Kidney cancer treatment in Iran

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Kidney cancer treatment in Iran

kidney cancer treatment in iran

Kidney cancer treatment in Iran

This is cancer that starts in the kidney. The most common type of kidney cancer is called Renal Cell Carcinoma (RCC). About 90 percent of all kidney cancers are renal cell carcinomas. The other 10 percent are made up of transitional cell carcinomas, Wilms tumours (found in children), and other rare tumours.

There are about 190,000 new cases of kidney cancer each year around the world, which means it accounts for about one in fifty cancers. In the UK and USA, it is about the tenth most common type of cancer. Estimated new cases and deaths from kidney (renal cell and renal pelvis) cancer in the United States in 2012: New cases: 64,770, Deaths: 13,570. Reports say even in India the incidence is increasing.

What is kidney cancer?

Kidney cancer, also known as renal cancer, is a type of cancer that starts in the cells in the kidney.

The two most common types of kidney cancer are renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) (also known as urothelial cell carcinoma) of the renal pelvis. These names reflect the type of cell from which the cancer developed.

The different types of kidney cancer (such as RCC and TCC) develop in different ways, meaning that the diseases have different long term outcomes, and need to be staged and treated in different ways. RCC is responsible for approximately 80% of primary renal cancers, and TCC accounts for the majority of the remainder.

Overall five year survival rate in the United States is 73%. For cancers that are confined to the kidney, the five year survival rate is 92%, if it has spread to the surrounding lymph nodes it is 65%, and if it has metastasized, it is 12%.

Clear cell renal cell carcinoma high mag cropped.jpg

Signs and symptoms

The most common signs and symptoms of kidney cancer are a mass in the abdomen and/or blood in the urine (or hematuria). Other symptoms may include tiredness, loss of appetite, weight loss, a high temperature and heavy sweating, and persistent pain in the abdomen,] especially in the early stages of the disease.

Causes

Factors that increase the risk of kidney cancer include smoking, which can double the risk of the disease; obesity; faulty genes; a family history of kidney cancer; having kidney disease that needs dialysis; being infected with hepatitis C; and previous treatment for testicular cancer or cervical cancer.

There are also other possible risk factors such as kidney stones and high blood pressure, which are being investigated. Some studies have linked regular use of NSAIDs such as ibuprofen and naproxen to increases of kidney cancer risk by up to 51%, but other research shows no such connection at least with regards to renal cell cancers.

Pathophysiology

Kidney cancer originates in the kidney in two principal locations: the renal tubule and the renal pelvis. Most cancers in the renal tubule are renal cell carcinoma and clear cell adenocarcinoma. Most cancers in the renal pelvis are transitional cell carcinoma.

Diagnosis

Types

 

Micrograph of a kidney cancer (chromophobe renal cell carcinoma, oncocytic variant), that may be challenging to differentiate from a benign kidney tumour (renal oncocytoma). H&E stain.

 

Micrograph of papillary renal cell carcinoma, a form of kidney cancer. H&E stain.

In addition to renal cell carcinoma and renal pelvis carcinoma, other, less common types of kidney cancer include:

  • Squamous cell carcinoma
  • Juxtaglomerular cell tumor (reninoma)
  • Angiomyolipoma
  • Bellini duct carcinoma
  • Clear-cell sarcoma of the kidney
  • Mesoblastic nephroma
  • Wilms' tumor, usually is reported in children under the age of 5.
  • Mixed epithelial stromal tumor

Rarely, some other types of cancer and potentially cancerous tumors that more usually originate elsewhere can originate in the kidneys. These include:

  • Clear cell adenocarcinoma
  • Transitional cell carcinoma
  • Inverted papilloma
  • Renal lymphoma
  • Teratoma
  • Carcinosarcoma
  • Carcinoid tumor of the renal pelvis

Cancer in the kidney may also be secondary, the result of metastasis from a primary cancer elsewhere in the body.

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Stages

For stage 4 kidney cancer, the most common sites kidney cancer metastasis are the lungs, bones, liver, brain, and distant lymph nodes.

kidney cancer treatment Iran

People with kidney cancer want to take an active part in making decisions regarding their medical care. They want to learn about the disease and their treatment choices. Often it helps to make a list of questions before appointment. Your doctor may refer to a specialist or patient may ask for referral to specialists such as urologists and medical oncologists and radiation oncologists who treat kidney cancers. Get your appointment with the Best Kidney Cancer Surgeon in Delhi on our website.

Getting a Second Opinion

Before starting the treatment, a patient with kidney cancer might want a second opinion about the diagnosis and the treatment. Some insurance companies need a second opinion, while others may cover a second opinion if the patient or doctor requests it.

Surgery
The following are the main type of surgery for kidney cancer, which type you will have depends on how advanced your cancer is:

Radical nephrectomy: It removes the kidney, adrenal gland and the surrounding tissue. Often it also removes the nearby lymph nodes. This is the most common surgery for kidney cancer and can also be done through a small incision with a laparoscope.
Simple nephrectomy: It removes the kidney only.
Partial nephrectomy: It removes the cancer in the kidney along with some tissue around it. This procedure is used for patients with smaller tumors which is less than 4cm or in those patients where a radical nephrectomy may hurt the other kidney.
You can survive with just a part of one kidney as long as it is still working. Even if the surgeon removes both kidneys or if both kidneys are not working, you’ll need dialysis or a kidney transplant.

If the surgery can’t remove your kidney cancer, then your doctor will suggest another option to help destroy the tumor:

Radiofrequency ablation uses the high energy radio waves to cook the tumor.
Cryotherapy uses extreme cold to kill the tumor.
Arterial embolization involves inserting the material into an artery which leads to the kidney. This blocks the blood flow to the tumor. The procedure may be done to help shrink the tumor before surgery.
Biological Therapy
It uses your immune system to fight the cancer by directing, boosting or restoring your body’s natural defences. The substances for the biologic therapy are made by your body or in a lab. Examples of biological therapy for metastatic kidney cancer include interleukin-2 or interferon alpha. There are many new immunotherapies that are actively studied for kidney cancer.

Targeted Therapy
This therapy uses drugs or other substances to find and target the cancer cells with less toxicity to normal cells. Anti-angiogenic agents are one type of targeted therapy which keeps the blood vessels from feeding the tumor, causing it to shrink or stop growing. Multikinase inhibitors or tyrosine kinase inhibitors are another type of targeted agent s or oral drugs which block an enzyme pathway thereby allows the cancer cells to grow. M-TOR inhibitors is a third type of targeted therapy and there are two of these drugs which are available one oral and the other IV. They will block a pathway which allows the blood vessels to help the tumor cells to grow. Each of these drugs has a unique place in the management of advanced kidney cancer.

Radiation Therapy
Often it is used to help with symptoms of kidney cancer or in patients who cannot have surgery. This treatment uses high-energy X-rays or orther types of radiation which kill the cancer cells or halt their growth. The external radiation therapy sends the radiation to the cancer from a machine outside the body.

Chemotherapy
This therapy uses drugs to kill cancer cells or stop them multiplying. It is less effective for kidney cancer than other types of cancer. Most it is used for a certain type of kidney cancer in which there spindle cells.

 

10 common Questions about kidney cancer

1What is the average life expectancy after a kidney transplant?
12 to 20 years As a result, the average life expectancy for a patient on dialysis is generally five years. On the other hand, patients who receive a kidney transplant typically live longer than those who stay on dialysis. A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years.
2Can you live a normal life with one kidney?
Most people who are born without a kidney (or with only one working kidney) lead normal, healthy lives. A person may have had one kidney removed during an operation in order to treat an injury or a disease like cancer. A person may have donated one kidney to a person who needed a kidney transplant.
3How dangerous is a kidney transplant?
Potential risks The most serious risk of a transplant is that your body rejects the kidney. However, it's rare that your body will reject your donor kidney. The Mayo Clinic estimates that 90 percent of transplant recipients who get their kidney from a living donor live for at least five years after surgery.
4What's involved in a kidney transplant?
A kidney transplant is a surgery done to replace a diseased kidney with a healthy kidney from a donor. ... In rare situations, he or she may get 2 kidneys from a deceased donor. The diseased kidneys are usually left in place. The transplanted kidney is placed in the lower belly on the front side of the body.
5Can donating a kidney shorten your life?
Donating a Kidney Doesn't Shorten Donor's Life. ... However, the findings do show a higher rate of death in the first 90 days after surgery for the live kidney donors compared with the control group. And certain subgroups have a greater mortality risk over the long-term than others.
6What are the disadvantages of having a kidney transplant?
A successful kidney transplant can improve your quality of life and reduce your risk of dying. ... Disadvantages — Kidney transplantation is a major surgical procedure that has risks both during and after the surgery. The risks of the surgery include infection, bleeding, and damage to the surrounding organs.
7Is it painful to donate a kidney?
Most kidney donors recover in the hospital for 2 to 5 days before they head home. You'll probably still have some discomfort for the next week or two, but you'll get a prescription for pain medication to keep you comfortable. Full recovery takes time. ... You may need 6 to 8 weeks to fully heal.
8How much water should you drink if you only have one kidney?
In general, special diets are not needed by individuals who have one healthy kidney. You should have a healthy well-balanced diet, reduce your salt intake and aim to drink six to eight glasses of water a day, or a minimum of two liters.
9What is the age limit for donating a kidney?
Consequently, patients are turning to older living donors. It is unclear if an upper age limit for donation should exist, both in terms of recipient and donor outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In the United States, 219 healthy adults aged ≥70 have donated kidneys at 80 of 279 transplant centers.
10Can you die from kidney transplant?
Kidney transplant surgery carries a risk of significant complications, including: ... Failure or rejection of the donated kidney. An infection or cancer that can be transmitted with the donated kidney. Death, heart attack and stroke.

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