Metastatic renal cell carcinoma affects over 70% of the patients diagnosed with kidney cancer. The prognosis for the renal cell carcinoma metastatic stage is very poor as the statistics show that the 5 years survival rate is 5 to 15%. However, if detected and treated early renal carcinomas are curable. Kidney cancer is though a concerning condition mainly because it lacks of early symptoms and most of the patients are diagnosed with it when the disease has already reached more advanced stages.
Renal carcinoma arises from the proximal renal tubular epithelium and it may be a hereditary or non hereditary condition. Renal cell carcinoma or RCC is the most common type of kidney cancers that occur primarily in men over 50 years old with no known cause. There are however certain risk factors that have a role in developing or not kidney cancer and these are dialysis treatment, genetics, smoking, family history and Von Hippel-Lindau disease.
Among the subtypes of the RCC, clear renal cell carcinoma is the type of cancer that accounts for 80% of the RCC patients. A clear renal cell carcinoma appears very pale or clear when is looked at under the microscope and this is where it got its name from.
Renal carcinomas tend to be asymptomatic in early stages. Renal cell carcinoma metastatic stages may cause bleeding in urine, back pain, unexplained weight loss, fatigue and intermittent fever. Some symptoms such as fatigue or fever are not specific and may be misleading especially in elder people. Symptoms may however vary significantly from patient to patient or they may miss at all.
Renal cell carcinoma treatment mainly consists in surgery. The prognosis for renal carcinomas that did not undergo surgery is very poor. Metastatic renal carcinoma is also treated with surgery and this may consist in removing the tumor along with a part of the surrounding kidney tissue or it may consist in the complete removal of the kidney. The type of procedure is however decided based on the stage and the location of the kidney tumor.
The most common surgical procedure used to treat renal carcinomas is radical nephrectomies. This type of surgery consists in removing the entire kidney along with the attached adrenal gland and the fatty tissue that surrounds the kidney. It can be performed in different ways. Commonly, an incision is made in the middle of the abdomen, just under the ribs or in the back, behind the affected kidney. A particular procedure is chosen based on the size and location of the tumor. The laparoscopic approach for a nephrectomy has become the most common type of surgical procedure that surgeon use to remove kidney tumors.
Treatment can also consist in chemotherapy or local therapies or targeted therapy for patients who are too weak to undergo surgery. Local therapy consists in cryotherapy (cryoablation), radiofrequency ablation, arterial embolization or radiation therapy. All therapies have side effects but they may be effective in destroying cancerous kidney tumors.
Kidney cancer and especially metastatic renal cell carcinoma tend to be resistant to chemotherapy but drugs such as vinblastine, floxuridine, 5-fluorouracil (5-FU), capecitabine, and gemcitabine were effective in a small number of patients.