da Vinci Surgery
 

Kidney Cancer

If you are facing kidney cancer surgery, you may have many questions about the disease, such as:

  • What is the prognosis for kidney cancer?
  • What is the survival or cure rate for kidney cancer patients?
  • What are the early signs and symptoms of kidney cancer?
  • What causes kidney cancer?
  • How is kidney cancer treated?
  • What is thermal ablation or freezing of kidney cancer?

When you visit your doctor, you may want to write down any questions you have about kidney cancer. Fully understanding the disease and treatment options will help you to make the best decisions about your care.

Overview

Each year, kidney cancer is diagnosed in about 190,000 people worldwide.1 Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years.2 It is important to realize that with early diagnosis and treatment, kidney cancer can be cured. In fact, if found early, the survival rate ranges from 79 to 100 percent.3

A kidney tumor is an abnormal growth in the kidney. The terms "mass," "lesion" and "tumor" are often used interchangeably. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common kidney mass is a fluid-filled area called a cyst. Simple cysts are benign, do not turn into cancer and usually do not require follow-up care. Solid kidney tumors can be benign, but are cancerous more than 90 percent of the time.3

It is possible that kidney cancer can grow into the renal vein and vena cava. The renal vein is the kidney's primary draining vein and the vena cava is the vein that takes blood to the heart. The portion of the cancer that extends into these veins is called "tumor thrombus." Imaging studies, such as an MRI, can help to find out if tumor thrombus is present.

For a tumor to grow and spread, it must stimulate new blood vessels to provide the tumor with nutrients and oxygen. This process is known as angiogenesis. Kidney cancers are considered very angiogenic and are very efficient at travelling through the blood vessels in the body. They do this by secreting a protein called vascular endothelial growth factor (VEGF). VEGF acts on nearby blood vessels and stimulates them to sprout new vessels to supply the tumor.3

Kidney cancer can form in the small tubes inside the kidney. Those tubes are located in the center of the kidney where urine collects and used to filter blood. The most common kidney cancer is called renal cell carcinoma.

Symptoms

Unfortunately, kidney cancer does not have early symptoms but you should see your doctor if you notice the following:3

  • Blood in your urine
  • Lump in your abdomen
  • Unexplained weight loss
  • Pain in your side
  • Loss of appetite

If cancer spreads (metastasizes) beyond the kidney, symptoms depend on the organ involved. Shortness of breath or coughing up blood may occur when cancer is in the lung. Bone pain or fractures may occur when cancer is in the bone. When cancer is in the brain, you may have neurologic symptoms.

In some cases, kidney cancer causes related conditions called paraneoplastic syndromes. These syndromes occur in about 20 percent of kidney cancer patients and can occur in any stage, including cancers confined to the kidney. Symptoms from paraneoplastic syndromes include weight loss, loss of appetite, fever, sweats and high blood pressure. In many cases, the paraneoplastic syndrome improves or disappears after the cancer is removed.

Causes & Risk Factors

Researchers have found several risk factors that make you more likely to develop kidney cancer. The following may increase your risk of developing kidney cancer:3

  • Smoking
  • Hypertension
  • Obesity
  • Family history of kidney cancer
  • Chronic kidney failure and/or dialysis
  • Diet with high caloric intake or fried/sautéed meat
  • Von Hippel Lindau disease (rare genetic disorder that causes tumor growths)
  • Tuberous sclerosis (common genetic condition that produces growths in the body from birth throughout adulthood)

Screening and Testing for Kidney Cancer

Unfortunately, there are no blood or urine tests that detect kidney cancer. When kidney cancer is suspected, your doctor will order a kidney imaging study. The initial imaging study is usually an ultrasound or CT scan. In some cases, a combination of imaging studies may be needed to completely evaluate the tumor.3

If cancer is suspected, you should be evaluated to see if it has spread beyond the kidney (metastasized). An evaluation consists of imaging studies such as an ultrasound or CT scan. These tests may be followed by an MRI, X-rays and blood tests. You may also need a bone scan if you have had bone pain, recent fractures, or abnormal blood tests. Additional tests may be ordered if your doctor feels they are needed to completely evaluate the tumor.

Treatment

The primary treatment option for kidney cancer is surgery to remove all or part of the kidney and the tumor; studies have found that kidney cancer does not respond well to radiation and chemotherapy treatments.4

Surgery to remove your entire kidney is known as nephrectomy. Surgery to remove only part of your kidney that contains the cancerous tumor is called a partial nephrectomy.

PN 1002149 Rev A 04/2013
  1. World Health Organization; Global cancer rates could increase by 50% to 15 million by 2020; URL: http://www.who.int/mediacentre/news/releases/2003/pr27/en/
  2. "Cancer Facts & Figures 2008", American Cancer Society, www.cancer.org , URL: http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf
  3. 'Kidney Cancer', American Urological Association Foundation, www.urologyhealth.org , URL: http://www.urologyhealth.org/adult/index.cfm?cat=04&topic=124
  4. American Urological Association; Guideline for Management of the Clinical Stage I Renal Mass; 2009; URL: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/renalmass09.pdf

All surgery presents risk, including da Vinci® Surgery and other minimally invasive procedures.  Serious complications may occur in any surgery, up to and including death. Examples of serious or life-threatening complications which may require hospitalization include injury to tissues or organs, bleeding, infection or internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Risks of surgery also include potential for equipment failure and human error. Risks specific to minimally invasive surgery may include: A long operation and time under anesthesia, conversion to another technique or the need for additional or larger incisions.  If your surgeon needs to convert the procedure, it could mean a long operative time with additional time under anesthesia and increased complications. Temporary pain or discomfort may result from pneumoperitoneum, the presence of air or gas in the abdominal cavity used by surgeons in minimally invasive surgery. Research suggests that there could be an increased risk of incision-site hernia with single-incision surgery. Results, including cosmetic results, may vary.  Patients who bleed easily, who have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci® Surgery. For more complete information on surgical risks, safety, and indications for use, please refer to http://www.davincisurgery.com/safety/. Patients should talk to their doctors about their surgical experience and to decide if da Vinci Surgery is right for them. Other options may be available. Intuitive Surgical reviews clinical literature from the highest level of evidence available to provide benefit and risk information about use of the da Vinci Surgical System in specific representative procedures. We encourage patients and physicians to review all available information on surgical options and treatment in order to make an informed decision. Clinical studies are available through the National Library of Medicine at www.ncbi.nlm.nih.gov/pubmed.

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