Why Choose Cedars Sinai Marina del Rey Hospital for Kidney Cancer Treatment?
With over 50 years of experience in providing quality healthcare to the community of Los Angeles, our hospital has the privilege of being equipped with state-of-the-art technology, by virtue of which our skillful and talented surgeons can offer you the treatment you need for kidney cancer. If you choose Cedars Sinai Marina del Rey Hospital for the treatment of kidney cancer, you will receive the healthcare you need in a warm and compassionate environment, as we always strive to create a comfortable and pleasant atmosphere for our patients.
The kidneys, which are located on either side of the spine in the mid-back region, have the purpose of removing water, excess salt, and waste products in the form of urine from the body. Consequently, they are vital organs and, since cancer can, unfortunately, occur anywhere in the body, the kidneys are no exception. By the end of 2021, approximately 73,750 people will have received a kidney cancer diagnosis in the United States and 13,780 will have lost their lives to the disease.
Kidney cancer is the sixth most common malignant disease in men and the eighth most common malignant disease in women. The lifetime risk of developing kidney cancer is 1 in 46 in men and 1 in 80 in women. Solid malignant tumors of the kidney are rare and for this reason, kidney cancer can easily spread to adjacent parts of the body.
There are numerous professionals involved in the treatment of kidney cancer, such as urologists, urologic oncologists, medical oncologists, radiation oncologists, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, and dietitians. They form a multidisciplinary team whose purpose is to design the most effective treatment plan for you, as every patient struggling with kidney cancer is unique and thereby requires a personalized therapeutic approach. When kidney cancer is found in the early stages, active surveillance may be recommended, which means that your doctor will ask you to come to frequent appointments in order to monitor the progress of your disease. Active surveillance is very effective for older adults and people who have a small renal tumor and other serious medical conditions, such as heart disease, chronic kidney disease, or severe lung disease. However, if kidney cancer seems to develop at a fast rate, you may be advised to undergo surgery, which will remove the malignant tumors. There are multiple types of surgery used for the treatment of kidney cancer, such as:
- Radical nephrectomy: During this surgery, the kidney affected by cancer will be removed, as well as the surrounding tissue. If the nearby lymph nodes are also damaged by cancer, a lymph node dissection will be performed along with a radical nephrectomy. During a lymph node dissection, the lymph nodes affected by cancer are removed. If kidney cancer has spread to the adrenal gland or to the nearby blood vessels, the surgeon will remove the adrenal gland during a procedure known as adrenalectomy, as well as certain parts of the blood vessels. Radical nephrectomy is usually employed to treat a large tumor when there is not much healthy tissue left. Sometimes, the malignant tumor will grow directly inside the renal vein and enter the vena cava on the way to the heart and, if this is your case, a complex cardiovascular surgical technique will also be necessary.
- Partial nephrectomy: With partial nephrectomy, only the malignant tumors that have grown on the kidney will be removed. The benefit of this procedure is that it preserves kidney function and reduces the risk of developing chronic kidney disease following surgery. Partial nephrectomy is very effective in treating early-stage kidney cancer when the surrounding tissue has not been damaged by cancer. This procedure may be minimally invasive for certain patients, depending on the size of the tumor and their general health.
- Laparoscopic or robotic surgery: These are minimally invasive surgical techniques used to remove the malignant tumors from the kidney when cancer has not spread to other parts of the body. They have numerous benefits, such as a low risk of postoperative complications, a faster recovery, a shorter hospital stay, minimal scarring, and less bleeding during surgery. However, it is important to keep in mind that not every patient with early-stage kidney cancer will be eligible for minimally invasive procedures, as large tumors can be removed only by using traditional surgical approaches.
For kidney cancer, non-surgical treatments are also available and are usually recommended to people whose malignant tumors cannot be removed through surgery for various reasons, such as poor health, which increases the risk of postoperative complications. The following are 2 of the most effective non-surgical treatments for kidney cancer:
- radiofrequency ablation: this procedure entails the insertion of a needle into the malignant tumor to destroy the cancer with electrical current and is performed by interventional radiologists or urologists after the patient is given local anesthesia so that they will not experience any discomfort or pain
- cryoablation: also known as cryotherapy or cryosurgery, cryoablation implies the freezing of malignant cells with a metal probe inserted through a tiny incision, and the patient is given general anesthesia before the procedure, which is carried out by interventional radiologists
As it is the case of the majority of cancers, chemotherapy is another effective treatment, which involves the patient receiving medication to destroy or keep the malignant tumors under control in the form of a pill or intravenous injection. A chemotherapy regimen usually consists of a specific number of cycles given over a set period of time. The patient may receive one drug at a time or a combination of different medications given at the same time. The following chemotherapy drugs have proven to be effective for the treatment of kidney cancer so far:
It is worthy of note that transitional cell carcinoma, also known as urothelial carcinoma, does not usually respond well to chemotherapy. For patients with this type of kidney cancer, there are other effective treatments available.
Radiotherapy is another treatment for kidney cancer, although it is rarely employed because it is usually not very effective in keeping malignant tumors under control or destroying cancerous cells. Thereby, it is not used as a primary treatment for kidney cancer, as it would greatly damage the healthy tissue of the kidneys. In the majority of cases, if a patient with kidney cancer receives radiotherapy, it is delivered to other areas of the body to which cancer has spread and not to the kidneys themselves.
People with kidney cancer can also undergo targeted therapy, which prevents the growth and spread of malignant cells by targeting the specific genes, proteins, or the tissue environment of the cancer. For kidney cancer, the following targeted therapies are available:
- Anti-angiogenesis therapy: This treatment focuses on preventing angiogenesis, which is the process of creating new blood vessels that supply blood to the malignant tumors in the kidneys. One antibody known as bevacizumab was found to slow tumor growth for people with metastatic kidney cancer. In combination with interferon, this antibody slows tumor growth and spread.
- mTOR inhibitors: Everolimus and temsirolimus are two medications that target a certain protein that promotes the growth of kidney cancer, which is known as mTOR. Medical studies found that these two drugs slow kidney cancer growth considerably.
- Combined therapies: The Food and Drug Administration approved 2 drug combinations for the treatment of kidney cancer in 2019. While the first combination involves axitinib and pembrolizumab, the second entails the use of axitinib and avelumab.
Lastly, immunotherapy is another treatment that can be very efficient in keeping malignant tumors under control in people with kidney cancer. There are multiple types of immunotherapy, such as:
- Interleukin-2: This is a type of immunotherapy that is used to treat late-stage kidney cancer and involves a cytokine, which is a protein released by white blood cells. It plays a crucial role in the function of the immune system, including in the destruction of malignant cells.
- Alpha-interferon: This immunotherapy is employed to treat kidney cancer that has spread to other parts of the body. Interferon seems to change the proteins on the surface of malignant cells and inhibit their growth. Even though it has not proven to be as beneficial as IL-2, alpha-interferon was found to prolong the lives of patients who struggle with kidney cancer when compared with the older treatment known as megestrol acetate.
- Immune checkpoint inhibitors: The Food and Drug Administration has recently approved a combination of 2 immune checkpoint inhibitors, namely nivolumab and ipilimumab, for the treatment of certain patients with late-stage kidney cancer who have not been previously treated. Nivolumab may also be used in conjunction with cabozantinib as a first-line treatment for advanced kidney cancer. Furthermore, the agency also approved combinations of the checkpoint inhibitor pembrolizumab or avelumab and targeted therapy, axitinib, as a first-line treatment for people with advanced kidney cancer.
There are multiple types of kidney cancer, depending on the malignant cells that form the tumor, namely:
- renal cell carcinoma (adenocarcinoma): as the most common type of kidney cancer, renal cell carcinoma accounts for approximately 85% of cases and develops in the proximal renal tubules that constitute the filtration system of the kidneys
- urothelial carcinoma (transitional cell carcinoma): this type of kidney cancer is responsible for 5% to 10% of cases and begins in the portion of the kidney where urine collects before moving to the bladder, known as the renal pelvis
- Wilm’s tumor (nephroblastoma): this form of kidney cancer is most common in children, accounts for only 1% of cases, and usually responds best to radiotherapy and chemotherapy
- sarcoma: while this type of kidney cancer is rare, it can still occur in certain patients and develops in the soft tissue of the kidney, usually being treated with surgery
- lymphoma: this malignant disease, which can also affect the kidneys, leads to the enlargement of both kidneys and is associated with enlarged lymph nodes, a condition known as lymphadenopathy, in other parts of the body, including the neck, chest, and abdomen
Symptoms of Kidney Cancer
Timely recognizing the symptoms of kidney cancer may lead to a favorable prognosis, as you will receive the treatment you need within the shortest time possible. The following are the most common symptoms of kidney cancer, regardless of the type of malignant cells involved in the tumor:
Diagnosis of Kidney Cancer
There are multiple effective tests and exams that you can undergo in order to confirm or deny the presence of kidney cancer in your body, such as:
- A physical exam: During a physical exam, the doctor will ask you about your health history and the symptoms you are currently experiencing. They will also examine your lower back and abdomen for a lump and will check whether certain risk factors that could have led to your kidney cancer are present in your life.
- Blood tests: While blood tests alone cannot confirm or deny the presence of kidney cancer, they are very useful in assessing your health. They include tests such as complete blood count, which measures the number of different cells in the blood. Usually, the results of this blood test are abnormal in people with kidney cancer. Another useful blood test for people in whom kidney cancer is suspected is blood chemistry tests, which are conducted because the presence of cancer often alters the chemicals in your blood. Furthermore, after a blood chemistry test, high blood calcium levels may be found, which may indicate the occurrence of kidney cancer and will often lead to your doctor ordering imaging tests. Lastly, blood chemistry tests also measure kidney function, which is particularly important if certain imaging tests or surgery is planned.
- Urine tests: There are special tests are conducted on urine samples to identify small amounts of blood and other substances that cannot be seen with the naked eye. Approximately half of the people with kidney cancer will have blood in their urine. If the patient has transitional cell carcinoma, a special test of the urine sample, known as urine cytology, will show whether there are malignant cells in the urine.
- CT scan: This imaging test uses X-rays to provide your physician with clear, high-quality images of the inside of your body. The presence of a tumor on your kidney will be visible during computed tomography and, thereby, the doctor will be able to assess the size of the malignant growth and whether it has spread to adjacent parts of the body.
- MRI scan: If the patient cannot receive the contrast agent used during computed tomography due to allergic reactions, they will undergo magnetic resonance imaging, another useful test that will help the doctor evaluate the size of the tumor and whether it has metastasized. Unlike computed tomography, this test uses strong magnetic fields and radio waves, which means that the patient will not be exposed to radiation.
- Ultrasound: This is another useful test in assessing whether there is a malignant growth on one of your kidneys, as well as whether it is solid or filled with fluid. It will help the doctor tell the difference between a benign and a malignant kidney tumor.
- Angiography: Before angiography, a special dye will be injected into the renal artery, which will highlight the blood vessels. Afterward, the doctor will use X-rays to examine the kidney area for the presence of a tumor.
- A biopsy: During a biopsy, a sample of tissue from the tumor is collected and is subsequently sent to a laboratory to be examined by a pathologist. They will be able to confirm or deny the presence of malignant cells in the tumor, as they specialize in recognizing cancerous cells.
While the exact cause of kidney cancer has not yet been found by medical researchers, there are a series of factors whose presence can increase the risk of developing kidney cancer, such as:
- smoking: because tobacco smoking can affect nearly every organ in the body, the kidneys are no exception, and this habit may thereby be very detrimental to the health of the kidneys
- obesity: people who are overweight or obese have a higher risk of developing kidney cancer, as their kidneys have to work additionally to release waste products from their bodies
- high blood pressure: suffering from high blood pressure can greatly affect the kidneys, as their blood vessels can become damaged over time
- a family history of kidney cancer: people whose immediate family members have had a diagnosis of kidney cancer have a greater risk of receiving the same diagnosis
- dialysis: undergoing dialysis, the treatment for chronic kidney disease, for a long time is associated with a high risk of developing kidney cancer
- being elderly: as you age, the risk of coming to struggle with kidney cancer increases
- certain inherited syndromes: people with inherited syndromes such as von Hippel-Lindau disease, Birt-Hogg-Dube syndrome, tuberous sclerosis complex, hereditary papillary renal cell carcinoma, or familial renal cancer have a greater risk of developing kidney cancer
A study published in the medical journal Pharmacognosy Magazine in 2011 found that honey induces apoptosis, the death of malignant cells, in people with renal cell carcinoma. Therefore, including this food in your daily diet may be a good idea if you struggle with kidney cancer. Furthermore, eating whole wheat bread, wild rice, and whole wheat pasta can also help you, as they contain fiber, iron, and vitamin B. Nevertheless, you should limit the amount you are consuming, as some of these foods are also rich in phosphorus and potassium, which can lead to problems if your kidneys are not functioning properly. As for the foods you need to avoid if you have kidney cancer, these are:
Although you cannot prevent the onset of kidney cancer if you have a predisposition to it, there are certain measures you can take to lower your risk of developing the disease, such as: