What Are MIIPs? / Kidney Cancer
My uncle was just told he has kidney cancer. How common is that?
In 2016, over 60,000 new cases of kidney cancer will be discovered in the US. Over 14,000 people will die from kidney cancer. It's one of the 10 most common cancers. About one in 63 people will get it in their lifetime. It's usually discovered in older people, average age 64. It's rare in people under 45. It's more common in men than women. African Americans and Native Americans get it a little more often than Caucasians.
What causes it?
Tiny changes in the cells that make up the kidney cause the cancers to grow. These are called genetic mutations. They can be handed down to a person from their parents or can be caused by other things, like smoking, being overweight, high blood pressure, bad kidney disease, certain chemicals or medications.
How do I know if I have it?
If the cancer is small, you may not notice anything. As it gets bigger, it can cause pain or a lump in one side of the stomach or back, blood in the urine, loss of appetite, low energy, weight loss, fever, or low blood count. A simple urine test can tell if you have blood in your urine. Different types of scans, like ultrasound, CT, or MRI can also find kidney cancer. Many times, kidney cancer is found unexpectedly when one of these scans gets done for a completely different reason.
Let's say I find out that I have kidney cancer. Now what?
The key to surviving kidney cancer is catching and treating it early. If the cancer is small and just in the kidney, your chance of living a long life is high. This goes down as the cancer gets bigger or has spread to other parts of the body. Usually people with kidney cancer get sent to a Urologist, a surgeon who specializes in treating the kidneys and other parts of the urinary tract.
What kind of treatment would I need?
It depends on the stage of the cancer. The stage depends on how big the cancer is, how fast it’s growing, and whether it has spread to other parts of the body. If the cancer is really small, your doctor may just want to watch it for a while to see if it’s growing. But the regular treatment for kidney cancer is surgery. The Urologist would take out either the whole kidney with the cancer or, if the cancer is small, part of the kidney with the cancer and leave the normal part of the kidney inside. Depending on how bad the cancer is, you might also need radiation or chemotherapy, or both.
Are there alternatives to surgery?
If the cancer is small and just in the kidney, it often can be treated by putting a special needle in it through the skin. The cancer is then killed by freezing it or heating it up through the needle. This procedure is called PERCUTANEOUS CRYOABLATION (freezing), RADIOFREQUENCY ABLATION (heating with electricity), or MICROWAVE ABLATION (heating with microwaves).
That sounds cool. How does it work?
The procedure is done by a specialized doctor called an Interventional Radiologist, or "IR" for short. She or he is trained to do special treatments, usually through needle punctures through the skin, using X- rays or some other kind of medical scan as a guide. For this procedure, usually a CT scan or ultrasound is used to see the cancer inside the kidney.
Before treatment, a tiny piece of the cancer is usually taken through a small needle, either on a different day or right before treatment. It's also done using CT or ultrasound (sometimes MRI) as a guide.
Sometimes, if the cancer has big blood vessels feeding it, they might need to be blocked first to prevent bleeding. For this procedure (called embolization), the IR would put a small plastic tube through a needle puncture into the artery of your arm or upper leg. Then the IR would look with X-rays while moving the small tube into the artery bringing blood to the cancer, then block that artery with a special plug delivered through the tube. The tube comes out afterward.
Will it hurt?
The IR will numb up the area to be worked on with a shot of local numbing medicine. You will usually also get extra pain medicine and medicine to make you sleepy through an IV placed in a vein in your arm at the start of the procedure. After that, you probably won't feel much of anything during the treatment.
Is it dangerous?
Because the IR is specially trained to do these kinds of treatments, the risks are very low. It depends on what your cancer looks like, where it is in the kidney, and what other organs are close to the cancer.
The IR first looks at your scans very carefully before getting started and decides what the best and safest treatment will be. It's always good to talk with the IR about the risks before the treatment.
How well does it work?
When the right cancers are picked for this kind of treatment, better than 9 out of 10 tumors are completely killed. Even if some cancer is left over, most of the time it can be killed with a second treatment. Though it's uncommon, this treatment doesn't work for everyone, and those people might then need to have surgery.
What happens to me afterward?
Most of the time you can go home the same day, after 4 to 6 hours of rest in the hospital. The nurse in charge of you watches to make sure you don't have any complications. You will probably have some pain afterward that could last for several days to a week or more, but your nurse can give you pain medication in the hospital and you'll have more to take home with you. It's best to take it easy for a week or so after--no sports, heavy exercise or heavy lifting. After that, most people can get back to their normal routine pretty quickly. And you'll need to get a follow-up CT or MRI scan in one to several
months after the treatment to make sure all the cancer is gone. After that, you may get a CT or MRI scan every 6 to 12 months for a while until your doctor is confident that the cancer has not come back.
How can I learn more?
Talk to your doctor, a Urologist, and an Interventional Radiologist. You can also get more information at: