Renal carcinoma is a malignant oncological disease. According to statistics, pathology is in tenth place in terms of prevalence. More than 40,000 cases are diagnosed every year in the world. Carcinoma can be localized in one or both kidneys. Most often, it is diagnosed in men over 50 living in the city.
Varieties
Neoplasm most often occurs in the superficial layer of the kidneys, eventually growing deeper into them. The tumor is made up of a mass of kidney cells. These particles begin to divide abnormally, not taking part in the production of urine and blood purification. There are several types of renal carcinomas:
1. Collecting duct carcinoma. Tumor growth is rapid. The rarest form of kidney cancer.
2. Clear cell carcinoma. It is 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. Rare, only 14% of cases.
4. Chromophobic carcinoma of the kidney, renal cell. A characteristic feature of this carcinoma is its slow growth. Occurs in 4% of cases.
5. Oncocytic. Formed from large, eosinophilic particles. Metastases are rare. Diagnosed in 5% of patients.
Stages of development of pathology
Like other cancers, kidney carcinoma goes through several stages of development. Depending on the stage at which the pathology is diagnosed, the outcome of the therapy depends. The following stages of renal carcinoma are distinguished:
1. First stage. Neoplasm cells are located only in the tissues of the kidneys. The size of the tumor is not more than seven centimeters. Metastases are absent. The initial stage of development of carcinoma is characterized by a high percentage of recovery. The condition for this is timely and correct therapy.
2. The second stage of renal 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 affected tissues of the kidneys. The size of the tumor differs, which begins to exceed seven centimeters.
3. Third stage. The neoplasm does not go 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 inthe second option is metastasis to the lymph nodes of the sinus of the kidneys.
4. Fourth stage. At the final stage of carcinoma development, pathogenic cells spread outside the organ.
Reasons
Until today, doctors cannot 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 developing carcinoma increases if one of the close relatives was ill with this pathology. This is due to a genetic disorder at the chromosome level. Papillary kidney cancer is considered genetically acquired.
2. Kidney injury. This phenomenon can provoke the active reproduction of malignant cells that form the basis of the tumor.
3. Taking certain medications. Long-term use of certain medicines can cause accelerated growth of the neoplasm.
4. Prolonged dialysis can cause cysts to form, which over time can develop into a tumor.
5. Contact with solvents of organic origin. It has been scientifically proven that direct work with asbestos and cadmium can cause carcinoma.
6. Smoking. Nicotine has a detrimental effect on kidney tissue. Statistics make it clear that the majority of patients with carcinoma are smokers.
7. Excessbody mass. Cell carcinoma of the kidney is often diagnosed in overweight women.
Symptoms
For the most part, carcinoma is discovered by chance when examining a patient for another reason. As a rule, pathology at the initial stages (before metastasis) proceeds in a latent form. The main, general and non-specific symptoms are distinguished.
The main signs of renal carcinoma include:
1. Hematuria, or blood 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 discomfort and appears at different intervals. Bleeding develops against the background of the destruction of renal tissues by the tumor.
2. Neoplasm in the abdomen. It is detected by palpation with a significant increase in the neoplasm. In thin people, the pathology becomes distinguishable even at an early stage of carcinoma.
3. Pain in the lumbar region. As a rule, this phenomenon indicates the spread of metastases to adjacent organs. When it extends beyond the kidney, the tumor can disrupt blood flow to the inferior vena cava. The result is an expansion of the veins of the spermatic cord.
General symptoms
Common symptoms (i.e. common to all types of cancer) include:
1. Loss of appetite.
2. Weight loss.
3. Temperature rise (to subfebrile).
4. Anemia.
5. Weakness.
6. Fever.
Non-specific signs
Non-specific signs due to the production of hormones and biologically active substances include:
1. Elevated calcium levels.
2. Rise in blood pressure.
3. Increased number of red blood cells.
4. Liver dysfunction.
In order to detect kidney carcinoma at an early stage, it is necessary to regularly donate urine and blood for examination, as well as undergo ultrasound.
Diagnosis
Diagnosis of renal carcinoma in modern conditions is not difficult. Treatment is prescribed by oncologists only after a thorough examination. The main methods for detecting carcinoma are:
- Ultrasound. It makes it possible to determine the size of the kidneys, the area of the lesion and the ongoing necrosis, hemorrhages and the contours of the tumor. A biopsy also uses ultrasound to guide the needle.
- Magnetic resonance imaging. The location of the tumor is revealed, even if the size of the neoplasm is no more than two centimeters. MRI determines the depth of germination of the tumor in the kidney, as well as its structure. In addition, this method shows the presence of metastasized cells and thrombi in the renal and vena cava.
- X-ray examination. It is carried out using a contrast agent. The picture helps to visualize the tumor,detects changes in the contours and shape of the kidney.
- Angiography. Allows differentiation of carcinoma from cysts, as well as X-ray reveals metastases and blood clots.
- Urography with contrast. Determines the function of the kidneys, reveals signs of oncological formation.
- Biopsy. It is a sampling of pathogenic tissues for the purpose of histological examination.
After a thorough examination, the type of tumor is determined - kidney carcinoma in this case, its stage and the final diagnosis is made.
Treatment
There are a number of factors that affect the treatment method:
1. type of neoplasm. Small tumors showing slow growth may require expectant management.
2. The patient's condition. In some situations, with severe comorbidities, surgery may be unacceptable.
3. Patient's age.
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 techniques 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 laparoscopically and openly.
2. Chemotherapy. This method is ineffective in renal carcinoma. They are used when excludedpossibility of surgical treatment of kidney carcinoma.
3. Radiation therapy. Like chemotherapy, radiation therapy for 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. Has the fewest possible side effects.
5. Hormone treatment. The success of therapy is only 5-10%. It is mainly used to reduce the intensity of tumor growth.
Prognosis for renal carcinoma
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 complete 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 for 5 years, in 43% - 10 years. If left untreated, metastases will cause necrosis and severe intoxication of the body. At the final stage, all organs and systems fail.
