Kidney carcinoma is a cancer of a malignant nature. According to statistics, pathology is in tenth place in terms of prevalence. Every year, more than 40 thousand cases are diagnosed in the world. Carcinoma can be localized in both one and both kidneys. Most often, it is diagnosed in men over 50 who live in the city.
Varieties
The neoplasm most often occurs in the surface layer of the kidneys, eventually growing deeper in them. A tumor consists of a mass of kidney cells. These particles begin abnormal division, not taking part in the production of urine and blood purification. There are several types of renal carcinomas:
1. Collective duct carcinoma. Tumor growth is rapid. The rarest form of kidney cancer.
2. Clear cell carcinoma. Formed from particles containing light cytoplasm. Diagnosed in 86% of cases.
3. Papillary. It is localized simultaneously in both kidneys, in the vast majority of cases it has a multiple character. It is rare, only in 14% of cases.
4. Chromophobic renal cell carcinoma. A characteristic feature of this carcinoma is its slow growth. It occurs in 4% of cases.
5. Oncocytic. Formed from large, eosinophilic particles. Metastases rarely occur. It is diagnosed in 5% of patients.
Stages of the development of pathology
Like other oncological diseases, renal carcinoma goes through several stages of development. Depending on the stage at which the pathology is diagnosed, the outcome of the therapy is determined. The following stages of renal carcinoma are distinguished:
1. The first stage. Neoplasm cells are located only in the tissues of the kidneys. The size of the tumor is not more than seven centimeters. There are no metastases. The initial stage of development of carcinoma is characterized by a high percentage of recovery. A prerequisite for this is timely and correct therapy.
2. The second stage of kidney carcinoma. The behavior of malignant cells does not differ at this stage from the first stage. Metastasis still does not occur, the formation cells do not leave the limits of the affected kidney tissue. The size of the tumor differs, which begins to exceed seven centimeters.
3. The third stage. The neoplasm does not extend beyond the boundaries of the renal membrane. This stage is divided into two subspecies depending on the further development of events. In the first, pathology affects the renal or vena cava, and in the second embodiment, metastasis to the lymph nodes of the sinus of the kidneys occurs.
4. The fourth stage. At the final stage of carcinoma development, pathogenic cells spread outside the organ.
Causes
Until today, doctors can not accurately determine the causes of kidney carcinoma. Most experts suggest that the development of pathology is due to a combination of many factors. So, among the possible causes of the appearance of carcinoma are:
1. Heredity. The risk of a carcinoma increases if someone from close relatives was ill with this pathology. This is due to a genetic disorder at the chromosome level. A papillary variety of kidney cancer is considered acquired at the genetic level.
2. Injury to the kidneys. This phenomenon can provoke active reproduction of malignant cells that form the basis of the tumor.
3. Taking some drugs. Prolonged use of certain drugs can provoke an accelerated growth of the neoplasm.
4. Prolonged dialysis can cause the formation of cysts, which over time can transform into a tumor.
5. Contact with organic solvents. It is scientifically proven that direct work with asbestos and cadmium can cause carcinoma.
6. Smoking. Nicotine adversely affects kidney tissue. Statistics make it clear that most patients with carcinoma are smokers.
7. Overweight. Kidney cell carcinoma is often diagnosed in overweight women.
Symptoms
For the most part, carcinoma is detected randomly when examining a patient for another reason. As a rule, pathology in the initial stages (before metastasis) proceeds in a latent form. The main, general and non-specific symptoms are highlighted.
The main signs of renal carcinoma include:
1. Hematuria, or the appearance of blood impurities in the urine. The amount of blood can be both significant and insignificant. In the latter case, the disease is detected by passing a urine test. Hematuria is not accompanied by unpleasant sensations and appears with different intervals. Bleeding develops against a background of destruction of the renal tissue by the tumor.
2. A neoplasm in the abdomen. It is detected by palpation with a significant increase in the neoplasm. In thin people, the pathology becomes discernible even at an early stage of carcinoma.
3. Soreness in the lumbar region. As a rule, this phenomenon indicates the spread of metastases to adjacent organs. When leaving the kidneys, the tumor may interfere with the flow of blood to the inferior vena cava. As a result, the veins of the spermatic cord expand.
Common symptoms
Common symptoms (that is, characteristic of any type of cancer) include:
1. Loss of appetite.
2. Weight loss.
3. An increase in temperature (to subfebrile).
4. Anemia.
5. Weakness.
6. Fever.
Nonspecific symptoms
Non-specific signs associated with the production of hormones and biologically active substances include:
1. Elevated calcium levels.
2. The rise in blood pressure.
3. Increased red blood cell count.
4. Dysfunction of the liver.
To detect kidney carcinoma at an early stage, you need to regularly pass urine and blood for examination, as well as undergo an ultrasound scan.
Diagnostics
Diagnosis of renal carcinoma in modern conditions does not seem difficult. Treatment is prescribed by oncologists only after a thorough examination. The main methods for detecting carcinoma are:
Ultrasound procedure. It makes it possible to determine the size of the kidneys, the affected area and the ongoing necrosis, hemorrhage and tumor contours. When conducting a biopsy, an ultrasound is also used to control the needle.
Magnetic resonance imaging. The location of the tumor is detected, even if the size of the neoplasm is not more than two centimeters. MRI determines the depth of tumor growth in the kidney, as well as its structure. In addition, this method shows the presence of metastasized cells and blood clots in the renal and vena cava.
X-ray examination. It is carried out using a contrast medium. The picture helps to visualize the tumor, reveals a change in the contours and shape of the kidney.
Angiography. It allows to differentiate carcinoma from a cyst, as well as an x-ray reveals metastases and blood clots.
Urography with contrast. Determines the function of the kidneys, reveals signs of cancer formation.
Biopsy. It is a fence of pathogenic tissues for the purpose of histological examination.
After a thorough examination, the type of tumor is determined - renal carcinoma in this case, its stage and the final diagnosis is made.
Treatment
There are a number of factors on which the method of treatment depends:
1. Type of neoplasm. Small tumors showing slow growth may require expectant management.
2. The condition of the patient. In some situations, with severe concomitant diseases, surgical intervention may be unacceptable.
3. Age of the patient.
4. Stage of development of carcinoma. At the last stage of the pathology, surgical removal of the tumor and metastasis is not performed.
The following methods are used to treat renal cell carcinoma of the kidney:
1. Surgical removal. This is the most effective way to fight the tumor. Removal can be performed both with the preservation of the organ, and completely eliminating the kidney. The operation is performed both laparoscopic and open method.
2. Chemotherapy. This method is ineffective in renal carcinoma. It is used when the possibility of treating kidney carcinoma by surgery is excluded.
3. Radiation therapy. Like chemotherapy, radiation in relation to renal carcinoma is ineffective. Most often, it is prescribed as an anesthetic when metastasis of bone structures and the brain has occurred.
4. Immunotherapy. It is carried out using interferon-alpha. It has the fewest possible side effects.
5. Hormone treatment. The success of therapy is only 5-10%. It is used mainly to reduce the intensity of tumor growth.
Prognosis for renal carcinoma
The prognosis for survival in renal carcinoma directly depends on the stage at which the pathology was detected. So, in the first stage, the probability of a full recovery is 81%, in the second - 74%, in the third - 53%, and in the fourth - only 8%.
In 53% of cases, subject to the treatment received, patients live 5 years, in 43% - 10 years. If untreated, metastases will cause necrosis and severe intoxication of the body. At the final stage, all organs and systems fail.