What is Renal Cell Carcinoma (RCC)?

Renal cell carcinoma (RCC) is the most common form of kidney cancer. It starts in the tiny tubes inside your kidneys called tubules. These tubules are vital because they help your body by moving water and nutrients into your blood while filtering waste out through your urine. RCC is responsible for up to 85% of all kidney cancers.

Usually, RCC begins as a single lump or tumor of cancer cells in one kidney, but sometimes a person can have several tumors in one or both kidneys.

What are the types of Renal Cell Carcinoma?

Clear cell renal cell carcinoma is the most frequent type of RCC. Beyond ccRCC, there are over 50 other types, though most are rare. Doctors and researchers classify these types in different ways, for example, by how the cells look under a microscope and by their genetic makeup (their DNA).

Some of the more common types of RCC are:

• Clear cell renal cell carcinoma (ccRCC): This subtype makes up 85% of all RCC cases. It's named this way because the cells in the tumor look clear when seen through a microscope.
• Papillary renal cell carcinoma: accounts for 10% to 15% of all RCC. It's called this because most of these tumours have finger-like growths (papillae) visible.
• Chromophobe renal cell carcinoma: This type makes up 5% to 10% of RCCs. The cells are usually light-colored, similar to those in clear cell carcinoma but typically larger.
• Unclassified RCC: About 6% of RCCs don't fit a specific category. Researchers are continuously developing new methods to further divide this group based on the unique microscopic appearance of the cancer cells, including their DNA.
• Medullary Renal Cell Carcinoma
• Collecting Duct Carcinoma (CDC)

Your doctor will describe RCC as either localised or advanced (metastatic). Localised RCC remains in the kidney and sometimes the surrounding tissues, while metastatic RCC has spread to other parts of your body. The treatments and outlook for a person with metastatic RCC are very different depending on their type.

How common is renal cell carcinoma?

Each year, 80,000 new cases of RCC are diagnosed in the United States, and 400,000 new cases are found globally. Although anyone can get RCC, it is most common in men between 60 and 80 years of age.

What are the symptoms of renal cell carcinoma?

Most people don't experience any symptoms during the early stages of RCC. If symptoms do occur, they are usually related to how the growing tumor is affecting nearby tissues or organs.

Symptoms of renal cell carcinoma may include:

• The presence of blood in your urine (hematuria).
• Pain in your side (the area between your hips and ribs).
• A firm lump in your abdomen, lower back, or side.
• A fever.
• Night sweats.
• Unexplained weight loss.

You might also feel symptoms of anemia, such as shortness of breath and weakness. In some cases, you could have symptoms of paraneoplastic syndromes, which happen when tumors release chemicals, like hormones, causing changes in your body.

What causes renal cell carcinoma?

RCC develops when abnormal kidney tubule cells start to grow uncontrollably. The exact reasons for this are unknown, but researchers have identified some factors that increase a person's risk of developing RCC.

What are the risk factors for Renal Cell Carcinoma?

The risk factors for renal cell carcinoma are:

• Smoking: Your risk increases with the more of smoke you consume.
• Obesity: Your risk increases with your Body Mass Index (BMI).
• High blood pressure (hypertension).
• Chronic kidney disease: This can involve long-term treatment with dialysis.
• Chronic hepatitis C infection.
• Long-term use of certain pain medications: These include NSAIDs and acetaminophen.
• Previous radiation treatment to the abdomen.
• Exposure to cancer-causing materials (carcinogens): Examples include cadmium and asbestos.
• Sickle cell disease: Linked to a rare form of RCC.
• Family history of kidney cancer.
• Genetic mutations: Changes in your cell DNA.
• Tuberous Sclerosis Complex.
• Von Hippel-Lindau disease (VHL).

If you have a condition or a family history that makes you more likely to develop kidney cancer, your doctor may suggest regular screenings to find tumors when they are still small.

How is renal cell carcinoma diagnosed?

Up to 25% of people with RCC are not diagnosed until the cancer is more advanced, which is typically when symptoms begin to appear.

However, doctors are now more frequently discovering tumors by chance while performing imaging tests for other conditions, before the patient ever develops symptoms. This means more patients are being treated early on, when the cancer is most likely to respond to therapy.

What tests are used to diagnose renal cell carcinoma?

Doctors use imaging exams to find tumors and create a treatment plan. The most common tests are:

• Ultrasound: High-frequency sound waves are used in this test to produce images of your body's tissues on a screen. An ultrasound can show whether a tumor is mostly fluid (which is normal for a cyst) or solid tissue (which is the case for most cancerous tumors).
• Computed tomography (CT) scan: This scan takes a series of detailed pictures of the inside of your body. You will likely have a scan before and after receiving a contrast dye injected into a vein. The dye highlights the tumor, which shows up in detail.
• Magnetic resonance imaging (MRI): This test uses a large magnet, radio waves, and a computer to create detailed pictures. An MRI is needed if you cannot have a CT scan (for example, if you are allergic to the dye) or if the results from an ultrasound and CT scan are not clear.

Although biopsies are a routine part of many cancer diagnoses, they are not typically done for renal cell carcinoma. A biopsy is when a doctor takes a small tumour tissue sample to examine under a microscope for cancer cells.

A biopsy for RCC is often considered too risky because it could damage the kidneys. Instead, doctors usually analyse the tumor cells after the entire tumor has been surgically removed during treatment. If imaging shows that the cancer has spread, they may take a tissue sample from another area of your body for testing.

By studying the cells, doctors can determine the specific type of RCC (if it wasn't already clear from the imaging) and which treatments would work best for that particular cancer.

What are the stages of Renal Cell Carcinoma?

Cancer staging assists your doctor in assessing the stage of your cancer. It shows if the cancer has spread (metastatic) or is confined. Planning your course of treatment and comprehending your prognosis—the expected result of your treatment—require this information.

Doctors use the TNM (tumor, lymph node, metastasis) staging system to stage RCC, which is assigned a stage from I to IV. Stages I through III are localised, while Stage IV is metastatic RCC.

• Stage I RCC: The tumor is smaller than 7 centimeters and is only inside your kidney.
• Stage II RCC: The tumor is larger than 7 centimeters and is only inside your kidney.
• Stage III RCC: The tumor can be any size and has spread to nearby tissues around your kidney.
• Stage IV RCC: The cancer has spread beyond your kidney to other parts of the body, including your lymph nodes and other organs.

Where does renal cell carcinoma first spread to?

RCC that returns as metastatic RCC most often spreads to your lymph nodes, lungs, bones, liver, and brain. It can also spread to the ovaries or testicles.

What is the treatment for renal cell carcinoma?

Treatment for RCC varies depending on several factors, such as the stage of the cancer and your overall health. The treatment for localised RCC is different from the treatment for metastatic RCC.

What is the treatment for localised Renal Cell Carcinoma?

Treatments consist of either surgically removing the cancer or destroying it with ablation techniques (using extreme heat or cold).

Surgery is the most common treatment for localised RCC.

• Radical nephrectomy: This procedure removes the affected kidney and nearby tissue, such as nearby lymph nodes or adrenal glands, which can also contain cancer cells. Most people can live a healthy life with just one kidney.
• Partial nephrectomy: This operation only removes the cancerous part of your kidney. It might be used for smaller cancers and allows you to keep some of your kidney function, which is especially important if you only have one healthy kidney

If you are not a good candidate for surgery, your surgeon might suggest ablation procedures as an alternative. These are:

• Cryotherapy: Freezing cancer cells to destroy them.
• Radiofrequency ablation: Killing cancer cells by burning them.

What is the treatment for metastatic Renal Cell Carcinoma?

Treatments for metastatic RCC are designed to fight cancer cells throughout your body. You can still have surgery to remove tumors, but it will not be enough on its own to get rid of metastatic cancer. However, removing tumors can help relieve symptoms and might allow you to delay other treatments for a while.

The most common treatments are immunotherapy and targeted therapy. Depending on the condition, these drugs are given alone or together.

• Immunotherapy treatments: Immunotherapy strengthens your immune system so it can better find and attack cancer cells. These medications include:
  • Avelumab (Bavencio®)
  • Ipilimumab (Yervoy®)
  • Nivolumab (Opdivo®)
  • Pembrolizumab (Keytruda®)
• Targeted therapy medications: Targeted therapy interferes with the process that allows cancer cells to grow. This treatment limits the blood flow to tumors, which stops their growth. These medications are:
  • Axitinib (Inlyta®)
  • Bevacizumab (Avastin®)
  • Cabozantinib (Cabometyx®)
  • Everolimus (Afinitor®)
  • Lenvatinib (Lenvima®)
  • Pazopanib (Votrient®)
  • Sorafenib (Nexavar®)
  • Sunitinib (Sutent®)
  • Temsirolimus (Torisel®)
  • Tivozanib (Fotivda®)

Your doctor may also recommend other cancer treatments, such as radiation therapy, depending on where the cancer is located, its severity, and how you respond to other treatments.

Is renal cell carcinoma curable?

It can be, but it depends on your specific diagnosis. People with localised RCC that is cured by surgery tend to have an excellent long-term outlook. Those with more advanced localised RCC will be given the option of receiving immunotherapy after their cancer is removed to also improve their long-term survival.

There is no cure for late-stage RCC that has spread outside the kidney. However, patients with metastatic RCC are living longer than ever before, thanks to the discovery of better treatments that target specific cancer cells.

What is the prognosis for renal cell carcinoma?

Doctors are now more often finding RCC in its earlier stages, when it is easier to treat. Early detection and better treatments have led to a higher survival rate. The five-year survival rate is 90% for Stage I RCC. While life expectancy for people with Stage IV renal cell carcinoma was once only a few months, many are now surviving for several years.

Can Renal Cell Carcinoma be prevented?

Renal cell carcinoma is not always preventable, but you can significantly lower your chances of getting it. For example, not smoking (and quitting if you already do) is one of the best things you can do to reduce your risk of getting this type of cancer.

How do I take care of myself?

You should discuss a care plan with your healthcare provider to help you manage cancer symptoms and any side effects from treatment. For instance, some people may need to undergo dialysis after surgery when one or both of their kidneys are no longer able to function. It is important to know how these treatments will affect you.

You might also need help with side effects from targeted therapy or immunotherapy. Ask your doctor what to expect before starting treatment.

What should I ask my doctor?

• What kind of RCC do I have?
• How advanced is my cancer?
• What are the benefits and drawbacks of the possible treatments?
• What side effects or complications should I know about before receiving treatment?
• How often will I need follow-up visits after treatment?
• What lifestyle changes can I expect during treatment?
• What is my prognosis?

Why choose Tender Palm Super Speciality Hospital for Renal Cell Carcinoma treatment in Lucknow, India?

Tender Palm Hospital has the most experienced team of Uro-Oncologists and diagnostics with the latest and International standard infection control measures in Lucknow, India. The Uro-Oncology team has decades of experience in successfully treating Renal Cell Carcinoma in Lucknow, India.

To seek an Expert consultation for Renal Cell Carcinoma treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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