Today we're talking about the C word, specifically kidney cancer. I'm Dr. Rena Malik,
urologist and pelvic surgeon, and if you're new here we talk about
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so today we're going to cover a lot of things about kidney cancer what exactly is it how common
is it what symptoms present with it how is it diagnosed and what are the treatment options so
starting off what exactly is kidney cancer kidney cancer is essentially abnormal growths or tumors
that occur in one or both of the kidneys everyone is typically born with two kidneys one on each
side in the back part of their abdomen and they function to remove the excess waste in your body
so your blood filters through the kidneys every day to clean out any waste that's accumulated in
your body so who gets it and how common is it well it's most common in people between the ages of 60
and 80 and more often seen in men in the united states we expect that about two percent of men and
one percent of women will get kidney cancer during their lifetime in fact in 2022 we expect about 79
000 cases of kidney cancer and 13 000 deaths due to kidney cancer well who gets kidney cancer
well we don't know exactly why it happens but we do know there are some people who are at
higher risk of getting kidney cancer than others those include people who smoke who have very high
blood pressure who are obese and who have certain exposures at work to things like cadmium asbestos
or gasoline we also know that people who develop lots and lots of cysts in their kidneys as adults
are higher risk for getting kidney cancer certain genetic conditions also which are
listed here can put you at higher risk of getting kidney cancers certain syndromes can also put
you at higher risk of getting benign tumors like angiomyolipomas which are a combination
of blood vessels muscles and fat while these in and of themselves in the small sizes are
not dangerous they can be dangerous if they increase in size or if you have multiple of them
and 80 of the time these occur sporadically whereas another 20 to 30 percent of the time these
are associated with a condition called tuberous sclerosis so how do you know if you have kidney
cancer so in the textbook they describe people who have kidney cancer to have three specific
symptoms blood in the urine pain in the flank or back and a mass a palpable mass in the backside
however that's only present about 10 of the time more often than not we're finding kidney cancers
incidentally what that means is that people are getting cat scans for other reasons they're going
to the emergency room with abdominal pain they're having constipation kidney stones whatever other
reasons they're getting cat scans for and we're finding kidney tumors however even though we're
finding them without the classic symptoms about a third of the time they're metastatic meaning that
they've already spread to other parts of the body so often when you've had metastatic disease you
may notice some symptoms pain that comes and goes having night sweats or unintentional weight loss
meaning you're losing weight but you're not really trying to and a fever that comes and goes so how
do we ultimately diagnose kidney cancer well we do a cat scan or an mri which is an imaging test
of the kidney we look at without contrast and with contrast to see how it uptakes that contrast if it
takes a lot of contrast up we have higher concerns for a cancerous lesion of the kidney also often
you'll get a chest x-ray because the most common place that kidney cancer spreads is to the lungs
as well as some blood work to see if there's other abnormalities that may be concerning and
to determine how well your kidneys are functioning at baseline so how do we treat kidney cancer well
if you're found to have a tumor in the kidney it depends on exactly how big that tumor is
and overall how healthy you are if you are very healthy have good kidney function and
the tumor size is greater than two or three centimeters very likely you'll then proceed
to have surgical removal of either part or the entire kidney depending on how big the tumor is
if however you're not very healthy and you have a lot of other comorbidities or you have other
medical conditions which might be causing you to have a mass in the kidney like some hematologic
conditions other cancers or inflammatory conditions then we'll proceed with what's called
a renal mass biopsy why don't we do a biopsy on everybody well about 10 to 15 of the time when
you do a biopsy of the kidney you won't actually get the answer you're looking for and there's a
very small but real risk of actually seeding the tract of the needle however this is very
uncommon so people who do need to get a kidney biopsy for other reasons should be rest assured
if you have a small kidney tumor less than two centimeters in size you can talk to your urologist
about potentially undergoing active surveillance and what that means is going undergoing periodic
imaging of the kidney to see if there are changes in size of the kidney mass rather than proceeding
directly to surgery if you've undergone surgery or been diagnosed with metastatic or advanced
kidney cancer then there are therapeutic options to help prevent the further spread or reduce the
spread of the kidney tumor lastly where does kidney cancer spread to as i mentioned earlier
kidney cancer most often spreads to the lung however it can also spread to the bone brain liver
and other lymph nodes of the people who do not present with metastatic disease which is again a
third of the people who present with kidney cancer so of the remaining 70 somewhere between 20 and
40 percent will go on to develop metastatic kidney cancer so it's really important that you follow up
for imaging even after surgery if you end up having surgery for a kidney cancer so i hope
this answers some of the most common questions about kidney cancer if you want to learn more
about kidney cancer i'm happy to reach out to some of my colleagues who are experts in treating
kidney cancer and can give you a more detailed answer to some of your questions please comment
below with your questions and as always remember to take care of yourself because you are worth it