- The main mistakes made by physicians and patients in the diagnosis and treatment of a malignant kidney formation
- How can we help in your specific case?
- What shortens the life of a kidney cancer patient?
- What complications are possible when postponing the examination and treatment?
- Kidney cancer therapy
- What complications develop with postponement of radical treatment of a renal cell malignancy?
- Kidney cancer: what to do next?
- Tumors can be benign and malignant
- Treatment stage one — surgery
- When is laparoscopic resection indicated?
- How to prepare for a laparoscopic resection?
- Consultation before surgical intervention
Expert medical assistance:
at stage 1:
method choice — an organ preservation surgery,
kidney preservation surgeries,
discharge on the 3rd day after surgery,
at stage 2:
method choice — a radical surgery,
minimally invasive surgeries,
discharge on the 5th day after surgery,
at stage 3:
method choice — a radical or cytoreductive surgery,
discharge on the 15th day after surgery,
at stage 4:
method choice — a radical or cytoreductive surgery,
discharge on the 30th day after surgery,
Cancer, cyst or benign tumor — you don’t know what’s been found on your ultrasound or MRI? You are looking for a reliable doctor?
- You are troubled, what is the correct diagnosis?
- is it possible to preserve the organ?
- do you need chemotherapy?
- how should you live from now on?
We have already helped hundreds of patients: we will personally analyze your case, develop a detailed treatment plan until full recovery, prepare the surgery and successfully perform it.
Clarify your diagnosis, get a plan and start treatment without delay and queues
The main mistakes made by physicians and patients in the diagnosis and treatment of a malignant kidney formation
- The main contingent here is a smoking man over 65 years old who avoids regular medical
check-upsand is overweight.
- Condition symptoms may be absent for a long time. In most cases, kidney neoplasms are discovered quite by chance in the course of an ultrasound scan prescribed for another disease, or in a physical examination.
- The factors not taken into account are the patient’s heredity that quadruples the probability of the disease, and the national predisposition, since the northern peoples are affected more often.
- A gene mutation of the third chromosome that is clinically manifested by subdued symptoms during adulthood is not diagnosed.
How can we help in your specific case?
Professional expert opinion or a case conference based on your medical records:
- Absentee consultation,
- Expert conclusion based on medical records.
Complete examination at the day of visit:
In-personconsultation with physical inspection and uroflowmetry,
- MSCT with contract enhancement,
- MRT with contract enhancement,
- Laboratory testing for oncomarkers,
- Diagnostics of related conditions.
Operative therapy of kidney neopasms:
- Open surgery,
- Radical nephrectomy,
What shortens the life of a kidney cancer patient?
During the span of life of a single human generation, the incidence of the condition has doubled, but the reasons for development of the malignant process have not become more clear.
There are no tumor markers that allow to diagnose renal cell carcinoma by a blood test or monitor the course of the disease, only a biopsy will give an accurate diagnosis.
What complications are possible when postponing the examination and treatment?
This disease is characterized by three clinical signs, but the presence of all the symptoms in the triad is not necessary:
- Presence of blood in the urine from detection of red blood cells in lab tests to «bloody» urine.
- Palpable tumor in the abdomen on the navel level.
- Pain in the back or hypochondrium unrelated to movement or load.
Signs that do not belong to typical symptoms but are often found in different combinations:
- An increased blood pressure which the patient absolutely does not feel.
- A persistent and «causeless» increase in temperature in the absence of any inflammation signs.
- An increase in vascular pattern and dilation of superficial veins of the testicle (varicocele).
- Decrease in red blood cells and hemoglobin levels in the blood (anemia).
- Blood coagulation with a significant increase in the level of red blood cells (polycythemia).
- Weight loss without reducing the amount of food consumed.
- Diffuse muscle pain and weakness.
The average survival rate with timely correct treatment of stage I and II kidney oncology:
Five-yearlife expectancy — 95%.
- Average life duration — 15 years.
The average survival rate with erroneous and belated treatment of stage III and IV kidney oncology:
Five-yearlife expectancy — 5%.
- Average life duration — 1.5 years.
Kidney cancer therapy
Today, there are effective drugs and innovative alternative surgical techniques, but only a timely surgery, a partial or complete organ removal, can heal renal cell cancer.
When the neoplasm is of small size (up to 7 cm), the distant results of partial excision (resection) and complete organ removal (nephrectomy) are the same.
If the second kidney performs its function not good enough, then the kidney affected by cancer is not removed entirely, only the affected area is excised.
The operation is performed using endoscopic laparoscopy or traditional incision in the lumbar region. The difference between them is not only visual, but determines also the duration of rehabilitation.
When the operation is impossible for technical reasons, alternative methods are used such as
At the metastatic stage, the affected organ is removed and all secondary formations in other organs are surgically excised. Additional chemotherapy with targeted drugs after surgery is necessary, as it can stop the disease spreading.
What complications develop with postponement of radical treatment of a renal cell malignancy?
- The speed of the malignant process is individual, but the growth of a cancer conglomerate will inevitably affect the inferior vena cava, and compression of the largest vessel will result in edema of the abdominal wall, on which a venous pattern called cirsomphalos appears, and ascites fluid will accumulate in the abdomen.
- Growth of the tumor into the vena cava is accompanied by formation of a blood clot, and its breakaway is fraught with death caused by pulmonary embolism or stroke.
- Kidneys synthesize the hormone erythropoietin, its insufficient production due to organ destruction leads to a severe and unremediable anemia, in which surgical intervention is intolerable, because even a small blood loss cannot be replaced by transfusions, and chemotherapy is impossible as it «kills» blood cells.
- The growth of a tumor conglomerate is accompanied by disintegration of tissues in the central part of the node, toxic products of which are absorbed into the bloodstream, causing cachexia, a severe intoxication with febrility and exhaustion.
Kidney cancer: what to do next?
Your doctor has just told you that you have a tumor. This is the moment when you need to think sensibly, despite your strong emotions.
Depending on the country, the disease ranks 10 to 14 in terms of prevalence among oncological conditions. Moreover, in recent years there has been a significant increase in its incidence due to spread of radiodiagnostics possibilities. Recent advances in the field of diagnostics, surgical and medical treatment allow increasingly more patients to live with this condition maintaining a high quality of life and not changing their lifestyle.
The global approval of new drugs for treatment of oncological conditions, even in their later stages, marked the beginning of a new era for cancer patients.
Tumors can be benign and malignant
Benign tumors are not cancer and are rarely
A malignant tumor is a more serious condition than a benign neoplasm. A malignant tumor can be removed, but there is a risk of its
Treatment stage one — surgery
What is laparoscopic resection or complete kidney removal?
Laparoscopic resection is also called laparoscopic partial nephrectomy. This is to differentiate it from radical nephrectomy. Nephrectomy means removal of the entire organ. Partial resection removes only a portion.
Previously, resection was performed openly, but in an attempt to reduce injury associated with open surgery, surgeons developed laparoscopic techniques for partial nephrectomy.
When is laparoscopic resection indicated?
In patients with tumors at stages T1 and T2 (a localized tumor that does not extend beyond the organ), surgical intervention is an effective treatment method that provides a
Previously, resection for cancer was indicated only to patients with a single kidney, poor function of both kidneys, or with a bilateral malignant process lesion. All other patients underwent radical nephrectomy. However, since the 1990s, the indications for this intervention have expanded and partial nephrectomy surgery has been approved for the treatment of patients with small tumors (T1 and T2).
Thus, laparoscopic resection represents an
To date, the vast majority of studies have shown equivalent efficacy in patients who underwent radical nephrectomy or kidney resection.
How to prepare for a laparoscopic resection?
Once the date of surgery is determined, you will be instructed on how to properly prepare for it.
Firstly, before the surgery you will need to undergo a standard examination including physical inspection and the following tests:
- General analysis of blood and urine;
- Biochemical blood assay;
- Blood coagulation profile;
- Tests for HIV, syphilis, hepatitis B and C;
- Tests for blood type and Rh;
- Abdominal and retroperitoneal ultrasound examination;
- Bleeding time or coagulogram.
If necessary, your physician may prescribe additional examinations. You can undergo a medical examination on an outpatient basis, that is, at a polyclinic a few days before hospital admission.
If you have previously been prescribed blood thinning drugs, you should stop taking them a week before the surgery, this will reduce the risk of bleeding during the operation and after it. If drug withdrawal is not possible, then prior to surgery you should consult a cardiologist to address this problem.
Intestinal cleansing is an important component of preparation for laparoscopic kidney removal. Laxative drugs and cleansing enemas on the eve of the operation help reduce intestinal gas content and avoid intestine damage during installation of trocars. To this end, we usually prescribe laxatives with osmotic properties. The dosage is selected per kilogram of body weight.
In the case of abundant hair on the abdomen and lower back, it is desirable to shave it on the eve of the operation.
Consultation before surgical intervention
Immediately before the surgery, you will meet your surgeon. At the consultation, you will discuss possible risks and complications. In addition, the surgeon will warn you that in certain cases it may be necessary to switch in the course of operation from laparoscopy to open kidney removal. Such a probability usually exists in 5% of cases, while previous inflammatory processes in the abdominal cavity or abdominal surgeries increase this risk. At the consultation you can ask the surgeon any questions you may have. At the end of the conversation, you will need to sign an informed consent for surgical treatment.
An anesthesiologist will also have a talk with you before the operation. He will also provide you with complete information about the forthcoming anesthesia, its risks and complications, and will answer all your questions. At the end of the conversation, you will sign an informed consent for the anesthesia.
Hospitalization is usually carried out one day before the surgery, meaning you will spend the night in the hospital. Sometimes hospitalization is permissible on the day of surgery, at the physician’s discretion. You need to take toiletries, personal hygiene items, maybe individually prescribed drugs that you take all the time. On average, the inpatient stay amounts to 5–7 days.
This text is based on the materials of NCCN (National Cancer Comprehensive Network).
- Frank M. A., Sanzharov А. Е., Shamuratov Sh. Sh., Uss А. G., Kapustin К. I., Panshyn S.
v. ,Sorochkin D. А. Laparoscopicoperations in treatment of renal cancer (In Russian) // Bashkortostan Medical Journal. 2013, No. 2.
- Shaplygin Leonid Vasilyevich, Olefir Yury Vitalyevich, Kozlov Sergey Vasilyevich, Gorbachev Andrey Lvovich, Evseev Dmitry Sergeevich Surgical treatment of locally advanced kidney cancer (In Russian) // Medical Almanac. 2012, No. 4.
- Loran O. B., Seregin А.
v. ,Shustitskiy N. А. Technicalpeculiarities during organ-preservingsurgery for kidney cancer (In Russian) // Bashkortostan Medical Journal. 2013, No. 2.
v. I.,Starinskiy v. V.,Pertova G. v. Malignantneoplasms in Russia in 2008 (In Russian) // Moscow, Moscow Scientific and Research Oncological Institute, 2010, 196 pp.