Kidney Cancer in the elderly can be a real challenge for an oncologic urologist. With the dramatic aging population, kidney cancer will have a massive impact on the urology department. More and more urologists will face elderly patients with renal cell carcinoma. Having a proper assessment of kidney cancer treatment is essential. An aggressive therapeutic approach may be balanced by the benefit of the treatment care or cure and the life expectancy and willingness of the patient. Many different treatment options would be available to the patient including surgery options such as radical or partial nephrectomy or treatment therapies such as cryotherapy or radiofrequency. With the increasing age population and the number of elderlies with cancer including renal cell carcinoma, it continues to grow. A study on cancer found with patients who have confined kidney tumors from ages 75 or older do not live longer even the whole kidney was removed.
What is Kidney Cancer?
Kidney cancer is also known as Renal cancer. It is cancer that involves the kidney. Smoking, old age, high blood pressure, and obesity can increase the risk in the development of kidney cancer. Renal cancer is where the kidney cells become cancerous and they grow out of control which then forms a tumor. Nearly every cancer of the kidney appears first in the tiny tubes lining of the kidney. This is called renal cell carcinoma. A lot of cancers of the kidney is found before spreading to other organs. If the cancer is caught early it will be more easily treatable.
Symptoms of kidney cancer
Usually, symptoms do not appear early in kidney cancer stages but some people can experience them initially if the cancer may have spread. The symptoms that can occur include:
- Pain in the side
- Blood in the urine
- Night sweat and a fever
- Vision changes
- Changes in liver function
- Loss of appetite
- Weight loss
- A mass or a lump in the lower back or the side
- High blood pressure
- Liver function changes
- Varicose veins in the testes
- An enlarged testicle
If you do experience any of these symptoms it is important to see a doctor.
It is unknown what causes kidney cancer but there are many different factors that can put you at risk of developing kidney cancer. Cancer of the kidney occurs in someone who is older than 40. Here are some of the factors:
- Obesity (your hormones can change if you are overweight putting you at risk
- Smoking if you are a smoker you are at risk of this cancer is a lot higher than those who don’t smoke
- Men, a man is twice likely to develop kidney cancer than women are
- Some medications for pain over a long period of time
- Advanced kidney diseases or are on dialysis long term
- Genetic conditions which is inheritance papillary renal cell carcinoma or von Hippel Lindau
- Kidney cancer history in the family
- High blood pressure
- Exposure to some chemicals which include organic solvents, asbestos, certain herbicides, and benzene.
There are several options for treating cancer however it depends on several factors, these include:
- The stage and type of kidney cancer
- Overall health
- Previous treatment for cancer
- Personal preferences
Modern Kidney Cancer Treatments
Once you have received a diagnosis and what stage your cancer may be at. The process for treatment is the next stage which your doctor will discuss and go through with you. You may need to be referred to see a specialist in regards to your treatment. This may include a surgeon, a urologist, and radiation or medical. With many different options for modern kidney cancer treatment surgery would be one of the main steps.
The Surgical procedure involves the removal of the kidney and the tissues around the surrounding areas. If the cancer has not spread to any other part of the body, the only treatment that may be needed is the removal of the tumor, part of the kidney removed, and possibly the nearby lymph nodes and tissue.
Types of surgery options
There are many different surgery options to treat cancer these include the following:
This type of surgery is a minimally invasive traditional keyhole surgery. The surgeon will operate through the body via small incisions generally through the belly button or abdomen. Long flexible tubes called a laparoscope are used during the surgery. The surgeon will then operate by removing some of the kidney or the entire kidney depending on the stage of your cancer. This type of surgery has many advantages such as recovering quicker and less scarring after the procedure. Laparoscopic surgery requires specialised training.
Partial nephrectomy can be keyhole or operation in some circumstances. This surgery is the removal of a tumor from a kidney or just part of the kidney with surrounding tissue. It is only performed if the tumor is small in size less than 4cm.
Radical nephrectomy is the surgical procedure performed for the removal of a tumor, the whole kidney, and the surrounding tissue. It is a common surgery treatment for kidney cancer and can be done through tiny incisions using a laparoscope. If nearby surrounding lymph nodes and tissue is the same and are also affected by the cancer a radical nephrectomy is performed to treat it. Radical nephrectomy is necessary if treating a large tumor where there is not much healthy tissue remaining.
In some cases, surgery may not be needed depending on the diagnosis, the risks, and the overall health. The following procedures may be necessary and all that is needed:
Also known as cryosurgery or cryotherapy. This treatment freezes the cancer cells with a metal probe that is inserted through small incisions. It is placed into the cancer tissue.
This treatment option is with the use of a needle that is inserted into the tumor to help destroy the cancer with an electric current. The procedure is performed by a urologist or an interventional radiologist.