Renal cell cancer refers to the condition where there is a growth of cancer cells form in the tubules of the kidney. The most common type of renal cancer appears in the renal (kidney) tissue that helps in filtering the blood and produces the urine. This condition is commonly known as renal cell cancer (or renal cell carcinoma). Another kind of adult kidney tumour grows in the renal pelvis where the urine collects and this type of renal cancer is called transitional cell carcinoma.

What are the signs of kidney cancer?

In most of the cases renal cancer is accidentally found on imaging (USG or CT) done for any other disease or on routine checkup.

• Most of the people accidentally find out about cancer on routine ultrasounds indicative of renal mass. Other signs might be
• (hematuria) blood in the urine
• Lower back pain on either side
• A lump on the side or on the lower back.
• Tiredness
• Loss of appetite.
• Weight loss
• Fever that does not occur due to an infection and that doesn’t go away(FUO)

What are the risk factors for renal cancer?

Following are the risk factors for renal cell cancer:

• Smoking
• Abuse of certain pain medicines, including over-the-counter pain medicines, for a prolonged period
• Obesity
• High blood pressure
• Hereditary renal cell cancer
• Presence of certain genetic disorders like hereditary papillary renal cell carcinoma or von Hippel-Lindau disease.

What are the ways to find whether one has a renal tumor?

The following tests and procedures may be used to detect renal cancer:

• Physical exam and history
• Ultrasound exam : It is the most popular primary test to diagnose a renal mass/cancer.
• Blood Test : Certain blood tests like LFT, KFT and Serum Calcium are done for finding any abnormality.
• Urinalysis : This analysis is done for checking the colour of urine and its components, like red blood cells,sugar, protein, and white blood cells.
• Liver function test : Liver Function test or LFT is a diagnostic measure by which a sample of blood is examined for measuring the amounts of enzymes released into the bloodstream by the liver. An elevated amount of an enzyme can be a sign of cancer that has spread to the liver. Certain conditions that might not be cancerous can also increase liver enzyme levels.
• CT scan (CAT scan) |Modality of choice : In this technique, the computer-generated pictures that are linked to an x-ray machine are taken. In this technique, a dye is injected into a vein to help the organs or tissues show up more clearly in the CAT scan. This procedure is known by various names like computed tomography, computerized tomography, or computerized axial tomography.
• MRI (magnetic resonance imaging): This technique makes uses a magnet, a computer and the radio waves for making detailed pictures of areas present inside the body. This procedure is also known as nuclear magnetic resonance imaging (NMRI).
• Biopsy : Biopsy refers to the extraction of cells or tissues so that they can be viewed under a microscope by a pathologist for finding any signs of cancer. For performing biopsy for renal cell cancer, a fine needle is inserted into a tumour and a sample of tissue is extracted.

What are the Stages of Renal Cell Cancer

• After the diagnosis of renal cell cancer tests are performed for finding out if cancer cells have spread within the kidney or to any other regions of the body.

Stage I

In stage I, the tumour is about 7 centimetres and limited to the kidney.

Stage II

In stage II, the tumour becomes larger than 7 centimetres and is found only in the kidney.

Stage III

In stage III:

• In stage III, the tumour is of any size and cancer can be found only in the kidney & in the nearby lymph nodes; or
• This stage of Cancer is found in the main blood vessels of the kidney or in the layer of fatty tissue that surrounds the kidney.

Stage IV

In stage IV, cancer spreads past the layer of fatty tissue surrounding the kidney and may be found in the adrenal gland present above the kidney, or in surrounding lymph nodes; or Cancer reaches the bloodstream in the kidney or in the layer of fatty tissue around the kidney. Cancer may be found in the nearing lymph nodes.

Surgical resection(radical or partial nephrectomy) is the affirmed, often therapeutic, treatment option for stage I, and II renal cell cancer. The surgical intervention includes removal of perirenal fat,kidney, adrenal gland, and Gerota fascia, with or without a local lymph node dissection.

In patients suffering from bilateral stage I neoplasms (concomitant or subsequent), unilateral partial nephrectomy with contralateral radical nephrectomy or bilateral partial nephrectomy when technically possible, maybe a selected alternative to bilateral nephrectomy with either transplantation or dialysis.

Growing evidence implies that a partial nephrectomy is remedial in selected cases. A pathologist should review the gross specimen apart from the frozen section from the parenchymal margin of extraction.

Laparoscopic Radical/Partial Nephrectomy is the technique that gives patients a safe and effective way of removing a diseased or cancerous kidney. Laparoscopic nephrectomy refers to a minimally invasive technique, that gives patients less trouble and gives similar results as compared to the larger incision needed with traditional open surgery.

What is laparoscopic partial nephrectomy surgery?

Laparoscopic Partial Nephrectomy is a minimally invasive technique used extensively for removing a portion of the kidney, used basically as a treatment for primary renal tumours.

It is a safer and effective way of removing a small renal tumour while protecting the remaining kidney. This is a minimally invasive procedure, that provides less discomfort to the patients with comparable results like the traditional open surgery.