Minimally Invasive Procedures for Kidney Cancer & Prostate Cancer

Kidney Cancer
Kidney Cancer
Kidney Cancer

Kidney Cancer

Important: This article is not intended to replace a physician examination, review of your pathology report and consultation.

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Renal Cell Carcinoma: Diagnosis and Treatment

Renal Cell Carcinoma (RCC) is the most common type of kidney cancer in adults. In early stages, RCC does not usually give obvious symptoms. It is common that the cancer goes undiscovered until it is in its advanced stages.

Symptoms for RCC:

-Blood in the urine (hematuria)

-Pain in the sides of the mid back (the flank)

-A lump in the abdomen or side of the back

-Weight loss

-Pain in the back, side, or stomach

If you are having any of these symptoms, talk to your doctor.

RCC Diagnosis:

Surprisingly most kidney tumors are discovered incidentally with an imaging study such as an ultrasound or CT scan of the abdomen. Many of these patients do not have symptoms of RCC.

If you have symptoms of RCC, your doctor may determine it appropriate to order an ultrasound or a CT scan to look at the kidneys. Contrary to other cancers, it is NOT always necessary to have a biopsy to determine if you have RCC. The diagnosis sometimes can be based on how the tumor looks on a CT scan.

RCC Staging:

RCC Stages are based on:

-The size of the tumor

-Spread of cancer to the lymph nodes

-If there are signs of cancer in other organs

Typically, lower stage cancers are less aggressive or advanced and less likely to come back after treatment. Stages I, II, and III RCC are referred to as “localized” RCC while stage IV is referred to as “advanced” or “metastatic” RCC.

RCC Treatment:

Localized RCC

For most people with localized RCC the preferred treatment is surgery to remove part or all of the kidney (Partial or Radical Nephrectomy). For others, Robotic Partial Nephrectomy or cryoablation may be a more desirable treatment, however this decision should be made after careful physician’s review of the patient’s renal mass and other health conditions.

Advanced RCC

In cases of Advanced RCC, medicine (in pill or sometimes IV form) may be recommended for treatment instead of or in combination with surgery. In these cases, surgery may not cure the cancer, but it may help to reduce symptoms or delay systemic medical treatment. Advanced RCC is difficult to cure and many times patients are encouraged to enroll in a clinical trial.

After RCC Treatment:

For many with Localized RCC further treatment may not be necessary after surgery. However, it is important to see your doctor on a regular basis after being treated to check for signs that the cancer has returned. During a follow-up visit, you may have an exam, lab tests, and x-ray tests. Depending on the individual, follow-up tests may be needed every 6-12 months for at least 5 years.

 

Important: This article is not intended to replace a physician examination, review of your pathology report and consultation.

CLICK HERE to schedule your appointment today!

Benefits of Partial Nephrectomy

Hypertension, obesity, diabetes, smoking, and chronic kidney diseases are all risk factors for certain types of kidney cancer. Another type of kidney cancer that looks similar to bladder cancer is also related to smoking. Patients who have kidney cancer are generally not as healthy as kidney donor patients.

Every effort should be made when possible to remove part of the kidney (partial nephrectomy) instead of the whole kidney (radical nephrectomy) when the tumor is less than 7 cm in size and its position in the kidney allows partial removal of the kidney. This effort should be made because the kidney without a tumor may not last as long as a normal kidney, especially in patients who have the aforementioned risk factors (hypertension, obesity, diabetes, smoking, and chronic kidney diseases) which cause more "wear and tear" to the kidney without the tumor.

Partial nephrectomy can be done with an open incision, laparoscopically, or with the robot. Firefly is a visualization system that allows the blood vessels of the kidney to glow so they are more easily seen. In standard partial nephrectomy, the main renal artery is clamped and blood flow to the normal parts of the kidney is stopped. Sometimes the part of the kidney preserved may not function as well when the blood supply is stopped for long periods of time. With detailed dissection of the renal arteries, the segmental blood supply to the tumor can often be stopped leaving normal blood flow to the part of the kidney to be preserved. This is known as selective renal artery segmental clamping. An experienced renal surgeon can successfully remove the tumor and preserve the better part of the kidney. By doing so, studies have shown less coronary artery disease, less renal failure, less dialysis, and better quality of life in the years to follow.

 

Important: This article is not intended to replace a physician examination, review of your pathology report and consultation.

CLICK HERE to schedule your appointment today!

Risk Factors for Kidney Cancer: Obesity, Smoking, and Hypertension

 

  • Kidney cancers account for 2-3% of new cases of cancer in the US.

  • Obesity and hypertension have been implicated as risk factors for the development of renal-cell cancer.

Recent Studies Have Shown:

  • There is a direct association between higher blood pressures and a higher risk of renal-cell cancer.

  • The risk of renal-cell cancer is consistently higher in men with a higher BMI or higher blood pressure.

  • Current or former smokers have a greater risk of both renal-cell cancer and renal-pelvis cancer than men who were not smokers.

  • Higher BMI and elevated blood pressure independently increase the long-term risk of renal-cell cancer in men. Each of these factors may increase the risk of renal-cell cancer through different mechanisms.

  • Renal tumors in their early stages, before diagnosis, may cause increases in blood pressure, and consequently contribute to the apparent risk associated with hypertension during the initial years of follow-up.

  • Cigarette smoking increases the risk of both renal-cell and renal-pelvis kidney cancer, and the increase is greater for renal-pelvis cancer than for renal-cell cancer.

  • Control of weight, smoking cessation, and a reduction in blood pressure are crucial strategies to implement to lower the risk of developing and progressing kidney cancer.

 

 

Chow, W. et al. Obesity, Hypertension, and the Risk of Kidney Cancer in Men. N Engl J Med 2000;343:1305-11.

Important: This article is not intended to replace a physician examination, review of your pathology report and consultation.

CLICK HERE to schedule your appointment today!

The Nature of Kidney Cancer

  • All cancer is essentially genetic.

  • Kidney cancer is not a single disease but rather comprises a number of different types of cancer that occur in the kidney.

  • Each cancer in the kidney is caused by a different gene with a different histology, and each cancer requires different clinical courses and responds differently to therapy.

 

Hereditary Kidney Cancer Syndromes:

  • Familial clear cell renal carcinoma

  • Familial chromophobe kidney cancer

  • Familial type 1 and type 2 papillary kidney cancer

  • Familial nonsyndromic renal carcinoma

  • Tuberous sclerosis complex

Is Kidney Cancer a Metabolic Disease?

  • Several investigators have recently stressed the importance of metabolic pathways in cancer.

  • Each of the kidney cancer genes identified so far interact with cell metabolism pathways involved in energy, nutrient, iron or oxygen sensing.

  • Mutations in each of the 7 known kidney cancer genes (VHL, MET, FLCN, FH, SDH, TSC1 and TSC2) lead to the dysregulation of at least one metabolic pathway that is mediated by oxygen, iron, energy or nutrient sensing, which suggests that kidney cancer is a disease of dysregulated cellular metabolism.

  • Many studies have shown a significant association between BMI, obesity and the development of kidney cancer.  These factors once again indicate that kidney cancer is fundamentally a metabolic disease.

  • Targeting metabolic abnormalities provides a new paradigm that will hopefully provide more effective forms of therapy for patients with kidney cancer.

 

 

Linehan, W. M. et al. Nat. Rev. Urol. 7, 277-285 (2010); doi:10.1038/nrurol.2010.47

Modern procedures involving kidney operations minimize scaring by applying a Single Port Access Method to Surgery. The port of access is simply your belly button. Such a method is used for various procedures as well including: appendectomies, nephrectomies, adrenalectomies, among others. During the procedure all precautions are taken to ensure your comfort using general anesthesia with the visual precision of laparoscopic visualization. The benefits are less pain after the operation, minimal blood loss, and improved, faster recovery time.  Your cosmetic appearance is maintained as your belly button heals after the surgery and scarring is minimal if existent.

People with kidney cancer are often treated by a team of specialists, which may include a urologist, an oncologist, and a radiation oncologist. Kidney cancer can be treated with surgery, radiation therapy, biological therapy, chemotherapy, or hormone therapy.

Sometimes a special treatment called arterial embolization is used. Cryotherapy, a minimally invasive method, can also be applied. The doctors may decide to use one treatment method or a combination of methods. A consultation is best to discuss the severity of the treatment (based on the nature of the cancer) and the accompanying side effects.
 

 

The risk of kidney cancer increases with age, most likely occurring within the ages of 50 to 70 years of age. It affects twice as many men as women. External risk factors include:

  • Tobacco Use;
  • Obesity;
  • Occupational Exposure;
  • Radiation Exposure (x-rays taken after 1930 pose a very small risk);
  • Phenacetin drug use;
  • Dialysis;
  • Von Hippel-Lindauh (VHL) disease.

There are often no obvious symptoms in the early stages of kidney cancer. As the tumor grows however, symptoms often include:

  • Fatigue;
  • Loss of appetite;
  • Weight loss;
  • Recurrent fevers;
  • A pain in the side that doesn't go away; and/or
  • A general feeling of poor health

Advanced Symptoms may include:

  • Blood in the urine. Traces of blood may be intermittent and not always visible. Detection of blood in the urine may require urinalysis, a basic lab test.
  • A lump or mass in the kidney area.

Cysts or an infection may cause similar symptoms but only a doctor can make such a diagnosis. It is important to note that the early stages of cancer does not cause pain; do not wait to feel pain before seeing the doctor.

Map to El Paso Urology

El Paso Urology
4687 N Mesa, Suite 100
El Paso, TX 79912
Ph. (915) 532 3119
Fax. (915) 351 6048

Business Schedule

Monday 9:00AM - 5:00PM
Tuesday 9:00AM - 5:00PM
Wednesday 9:00AM - 5:00PM
Thursday 9:00AM - 5:00PM
Friday* 9:00AM - 2:00PM

*Friday by appointment only*