Kidney Cancer

The following provides information on kidney cancer, one of the 15 health conditions covered by the VA for Camp Lejeune victims.  Information is compiled from various sources, including the Kidney Cancer Association, Mayo Clinic, American Cancer Society, NIH, and others.

Overview From the KCA:

Sometimes kidney cancer is called by its medical name, renal cell carcinoma. Renal is from the Latin word renalis for kidneys. Kidney cancer includes various forms, including clear cell, papillary, sarcomatoid, transitional cell, and others. These will be explained in more detail later.

Some patients are diagnosed before the cancer has metastasized (spread) to other parts of the body, while others have metastatic disease when their cancer is initially diagnosed. Surgery may be the first course of treatment, or systemic treatment — that is, a treatment that is injected into the bloodstream or swallowed — may be recommended prior to surgery (though this tends to be rare). If surgery is done first, additional treatment may be recommended to delay the cancer’s return, or to treat metastatic disease.

The choice of treatment, where treatment is administered, the frequency of check-ups, and many other aspects of the management of your disease are determined with input from you. The more you know, the better your decisions, and the more you can feel in control of your illness. Knowledge about your disease will help you better communicate with your doctor and nurse, and increase your confidence in the treatment that you receive. Getting smarter about kidney cancer is an important step in effectively fighting your disease.

Symptoms:

• Blood in your urine, which may appear pink, red or cola colored
• Back pain just below the ribs that doesn’t go away
• Weight loss
• Fatigue
• Intermittent fever

Causes:

It’s not clear what causes renal cell carcinoma. Doctors know that kidney cancer begins when some kidney cells acquire mutations in their DNA. The mutations tell the cells to grow and divide rapidly. The accumulating abnormal cells form a tumor that can extend beyond the kidney. Some cells can break off and spread (metastasize) to distant parts of the body.

Risk Factors:

• Older age.
• Smoking. Smokers have a greater risk of kidney cancer than nonsmokers do. The risk decreases after you quit.
• Obesity. People who are obese have a higher risk of kidney cancer than do people who are considered average weight.
• High blood pressure (hypertension). High blood pressure increases your risk of kidney cancer.
• Treatment for kidney failure. People who receive long-term dialysis to treat chronic kidney failure have a greater risk of developing kidney cancer.
• Certain inherited syndromes. People who are born with certain inherited syndromes may have an increased risk of kidney cancer, including those who have von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis and familial papillary renal cell carcinoma.

Diagnosis:

• Blood and urine tests. Tests of your blood and your urine may give your doctor clues about what’s causing your signs and symptoms.
• Imaging tests. Imaging tests allow your doctor to visualize a kidney tumor or abnormality. Imaging tests might include ultrasound, computerized tomography (CT) scan or magnetic resonance imaging (MRI).
• Removing a sample of kidney tissue (biopsy). In rare cases, your doctor may recommend a procedure to remove a small sample of cells (biopsy) from a suspicious area of your kidney. The sample is tested in a lab to look for signs of cancer.

Stages:

• Stage I. At this stage, the tumor can be up to 2 3/4 inches (7 centimeters) in diameter. The tumor is confined to the kidney.
• Stage II. A stage II kidney cancer is larger than a stage I tumor, but it’s still confined to the kidney.
• Stage III. At this stage, the tumor extends beyond the kidney to the surrounding tissue and may also have spread to a nearby lymph node.
• Stage IV. Cancer spreads outside the kidney, to multiple lymph nodes or to distant parts of the body, such as the bones, liver or lungs.

Treatment:

• Surgery
• Ablation and other local therapies
• Active surveillance
• Radiation therapy
• Targeted therapy
• Immunotherapy (biologic therapy)
• Chemotherapy

After treatment for kidney cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. As part of this follow-up care, patients should receive regular blood tests to check kidney function, chest x-rays, CT scans of the abdomen and chest, and other imaging tests to watch for recurrence or metastasis. Patients should have a checkup every three months for the first year, every four months for the second to fifth year, and once a year after that.

Because people treated for kidney cancer often have a single kidney, they will need to be monitored for possible declining kidney function for the rest of their lives. There are few long-term side effects, although some patients may have chronic pain from the surgical scar. Also, people treated for kidney cancer have a slightly higher risk of developing colon cancer and prostate cancer.