Kidney cancer

Introduction

iTAcC’s team of specialists always proposes the possibility of performing minimally invasive surgery based on techniques of laparoscopic surgery

The kidneys are two organs located symmetrically in the posterior part of the abdomen.  Their purpose is multiple; filtering blood, removing impurities, help control blood pressure and regulate the production of red blood cells. The cause of kidney cancer is unknown; however.  It is true that tumors originate as a consequence of alterations in the DNA of cells of the kidney leading to their uncontrolled growth.

The risk of developing kidney cancer is from 60 years of age and is more frequent in males. Some relation has been found with the consumption of tobacco, exposure to asbestos or cadmium as well as obesity.

Diagnosis

The diagnosis of kidney cancer is often a chance discovery prior to the onset of symptoms.

The diagnostic tools to determine the possible presence of kidney cancer and spread are:

  • Ecografía abdominal: es una técnica no invasiva que se utiliza como primer escalón ante la sospecha de una lesión renal.
  • CT (Computed Tomography):  is useful for tumor lesions, their spread and to guide punctures with those lesions from which biopsies can be taken.
  • MRI (magnetic resonance imaging):  is another technique that provides the specialist with abundant information on the nature and spread of renal tumors.
  • PET-CT (Positron Emission Tomography):  is it more useful for discovering the presence distant metastases because when a radiopharmaceutical is used, it is excreted by the kidneys and this can lead to misinterpretation.
  • Fine-needle aspiration biopsy is a minimally invasive technique used for taking a tissue sample.  It can, in selected cases, by a pathologic examination (under the microscope) confirm the presence or absence of a kidney carcinoma before subjecting the patient to surgery. This technique is only used in selected cases as it is often preferable to evaluate the patient surgically.

Treatment

Choosing the best treatment option depends primarily on the tumor type, its location, spread, the patient’s clinical condition and desires.

The treatment approach should be defined by a multidisciplinary committee evaluating each case on an individual basis. At iTAcC this committee is formed by an urologist, a radiation oncologist, a medical oncologist, nephrologist, radiologist, and pathologist.  When necessary, other specialists such as a surgeon of the digestive system, a vascular surgeon and a nuclear medicine specialist may participate in the treatment decision process.  The committee is also is open to the opinions of the physicians trusted by the patient. The purpose of this group of professionals is to offer treatment to each patient in a personalized way, with greater curative options and better functional results.

Surgery and drug therapy are the treatment backbones of renal tumors.

Surgery

The treatment of choice for kidney cancer is surgery. Urologists at iTAcC are experts in all forms of renal cancer surgery with particular reference to the minimally invasive laparoscopic surgery.

Surgical options for kidney cancer are:

  • Partial nephrectomy: When the diagnosis is made at an early stage of the disease and the tumor is localized organ-sparing surgery is proposed in order to maintain its function.
  • Radical nephrectomy: If the tumor is in an advanced stage but within the kidney it may be necessary to perform a complete removal of it along with the adrenal gland and nearby lymph nodes.
  • Whenever possible, the team of specialists at iTAcC always proposes performing minimally invasive surgery based on techniques of laparoscopic surgery.

Medical Treatment

In recent years biological drugs have been developed.  They are capable of inhibiting the molecular receptors responsible for the neoplastic proliferation.  This therapeutic advance has significantly improved the prognosis of this disease. These drugs have the ability to act selectively on tumor cells while at the same time preserving healthy ones, thereby reducing toxicity for the patient. Moreover, many of them have the advantage of being orally administered.

Treatment of metastatic renal cell carcinoma:

Follow up

The multidisciplinary team establishes a customized control plan after treatment according to the needs of each patient and the biology of the disease in order to rule out or for early detection of any recurrence.

Follow up is done as in the case of all oncological activity at iTAcC, in a personalized manner in cooperation of the doctors who have been involved in the diagnosis and treatment of each case. iTAcC is an open institution and works closely them.