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Kidney Cancer Treatment Options

Kidney cancer

Renal adenocarcinoma is the most common type of tumour in the kidney. The primary kidney cancer treatment in Delhi is surgery. A large percentage of them are now diagnosed incidentally, which allows in many cases to make a conservative treatment of the renal unit through partial surgery. During the last years, new technologies have been incorporated in its treatment, with lower morbidity, shorter hospital stay, and the same oncological safety. The procedures and techniques that urologist in Delhi uses are the following:

Advanced     imaging techniques for diagnosis (Helical CT with "3D"     volumetric reconstruction, Uro-NMR, digital angiography, etc.)

Conventional     and minimally invasive surgical techniques:

Open     nephrectomy, radical and partial robotic onco surgery in     Delhi

Kidney     Tumour with Venous Thrombus: Radical nephrectomy with thrombectomy

Percutaneous     and laparoscopic ablation

What is a kidney tumour?

A kidney tumour is an abnormal growth inside the kidney. Often the terms "mass", "injury" and "tumour" are used as synonyms. Tumours can be benign or malignant (cancer). The most common kidney injury is the presence of a fluid-filled area called a cyst. Simple cysts are benign and look typical in imaging studies. They do not progress to cancer and usually do not require follow-up or treatment. Solid kidney tumours may be benign, but in more than 80 percent of cases, they are malignant.

What statistical data are available about kidney cancer?

In India, it accounts for 5 percent of all cancers. Kidney cancer is more common in men and is usually diagnosed between 50 and 70 years of age. The most common kidney cancer is called renal cell carcinoma.

What risk factors are associated with kidney cancer?

The following associations may increase the risk of developing kidney cancer:

Smoke

Family history     of kidney cancer

Polycystic     kidney disease

Chronic     kidney failure, dialysis, or both

Von     Hippel-Lindau disease

Tuberous     sclerosis

Exposure     to asbestos, blast furnaces and furnaces used in the iron and steel     industry

What are the symptoms of kidney cancer?

Many kidney tumours do not produce symptoms, but they can be detected accidentally during the evaluation by some other unrelated problem. Compression or invasion of neighbouring structures can cause pain (in the flank, abdomen or back), the presence of a palpable mass and blood in the urine (microscopic or visible to the naked eye). If cancer spreads (metastasis) beyond the kidney, the symptoms will depend on the affected organ. In some cases, the cancer causes associated clinical or laboratory changes called paraneoplastic syndrome. This syndrome is observed in approximately 30 percent of patients with kidney cancer and can occur at any stage, even those early limited to the kidney.

How is kidney cancer diagnosed?

Unfortunately, there are no blood or urine tests that can directly detect the presence of a kidney tumour. When a kidney tumour is suspected, an imaging study is done. The first study is usually an ultrasound or a computed tomography (CT) scan.

What are the treatment options for tumours that appear to be confined to the kidney?

When the tumour appears to be confined to the kidney ("localized" tumour), there are three main options of kidney cancer treatment in Delhi: tumour resection, tumour ablation, and surveillance. The chemotherapy, the hormone treatment, and radiotherapy are not effective for kidney cancer treatments.

Resection of the tumour

Tumour resection is considered the standard mode of treatment for most patients and is achieved through surgery: nephrectomy. A radical nephrectomy is the surgical resection of everything within Gerota's fascia, including the entire kidney. Partial nephrectomy is the surgical resection of part of the kidney (in this case, the part that contains the tumour).

The goal of partial nephrectomy is to resect an entire tumour by the best urologist in Delhi while preserving as much normal kidney tissue as possible. Renal tissue that is preserved can avoid the need for dialysis if further kidney damage occurs later. It is possible to perform the nephrectomy through a traditional incision (open surgery) or with minimally invasive techniques (laparoscopic surgery).

When it is not possible to safely resect the tumour with a partial nephrectomy, radical nephrectomy is performed. If you choose to have a partial nephrectomy, there is always a risk that you need to perform a radical nephrectomy.

Tumour ablation

Tumour ablation destroys the tumour without surgically removing it. Examples of different technologies that can be applied for ablation include cryotherapy, radiofrequency interstitial ablation, high-intensity localized ultrasound (HIFU), microwave thermotherapy, and laser coagulation. Ablation can be achieved during access through robotic onco surgery in Delhi or percutaneously (through the skin).

Because ablation of a kidney tumour is a relatively new procedure, the long-term results are not yet known. However, ablation may be less invasive than a nephrectomy and may be useful in patients who cannot tolerate more extensive surgeries.

Embolization

This is not a standard treatment option but can be considered in patients who cannot tolerate tumour resection or ablation. Cancer surgeon in Delhi considered it as a coadjutant treatment to standard forms of treatment, especially when the tumour presents active bleeding.

Embolization can stop bleeding and allows the uro oncologist in Delhi to stabilize the patient before surgery.

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Initial treatment of prostate cancer according to stage

According to the best urologist in Delhi the stage of cancer is one of the most important factors in selecting the best way to treat prostate cancer. Prostate cancer is classified according to the extent of the cancer (using the T, N, and M categories), the PSA level, and the Gleason score at the time of diagnosis.

However, other factors, such as your age, general health, life expectancy, and personal preferences should also be considered when analysing treatment options. In fact, many doctors determine the possible treatment options for a man not only according to the stage but taking into account the risk of the cancer coming back (recurrence) after the initial treatment and the life expectancy of the man.

It would be advisable to consult with onco surgeon in Delhi the factors that he (or she) is taking into account when considering your treatment options. Some doctors may recommend options that are different from those presented in this article.

Stage I

These prostate cancers are small (T1 or T2a) and have not grown outside the prostate. They have low Gleason scores (6 or less) and low PSA levels (less than 10). They usually grow very slowly and may never cause any symptoms or other medical problems.

Urologist in Rohini suggests, for those men who do not have any symptoms of prostate cancer and who are of advanced age or other serious medical problems that could limit their lifespan, it is often recommended to wait for observation or active surveillance. On the other hand, radiation therapy (external radiation or brachytherapy) or radical prostatectomy may be options for men who wish to start treatment.

Younger men who enjoy good health may consider active surveillance (knowing that they will need further treatment), radical prostatectomy, or radiation therapy (external radiation or brachytherapy).

Stage II

Stage II cancers have not yet grown outside the prostate gland, but are larger, have higher Gleason scores, and / or higher PSA levels compared to stage I cancers. Stage II cancers that are not treated with surgery or radiation have, over time, more likely to spread beyond the prostate and cause symptoms than stage I cancers.

As with stage I cancers, active surveillance is often a good option for men with cancers that do not produce any symptoms and those who are of advanced age or have other serious medical problems. Radical prostatectomy and radiation therapy (external radiation or brachytherapy) may also be appropriate options.

According to uro oncologist in Delhi treatment options for younger and otherwise healthy men may include:

Radical prostatectomy (often with removal of the pelvic lymph nodes). This may be followed by external radiation if your cancer is found to spread beyond the prostate at the time of surgery, or if the PSA level is still detectable several months after surgery.

External radiotherapy only *

Brachytherapy only *

Brachytherapy and external radiotherapy combined *.

Participation in a clinical study of newer treatments

* All radiation options can be combined with several months of hormone therapy if there is a high probability of cancer recurrence based on the PSA level and / or Gleason score.

Stage III

Stage III cancers have spread beyond the prostate but have not reached the bladder or rectum (T3). There is no spread to the lymph nodes or distant organs. These cancers are more likely to return after treatment than tumours in earlier stages.

Treatment options at this stage may include:

External radiation plus hormone therapy

External radiation plus brachytherapy, possibly with a short course of hormone therapy

Radical prostatectomy in selected cases (often with removal of pelvic lymph nodes). Radiation therapy may be administered after this treatment.

Older men with other health problems may opt for less aggressive treatment, such as hormone therapy (on its own) or even active surveillance.

Participating in a clinical trial of newer treatments is also an option for many men with stage III prostate cancer.

Stage IV

Stage IV cancers have already spread to adjacent areas, such as the bladder or rectum (T4), and to nearby lymph nodes or distant organs, such as bones. Few T4 cancers can be cured using some of the same treatments used for stage III cancers. Most stage IV cancers cannot be cured, but they can be treated. The goals of treatment are to keep cancer under control for as long as possible and to improve a man’s quality of life.

As per urologist in delhi Initial treatment options may include:

Hormone therapy, possibly together with chemotherapy

External radiation therapy (sometimes combined with brachytherapy), in addition to hormone therapy

Radical prostatectomy in selected patients with cancer that has not spread to the lymph nodes or other parts of the body. After this treatment, external radiotherapy can be administered.

Surgery (TURP) to relieve symptoms such as bleeding or urinary obstruction

Treatments directed at bone metastases, such as denosumab (Xgeva), a bisphosphonate such as zoledronic acid (Zometa), external radiation directed at the bones or a radiopharmaceutical such as strontium-89 or samarium-153 or radio-223

Active surveillance (for those who are older or have other serious health problems and do not have major symptoms of cancer)

Participation in a clinical study of newer treatments.

Treatment for stage IV prostate cancer may also include treatments to help prevent or relieve symptoms, such as pain.

The above options are for the initial treatment of prostate cancer in different stages. But if these treatments do not work (the cancer continues to grow and spread) or if the cancer comes back, other treatments may be used.

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What is prostate cancer?

Cancer arises when the cells in the body begin to grow uncontrollably. Cells in almost any part of the body can become cancer cells and can spread to other areas of the body. To know more about the origin and spread of cancer, a person should meet onco surgeon in Delhi.

Prostate cancer starts when the prostate cells start to grow out of control. The prostate is a gland that only men have. This gland produces part of the fluid that makes up the semen.

The prostate is below the bladder and in front of the rectum. The size of the prostate changes with age. In younger men, the prostate is about the size of a walnut. However, it can be much larger in older men.

Just behind the prostate are the glands called seminal vesicles, which produce most of the semen fluid. The urethra, which is the tube that carries urine and semen out of the body through the penis, passes through the centre of the prostate.

Types of prostate cancer

Almost all prostate cancers are adenocarcinomas. These cancers develop from the cells of the gland (the cells that produce prostatic fluid that is added to semen).

The other types of prostate cancer include:

Sarcomas

Small cell carcinomas

Neuroendocrine tumours (apart from small cell carcinomas)

Transitional cell carcinomas

These other types of prostate cancer are rare. If you have prostate cancer it is almost certainly an adenocarcinoma.

Some prostate cancers can grow and spread quickly, but most grow slowly. In fact, studies conducted at some autopsies show that many elderly men (and even some younger men) who died from other causes also had prostate cancer that never affected them during their lives. In many cases, they did not know, and not even their doctors, that they had prostate cancer.

Possible precancerous conditions of the prostate

According to the best urologist in Delhi, prostate cancer begins with a precancerous condition, although this is not yet known with certainty. These conditions are sometimes found when a man’s prostate biopsy is done (removal of small pieces of the prostate to detect cancer).

Prostatic intraepithelial neoplasia

Prostatic intraepithelial neoplasia in (prostatic intraepithelial neoplasia, PIN), there are microscopic changes in the appearance of the prostate gland, but do not appear abnormal cells invade other parts of the prostate (as it would cancer cells). Based on how abnormal the cell patterns are, they are classified by uro oncologist in Delhi as follows:

Low-grade PIN: the patterns of the prostate cells look almost normal.

High grade PIN: the patterns of the cells look more abnormal.

In some men this condition already begins to appear in the prostate from 20 to 29 years of age, says urologist in Rohini.

Many men begin to have a low-grade neoplasm when they are young, but they do not necessarily have cancer. The possible link between low-grade prostatic intraepithelial neoplasia and prostate cancer is not yet clear.

If high-grade prostatic intraepithelial neoplasia was found in the prostate sample that was obtained by biopsy, there is an approximately 20% chance that you will also have cancer in another area of the prostate.

Proliferative inflammatory atrophy

In proliferative inflammatory atrophy (PIA), the prostate cells look smaller than normal, and there are signs of inflammation in the area. PIA is not cancer, but researchers believe it can sometimes develop into a high-grade PIN or perhaps directly into prostate cancer.