The two kidneys present in the abdomen, clean the blood of the various harmful metabolic products such as urea, creatinine, and keep a balance of water and other electrolytes in the body.
Cancer of the kidney are:
1. Hypernephroma
2. Wilm’s tumour
Hypernephroma is found in adults and older age-group people. Wilm’s tumour occurs more often in children.
Hypernephroma
Causes
It is not known. Smokers suffer from kidney cancer five times more than the non-smokers. Some chemicals used in the industry also can cause it. It occurs more often in males, after the age of 50 years.
Symptoms
· General ill health in the early stages.
· Loss of weight.
· Loss of appetite.
· Blood in urine.
· Fever of unexplained origin.
· Pain in the abdomen.
Diagnosis
· Routine: History taking.
· Blood: Hb, TLC, DLC, ESR may show no significant change.
· Urine : Usually shows presence of red blood cells in it. Special: Ultrasound scan of the kidney. CT scan of the kidney. Intravenous pyelogram.
· Fine needle aspiration biopsy of the kidney and its examination for cancer cells establishes the diagnosis.
· Additional: Bone scan and lung X-ray and scan, to see if the tumour has spread in these parts.
Treatment
· Surgery: If the tumour has not spread beyond the kidney, removal of the diseased kidney can cure the patient. The other normal kidney can look after the function of the both.
· Radiation: If the cancer has spread to bones or other parts, radiation may relieve symptoms.
· Hormones: In advanced cases of cancer, giving female sex hormone progesterone, or male sex hormone (androgen) may help in reducing the size of the cancer.
· Chemotherapy: It is not helpful.
Prognosis
The outlook is variable. Sometimes spontaneous remissions occur. At other times, the patient may continue living for years.
Wilm’s Tumour
It is a cancer of the kidney, occurring more often in children between the ages of 1 to 5 years.
Causes
It is not known.
The children who suffer from this cancer, often have partial or complete absence of the iris of the eye-balls, have abnormalities of the urinary system, i.e. in kidneys, ureters or the bladder.
Symptoms
· A firm irregular, non-tender lump in the abdomen.
· Abdominal discomfort.
· Blood in the urine.
· Fever.
· Loss of appetite and weight. Sometimes it is discovered accidentally by the patient. Blood in the urine occurs late in the disease.
Diagnosis
· Routine: History taking
· Blood: Hb, TLC, DLC, ESR may show no change.
· Urine : Presence of red blood cells.
· Special: Plain X-ray of the abdomen.
· IVP of the kidneys.
· Ultrasound of the abdomen.
· CT scan of the abdomen.
· Fine needle aspiration biopsy of the kidney, establishes diagnosis.
· Additional: X-ray chest and bones. CT scan of the chest, liver and suspected bones, to locate the spread of cancer.
Treatment
Surgery: It is the treatment of choice for a cancer which is still localized to the kidney. Removal of the involved kidney, provides a cure.
Radiation: It is usually given after the operation, when it is suspected that the complete removal of the cancer has not been possible.
Chemotherapy: This treatment is given along with radiation in cancer suspected to have spread around. Actinomycin-D has been given successfully in these cases. Adriamycin and Vincristine have also been used lately with good results. Chemotherapy is started soon after the surgery and is continued on intermittently for a period up to 15 months.
Prognosis
The chances of cure are the best in children under 2 years of age, where the cancer is still confined to the kidney. Up to 80 per cent of the patients get cured after chemotherapy treatment.
Early Detection
Signs & Symptoms
· Pain in the abdomen.
· Fever.
· Loss of weight.
· Presence of blood in the urine.
Investigations
· Ultrasound and CT scan of the kidney
· Fine needle aspiration biopsy of the kidney and its examination.