N0), and no spread to distant organs. (M0). Or stage three cancer could be that the main tumor is any size and may be outside the kidney, but it has spread beyond the Gerota´s Fascia (T1-T3), the cancer has already spread to nearby Lymph Nodes (N1), but it has not spread to distant Lymph Nodes or other organs (M0). Stage four Kidney cancer can either be that the tumor had grown beyond the Gerota´s Fascia and may be even into the Adrenal Gland (T4), it may or may not have spread to Lymph Nodes (any N), and it has not spread to distant Lymph Nodes or other organs (M0). The other case would be that the main tumor could be any size and may have grown outside the Kidney (any T). It may or may not have spread to nearby Lymph Nodes (any N), and it has spread to distant organs and/or Lymph Nodes (M1).
There are a few types of Kidney Cancers out there, the most common type is Renal Cell Carcinoma (RCC). Nine out of ten (9 out of 10) cases of kidney cancer are RCCs . RCCs can be from an inherited genetic syndrome. There is even different types of RCC’s. Some of them are Clear Cell Renal Cell Carcinoma (CCRCC), seven out of ten (7 out of 10) people with RCC have CCRCC. When seen under a microscope the cancer cells are clear. Papillary Renal Cell Carcinoma (PRCC) is the 2nd most common type of RCC, one out of ten (1 out of 10) cases of RCC are PRCC. When PRCC is looked at with a microscope they are pink, and look like little fingers. Another type is Chromophobe Renal Cell Carcinoma (CRCC) is found in 5% (five out of one hundred) cases. This kind of Kidney Cancer looks like CCRCC, clear or a pale color, but this cell is much larger than the CCRCC cells. The kinds of Kidney Cancers that make up the last 1% is Collecting Duct Renal Cell Carcinoma, Multilocular Cystic Renal Cell Carcinoma, Mucinous Tubular and Spindle Cell Carcinoma, and Neuroblastoma-associated Renal Cell Carcinoma. Very, very, very rarely there will be a case where they would call the cancer Unclassified Renal Cell Carcinoma. The Doctors will do this if they can't match the shape, size, and color of the cells to an already known type. RCC isn't the only kind of Kidney Cancer, there is also Transitional Cell Carcinoma (TCC). Out of 100 Kidney Cancers 5-10% of them are TCCs. What's unique about TCCs is that the cancer does not start in the Kidney it starts in the lining of the Renal Pelvis. The Renal Pelvis is where the urine goes before entering the Ureter, and the Ureter is a tube that carries the urine to the bladder from the Kidney. Unfortunately TCCs have the same symptoms of RCCs, so that makes it harder to find it. Luckily nine out of ten (9 out of 10) TCCs are cured if found at an early stage. The bad thing about TCCs is that it can come back in the bladder or in other locations. There are two other types of Kidney cancer Wilms Tumor (Nephroblastoma) and Renal Sarcoma. Wilms Tumor is almost always in children and is extremely rare among adults. Renal Sarcoma is also extremely rare; it makes up less than 1% of all Kidney Cancers. What makes this tumor so rare is that when it forms it starts in the blood vessels or connective tissue. There are so many different kinds of Kidney Cancer, and if the doctors can determine what kind you have they will have an easier time deciding how to treat it.
There are many different ways to treat or manage Kidney Cancer. One of the most commonly used way is surgery. If you have cancer in one Kidney the surgeons will likely remove the whole Kidney. Usually if the cancer is more severe the doctors might say to the patient that they need to have other treatments. Some of those treatments are Ablation Therapy (uses a needle that creates radio waves with electric currents that heat the tumor), and other local therapies such as Arterial Embolization and Cryotherapy. Arterial Embolization is when the surgeons block the artery that feeds the tumor with blood, and Cryotherapy is when the doctors use a needle that pushes extreme cold into the tumor and destroys it. There are also targeted therapies that focus on just Kidney Cancer, the therapy shrinks the tumor and slows the growth down. Unfortunately it does not cure the cancer, but it has less side effects than Chemotherapy. Immunotherapy (biological therapy) has many different types of it, IL-2 is the most commonly used, although Immunotherapy is used only in the most extreme cases. Some of the side effects to IL-2 include extreme fatigue, low blood pressure, fluid building up in the Lungs, trouble breathing, heart attacks, Kidney damage, Intestinal bleeding, diarrhea and/or abdominal pain, a high fever and chills, rapid heart rate, and possibly mental changes. Using Immunotherapy has great risks with it. Chemotherapy (also known as Chemo) is used after targeted therapy and Immunotherapy. Not only Immunotherapy has bad side effects Chemo has bad ones too. Some of those include hair loss, mouth sores, loss of an appetite, nausea and vomiting, diarrhea or constipation, a higher risk of infections (due to low white blood cell counts), easy bruising or bleeding (due to low blood platelet counts), and fatigue (due to low red blood cell counts). Radiation can also be used, but again only in the most extreme cases because it doesn't work as well as the others. Some side effects are nausea and vomiting, diarrhea, fatigue, and skin problems (dryness, itching, blistering, and peeling). Even though these treatments have some really bad side effects they can treat/cure Kidney Cancer.
The bad thing about Kidney Cancer is that the symptoms can only be detected when the cancer is far along (at a late stage). The possible symptoms are blood in urine (not always Kidney Cancer), lower back pain on one side (not caused by an injury), a mass or lump on the side or lower back, fatigue, loss of appetite, weight loss (not from dieting), anemia (low red blood cell counts), and a fever not caused by an infection and won't go away. Early Kidney Cancers do not have any symptoms so it's likely a person will find the cancer when it is very large and/or has spread to other organs. It is also hard to find because the Kidney is deep into the body and can't be seen or felt during a regular physical.
There are definitely some long term and short term effects. Luckily for some people the treatment they get can cure or get rid of the cancer/tumor, but not everyone can. If you were one of those people who couldn't fully get rid of the cancer, you would have to get treatments on a regular basis using targeted therapies. For the people that did get rid of it all, they would have to have check ups every once and awhile to see how they feel, and if anything jurassic has changed. Since the patients have had surgery and unnatural chemicals in their body there will likely be some aftereffects. A person could have Emotional aftereffects, physical effects, or both. Emotional effects are usually distress, fear, anxiety, and maybe depression. These effects are probably not from any of the medicines the patients are taking, they are probably from the experience of having so many treatments, and so many surgeries. There are also likely going to be some physical effects on the patient. Some of these aftereffects are fatigue, nausea and vomiting, pain, Anemia (low red blood cell counts), Lymphedema (Lymph fluid building up in the fatty tissue under the skin), infections, unable to reproduce (make a child, can be in men or women), Ostomies (a surgical opening in the flesh so waste can exit the body), and Incontinence (loss of urine control or having leaking or dribbling, usually in men). A very important thing to remember if you have Kidney Cancer is that it’s extremely important to keep well nourished. Going through cancer can be a very hard thing to do and I congratulate all that have worked though it.
What gave me an inspiration to focus on Kidney Cancer was my grandma. Before I was born my grandmother had tingling in her fingers so she decided it would be best for a doctor to see what was going on. The doctor concluded that it might be cancer and thought that they should check her back. The test results showed that there was a mass on her spine that looked cancerous. The doctors decided it would be best to check and see if the cancer on her spine had spread to another location. During the exploration they found that the cancer had spread to her Kidney. When the doctors looked closer at her case they found out that the cancer on her back wasn't really cancer it was arthritis. They found her Kidney Cancer completely on accident. Thankfully the doctors caught the cancer at stage one. They found out it was Renal Cell Carcinoma (RCC) and decided to do surgery to remove the whole Kidney. The doctors used a new technique (back then) cutting only a few incisions in her abdomen just enough to resect the Kidney. She was only in the hospital for five days afterward. Now she cant take any Ibuprofen® or Alive® because those medicines get processed through the Kidney. She can take Tylenol® though because it is processed through the Intestine.
My grandmother is a cancer survivor along with lots of other people in this world. I really hope a brilliant scientist or doctor finds the cure for cancer because it would save so many lives, even though there are already a lot of treatments, not all of them work. If one of your family members or yourself got this, would you like a cure?
Bibliography
http://www.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-new-research
http://www.cancer.net/navigating-cancer-care/how-cancer-treated/radiation-therapy/side-effects-radiation-therapy
http://www.cancer.net/cancer-types/hereditary-papillary-renal-cell-carcinoma
http://www.healthline.com/human-body-maps/ureter
http://www.cancer.org/
http://www.cancer.org/cancer/cancerbasics/lymph-nodes-and-cancer
http://www.cancercenter.com/spinal-cancer/radiation-therapy/