Renal Cell Carcinoma

The most
common type of kidney
cancer is Renal Cell Cancer, also called
Renal Adenocarcinoma or
Hypernephroma.

Copyright, 2004 Debi Foli

The Kidneys
The kidneys are a pair of
organs on either side of
the spine in the lower
abdoman. Each kidney is
about the size of a fist.
Attached to the top of each
kidney is an adrenal gland.
A mass of fatty tissue and
an outer layer of fibrous
tissue (Gerotas fascia)
enclose the kidneys and
adrenal glands.

7/17/04
Debi Foli - Bio 316

Renal Cell Cancer Risk

Factors

Smoking: Cigarette smokers are twice as likely as nonsmokers to

develop kidney cancer.

Obesity: People who are obese have an increased risk of kidney

cancer.

High blood pressure: Increases the risk of kidney cancer.

Long-term Dialysis: Being on dialysis for many years is a risk factor

for kidney cancer.

Von Hippel-Lindau Syndrome: VHL is a rare disease that runs in

some families. An abnormal VHL gene increases the risk of kidney
cancer.

Occupation: Coke oven workers in the iron and steel industry are at
risk. Workers exposed to asbestos or cadmiumalso may be at risk.

Gender: Males are more likely than females to be diagnosed with

kidney cancer.

7/17/04
Debi Foli - Bio 316

Renal Cell Cancer

Symptoms

Blood in the urine (making the urine slightly

rusty to deep red)

Pain in the side that does not go away

A lump or mass in the side or the abdomen

Weight loss, fever, anemia

Feeling very tired or having a general feeling of

poor health

7/17/04
Debi Foli - Bio 316

Background and statistics

In the United States, kidney cancer accounts for about 3% of

all cancers, with approximately 12,000 kidney cancer
deaths each year.

Kidney cancer strikes more than 28,000 Americans each year

many of whom have no overt symptoms.

The majority of people with kidney cancer are past the age
of 40, and it strikes men twice as often as women. Kidney
cancer is usually diagnosed between the ages of 50 and 70,
but can occur at any age.

It is one of the fastest-growing cancers in the United Kindgom.

There are several genetic factors that predispose people to

kidney cancer but this only happens in 5% of the cases.

7/17/04
Debi Foli - Bio 316

Treatment

Surgery is the standard treatment for contained kidney

cancer. Various surgical options may be available to
you, depending on tumor size and location within the
kidney capsule. Such surgery is performed by a
urologic surgeon.

Radiation and chemotherapy are not very effective in

treating kidney cancer. Biologic therapies are used
more frequently.

7/17/04
Debi Foli - Bio 316

Prognosis

In 40% of patients, renal cell cancer will be limited to the kidney and is
treated exclusively by surgery, which is curative 90% of the time.

In the 60% of patients with renal cell cancer that has spread outside the
kidney, the disease is generally not curable with surgery and other
specialists, such as medical oncologists and possibly even radiation
therapists, are involved with treatment.

According to the most recent follow-ups from patients treated at the Mayo
Clinic between 1996 and 1999, 79% of patients who underwent partial
nephrectomy were cancer-free, compared to 77% of patients who
underwent radical nephrectomy. Furthermore, the incidence of kidney
failure was only 11% in the group of patients who underwent partial
nephrectomy, compared to 22% in the group who underwent radical
nephrectomy. These results suggest that partial nephrectomy is equally as
beneficial as radical nephrectomy and reduces the chance of kidney
failure.

7/17/04
Debi Foli - Bio 316

Prognosis Continued
1997 AJCC Pathologic Stage
Chance of Cure 5 Years after
Surgery
Open Partial Nephrectomy
Open Radical Nephrectomy
Laparoscopic Radical
Nephrectomy
T1 N0 M0 (< 4 cm tumor)
91-100% 96-97% 89-100%
T1 N0 M0 - 95-96%
T2 N0 M0 - 88%

7/17/04
Debi Foli - Bio 316

1997 AJCC Pathologic

Stage Chance of
Survival at 5 years with
Open Radical
Nephrectomy
T3 N0 M0 40-70%
T4 N0 M0 0-28%
N+ 0-33%
M1 0-20%

Conclusion - Renal Cell

Carcinoma

Kidney Cancer is not common in US - 28,000

cases vs. overall 1,334,100 in 2003 (2.09%)

Caught early - chances of survival and cure

are excellent (91 - 100%)

Radiation and Chemotherapy are not very

effective for Kidney Cancer (M+ 0 - 20% : N+
0 - 33%)

One Mans Pathology Report gives interesting

detail - he is yet to pass his 5 year mark but
doing well

7/17/04
Debi Foli - Bio 316