Renal cell carcinoma

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Malignant degeneration of the epithelium of the renal tubules is arenal cell carcinoma. It is diagnosed in 3% of cases among all urological oncopathology.

In the structure of cancer diseases in urology, he concedes the first places only to cancer of the prostate and bladder. However, kidney cancer is the leading cause of death in urology.

In addition, it is worth noting that in recent years the number of malignant neoplasms has been steadily increasing, despite the improvement of diagnostic equipment and treatment techniques. Men suffer several times more often than women.

Until now, it has not been possible to reduce the number of cases of detection of cancer in 3-4 stages, so the prognosis for life is unfavorable. This is due to a pronounced metastasis and a high risk of recurrence (re-development of the malignant process).

Causes

It is not possible to isolate the main causes of this cancer. However, it is possible to identify predisposing factors that increase the likelihood of a cancer process. To such it is possible to carry:

  • Smoking that increases the risk of cell malignancy by 30%;
  • occupational hazards (work with asbestos, nitrates, heavy metal salts, oil derivatives and other toxic chemicals);
  • ionizing radiation;
  • long-term use of analgesic drugs, excreted by the kidneys, and diuretics;
  • endocrine dysfunction (diabetes, obesity);
  • hypertensive disease of the subcompensated or decompensated stage;
  • infectious pathology (tuberculosis);
  • inflammatory diseases of the kidneys (pyelonephritis, glomerulonephritis);
  • urolithiasis and chronic renal insufficiency;
  • anomalies of kidney development (polycystosis, horseshoe shape).

The genetic factor plays a less significant role in the development of renal cancer.

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Classification

Renal cell carcinoma can occur in several forms:

  • papillary type occurs in 10-15% and has a relatively favorable prognosis;
  • The cancer of the collecting tubules (Bellini) is diagnosed in less than 1% of cases. Occurs in the medulla of the kidney and has an unfavorable prognosis, as it is resistant to treatment;
  • chromophobic - develops in 4-5% of the cortical part of the collecting tubules of the kidney;
  • renal cell carcinomais about 75% of all oncogenes.

Separately, it is necessary to distinguish unclassifiable forms of renal failure, when it is not possible to establish exactly the origin and cellular composition of the tumor.

How is renal cell carcinoma manifested?

Typical clinical signs of kidney cancer are:

  • hematuria;
  • pain syndrome;
  • presence of a tumor conglomerate, which can be palpated.

Hematuria is the appearance of blood in the urine. Initially there is a microhematuria, in which the urine becomes more saturated and acquires a reddish hue.

Later, the amount of blood released in the urine gradually increases, and the color of urine becomes red. Hematuria can disappear and appear again.

Aching painful sensations are troubling when the size of the tumor grows. They can spread to the inguinal, lumbar, femoral and suprapubic area.

In the late stages of malignant pathology, the tumor can be probed through the abdominal wall in the form of a dense, bumpy formation.

Surveys and tests to be taken

Diagnosis of the disease begins with the analysis of patient complaints and palpation of the kidney area. Then it is necessary to perform a blood test, where anemia, elevated ESR, and urine with hematuria are detected.

From instrumental methods ultrasound examination of the retroperitoneal space and abdominal cavity, bone scintigraphy, cystoscopy, urography and renal angiography are prescribed.

With the help of computer and magnetic resonance imaging, it is possible to clearly define tumor localization, its size, structure and presence of metastases in other organs. Confirmation of the diagnosis is the results of a histological examination of the material taken from a biopsy.

Modern treatment of renal cell carcinoma

Surgical intervention is considered to be an effective method. The scope of the operation is determined individually in each case. One kidney can be removed from the surrounding fiber, but often the removal of the adrenal gland, lymph nodes and other metastatic organs is required.

If the tumor is inoperable (not amenable to surgical treatment), then radiation and chemotherapy are used. After treatment, a urologist needs to be monitored to prevent the recurrence of a malignant disease.

Complications caused by the disease

The number and severity of complications increases with the growth of the neoplasm. Among them it is necessary to note:

  • anemia, when the blood levels of hemoglobin and erythrocytes decrease due to their intensive excretion in the urine;
  • acute urinary retention, which develops due to the obstruction of the ureteral lumen with a blood clot or a squeezing of the tumor;
  • infarct of the kidney, when the organ site dies;
  • disintegration of the tumor, which leads to severe pain syndrome and intoxication;
  • attachment of secondary infection with fever;
  • cachexia;
  • pain in the joints and muscles;
  • renal colic.

In addition, metastasis affects distant organs with the appearance of characteristic symptoms for them.

Forecast

The prognosis and life expectancy depend on the prevalence of oncology, the general condition of the patient and the presence of concomitant pathology.

Having diagnosedrenal cell carcinoma, often performed surgical intervention. After treatment, the 5-year survival rate at stage 1 is 75%, at stage 2 - 50-70%, at 3 stages - about 50%, and on 4 - not more than 10%.

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