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KINDEY CANCER
Kidney cancer is a disease in which the cells in certain tissues of the kidney start to grow uncontrollably and form
tumors. Renal cell carcinoma, which occurs in the cells lining the kidneys (epithelial cells), is the most common type
of kidney cancer. Eighty-five percent of all kidney tumors are renal cell carcinomas. In terms of all cancers, renal
cell carcinoma is relatively rare, representing about 3% of all adult cancers. It is usually treated initially with
surgery to remove the tumor. If caught in early stages, the chance that it will return is low. Unfortunately, it has
few symptoms in its early stages so it is usually undiagnosed or misdiagnosed and not detected until the tumor has grown
fairly large. At that point, it displaces other nearby organs, causing symptoms. Many kidney (renal) tumors are found
incidentally on x-rays or ultrasound examinations performed for reasons that don't relate to the tumor or any of its
potential symptoms.
Thirty percent of kidney cancer patients show signs of advanced renal cell carcinoma when diagnosed. Fifteen to 25 percent
of patients have metastatic disease at the time of their diagnosis, meaning their cancer has spread to other areas of the body.
The most common symptom of kidney cancer is painless urination of blood, a condition known as hematuria. This symptom occurs in
40% to 50% of patients. Often, blood in the urine will occur one day and not the next. (Note that blood in the urine can indicate
other diseases besides kidney cancer, such as kidney stones. When blood in the urine does occur, a doctor should evaluate this
symptom immediately.)
Other common symptoms of kidney cancer include the presence of an abdominal mass, a hard lump or a thickening or bulging under the
skin that can be seen or felt as the tumor grows. There also may be back or flank pain or pressure. Kidney cancer occurs most often
in men between the age of 40 and 60. Since back pain is common among people over 40 years of age, such pain is often ignored and the
presence of kidney cancer can go undetected.1
Depending on the tumor size, location and stage, the surgical oncologist may choose to remove the entire kidney (radical nephrectomy) or
just the portion affected by cancer (partial nephrectomy).
For advanced or metastatic kidney cancer, surgery can play a role along with other treatments. The prognosis is poor for metastatic disease,
but MD Anderson is studying radical nephrectomy combined with interferon therapy to improve outcomes for these patients.
Renal cell carcinoma (RCC) is very responsive to immunotherapy, which has become the standard of care for metastatic disease( RCC that has spread
to other parts of the body). Two types of immunotherapy are used to treat metastatic RCC:
Interferon-alpha is a protein produced by white blood cells in response to a viral infection. It increases antigens on the surface of cancer cells,
making them more susceptible to attack by the immune system. Interferon is an outpatient treatment administered via injection, which patients can
do themselves. Side effects of interferon therapy include flu-like symptoms (fever, muscle aches, headache and nasal congestion), depression, fatigue
an
d nausea.
Interleukin-2 (IL-2) is a protein that stimulates the growth of immune cells and activates them to destroy tumor cells. High-dose IL-2 therapy is
administered intravenously, and treatment requires a five-day hospital stay. Side effects include hypotension (low blood pressure), flu-like symptoms
(fever, muscle aches, headache and nasal congestion), decreased urine production, nausea and diarrhea.
Both of these therapies have only a general, non-targeted effect on the immune system, and their intense side effects are not well-tolerated by many patients.
Both therapies have about a 15% response rate, but those who do respond do so quite dramatically.2
1 Kidney Cancer Association
2 MD Anderson Cancer Center
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