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Urologic cancers can occur in any organ of the urologic system and the male reproductive system. These can include kidney cancer, prostate cancer and testicular cancer. Each type of cancer has different symptoms and treatments and affects different groups of the population with varying frequency.
Most cancers are named after the part of the body where the cancer first begins, and kidney cancer is no exception. Kidney cancer begins in the kidneys--two large, bean-shaped organs--one located to the left, and the other to the right of the backbone. Renal is the Latin word for kidney, and kidney cancer may also be referred to as renal cancer.
According to the American Cancer Society (ACS), about 65,000 people in the U.S. were expected to be diagnosed with kidney and renal pelvic cancers in 2012. The most common type is called renal cell cancer. The information contained on this page refers to renal cell cancer.
The exact cause of renal cell cancer is unknown. However, there are certain risk factors that are linked to it. These risk factors, according to the ACS, are as follows:
Smoking. Smoking increases the risk of kidney cancer. The risk seems related to the amount you smoke.
Asbestos. Studies show a link between exposure to asbestos and kidney cancer.
Cadmium. There may be a link between cadmium exposure and kidney cancer. Cadmium may increase the cancer-causing effect of smoking.
Family history. Family history of kidney cancer increases a person's risk.
Gender. Men are twice as likely to develop renal cell cancer than women.
Von Hippel-Lindau syndrome. This is a disease caused by a gene mutation that increases the chances of renal cell cancer.
Birt-Hogg-Dube syndrome. Patients who have this disease are more likely to develop renal cell cancer.
Other hereditary syndromes. Patients with hereditary papillary renal cell carcinoma, hereditary leiomyoma-renal cell carcinoma, and hereditary renal oncocytoma are more likely to develop kidney cancer.
Obesity. Obesity increases a person's risk of kidney cancer.
Advanced kidney disease. Patients with advanced kidney disease who have been on dialysis for a long time may develop renal cell cancer.
High blood pressure. Patients who have high blood pressure have a higher risk for kidney cancer.
Diuretics (water pills). Drugs that eliminate excess body fluid may raise the risk of kidney cancer, although this is not clear.
Race. African-Americans have a slightly higher risk of kidney cancer.
The following are the most common symptoms of renal cell cancer. However, each individual may experience symptoms differently. Symptoms may include:
Blood in the urine
Rapid, unexplained weight loss
Low back pain (not caused by an injury)
Loss of appetite
Swelling of ankles and legs
Mass or lump on the side or lower back
Recurrent fever (not caused by a cold or the flu)
High blood pressure (less frequently)
Anemia (less frequently)
Unrelieved pain in the side
The symptoms of renal cell cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for kidney cancer may include the following:
Blood and urine laboratory tests
Intravenous pyelogram (IVP). A series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
Renal angiography (also called arteriography). A series of X-rays with the injection of a contrast dye into a catheter, which is placed into the blood vessels of the kidney, to detect any signs of blockage or abnormalities affecting the blood supply to the kidneys.
Other imaging tests (to show the difference between diseased and healthy tissues), including the following:
Computed tomography scan (also called a CT or CAT scan). A noninvasive type of X-ray procedure that takes horizontal, or axial, images of the brain or other internal organs to detect any abnormalities that may not show up on an ordinary X-ray.
Magnetic resonance imaging (MRI). A noninvasive procedure that uses radio waves and strong magnets to produce very detailed two-dimensional views of an internal organ or structure, especially the brain and spinal cord.
Ultrasound (also called sonography). A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Bone scan. A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints to detect bone diseases and tumors to determine the cause of bone pain or inflammation.
Based on results of other tests and procedures, a biopsy may be needed. A biopsy is a procedure in which a sample of the tumor is removed and sent to the laboratory for examination by a pathologist.
Specific treatment for kidney cancer will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Surgery. Surgery to remove the kidney is called a nephrectomy and it is the most common treatment for kidney cancer. The following are different types of nephrectomy procedures:
Radical nephrectomy. The whole kidney is removed along with the adrenal gland, tissue around the kidney, and, sometimes, lymph nodes in the area.
Simple nephrectomy. Only the kidney is removed.
Partial nephrectomy. Only the part of the kidney that contains the tumor is removed.
The remaining kidney is generally able to perform the work of both kidneys.
Radiation therapy. Radiation therapy uses high-energy X-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.
Targeted therapy. Targeted therapy uses drugs that attack specific parts of cancer cells. These drugs work differently from standard chemotherapy drugs, and often have less severe side effects. They are commonly the first line of treatment for advanced kidney cancer. Examples include sunitinib (Sutent), sorafenib (Nexavar), temsirolimus (Torisel), everolimus (Afinitor), bevacizumab (Avastin) and pazopanib (Votrient).
Biological therapy (also called immunotherapy). Biological therapy is a treatment that uses the body's own immune system to fight cancer.
Chemotherapy. Chemotherapy is the use of drugs to kill cancer cells. Unfortunately, kidney cancer is often resistant to chemotherapy drugs.
Arterial embolization. Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow. It may also be used before an operation to make surgery easier, or to provide relief from pain when removal of the tumor is not possible.
If you or a family member has been diagnosed with kidney cancer, you may want to consider getting a second opinion. In fact, some insurance companies require a second opinion for such diagnoses. According to the ACS, it's rare that the time it will take to get a second opinion will have a negative impact on your treatment. The peace of mind a second opinion provides may be well worth the effort.
Kidney cancer starts small and can be in either one or both kidneys. It is usually found after it has grown quite large, but often before it has spread to other organs.
Prognosis is the word your healthcare team may use to describe your likely outcome from cancer and cancer treatment. A prognosis is a calculated guess. It’s a question many people have when they learn they have cancer.
The decision to ask about your prognosis is a personal one. It’s up to you to decide how much you want to know. Some people find it easier to cope and plan ahead when they know their prognosis and the statistics for how well a treatment might work. Other people find statistics confusing and frightening. Or they might think statistics are too general to be useful.
A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. For instance, a favorable prognosis (which means you’re likely going to do well) can change if the cancer spreads to key organs or doesn’t respond to treatment. An unfavorable prognosis can change, too. This can happen if treatment shrinks and controls the cancer so it doesn’t grow or spread.
When figuring out your prognosis, your doctor will consider all the things that could affect the cancer and its treatment. Your doctor will look at risk estimates about the exact type and stage of the cancer you have. These estimates are based on what results researchers have seen over many years in other people with the same type and stage of cancer.
If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. This means you’re expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. It’s important to keep in mind that a prognosis states what’s likely or probable. It is not a prediction of what will definitely happen. No doctor can be fully certain about an outcome.
Your prognosis depends mainly on:
The exact type of cancer
The stage of the cancer
Your overall health
Your treatment decisions
How well your cancer responds to treatment
Survival rates show what portion of people live for a certain length of time after being told they have cancer. The rates are grouped for people with certain types and stages of cancer. Many times, the numbers used refer to the 5-year or the 10-year survival rate. That’s how many people are living 5 years or 10 years after diagnosis. The survival rate includes:
People who are cancer-free
People who are still getting treatment for their cancer
Here are the 5-year survival rates for testicular cancer, according to the National Cancer Institute. These include all types of testicular cancer. The outlook for some types might be better than others.
Overall, the 5-year survival rate for testicular cancer is about 95%.
For men whose cancer is found before it has spread to lymph nodes or other organs, the 5-year survival rate is about 99%.
The 5-year survival rate for testicular cancer that has reached nearby organs or lymph nodes is about 96%.
Once testicular cancer has spread to distant organs, the 5-year survival rate is about 74%.
These numbers are adjusted to account for the fact that some people with testicular cancer may die from other causes.
You can ask your healthcare provider about survival rates and what you might expect. But remember that statistics are based on large groups of people. They cannot be used to say what will happen to you. No two people are exactly alike. Treatment and how well cancer responds to treatment vary.
Testicular cancer can occur in one or both testicles, usually in young men. It can be treated and very often cured.
Prostate cancer is the second most common cancer found in American men, second only to skin cancer. Approximately one in six men will develop prostate cancer in his lifetime. We offer the da Vinci® Robotic Surgical System, a robotic-assisted procedure for men with prostate cancer.
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