Kidney cancer may result in various symptoms, but kidney pain or blood in the urine are most common. However, many kidney cancers are found by chance on scans done for other reasons, often in the absence of any symptoms. On the other hand, kidney cancers can occasionally cause substantial illness, including fevers, weight loss, tiredness etc.
Kidney cancers can usually be diagnosed with reasonable certainty from suitable scans. In doubtful cases, a biopsy may be carried out, whereby a needle is placed into the abnormal area of the kidney using scans for guidance. However, this procedure carries some risk, in particular of bleeding, and may also return uncertain results.
Kidney cancers are usually treated by surgical removal, either of the whole kidney (nephrectomy) or only the portion involved by the cancer. If the other kidney (the one not involved by cancer) is healthy, it is generally preferable to remove the whole kidney. However, for small cancers growing on the external surface of the kidney, it may be advantageous to remove only the tumour and preserve a functioning kidney. Kidney operations may be carried out by open surgery or laparoscopy (keyhole surgery).
If the cancer has spread beyond the kidney, it is usually incurable, but there may still be important reasons to remove the kidney. This allows effective control of symptoms related to the kidney, such as pain or bleeding, and may lead to improved response to further treatment. Further treatment may include medications which are growth-regulatory, such as Sorafenib or Sunitinib. You will need to see an oncologist for such treatment. Sometimes, radiotherapy may be required, especially for cancer that has spread to bones.(top)
A cyst is a thin-walled fluid-filled cavity within the body. Cysts can occur in various bodily organs, most commonly the liver and kidneys. Kidney cysts are extremely common, and often increase in number and size with age. Kidney cysts are frequently found on scans done for other reasons, and, if not causing any symptoms, can be left alone.
Occasionally, cysts may be the cause of symptoms, such as pain or bleeding. Pain may result if there is bleeding or infection within a cyst or if it is causing blockage to the kidney. Usually this is the case with larger rather than small cysts; bleeding may be caused by an injury to the kidney, such as after a fall. Such symptoms may resolve over time. Therefore, initial treatment may consist of painkillers, antibiotics as required and observation. Sometimes surgery to remove the cyst may be required if symptoms persist.
Although most kidney cysts are clearly diagnosed on scans, some cysts may have an abnormal appearance that raises the suspicion of a tumour. This is a difficult problem, and requires discussion between your urologist and radiologist (X-ray specialist). Depending on the degree of suspicion, recommendations will be made for follow-up scans after a period of time or surgery to remove the suspicious area.
Rare genetic diseases (Polycystic kidney disease) may lead to the whole kidney being replaced by cysts. Typically, this condition runs in the family, and may be known to have affected other relatives. Polycystic Kidney Disease can cause high blood pressure, kidney pain, bleeding in the urine, or kidney failure.(top)
Stone formation
Kidney stones form as a result of crystal deposition of substances normally contained in urine, most commonly with calcium. Most non-calcium stones are made of uric acid, which is also the cause of a form of arthritis known as gout. In most cases, there is no identifiable cause for why kidney stones develop. However, many kidney stones develop in summer, and appear related to insufficient fluid intake and resultant dehydration.
Some kidney stones may be related to an excess of calcium in the blood, which is most commonly caused by a hormonal abnormality within the body. Among patients who have suffered recurrently from stones, other tests may be required, since abnormalities may be found in the mineral content in the blood or urine.
On occasion, other factors may lead to kidney stone formation, including: urine infection, kidney blockage, foreign material within the kidney (such as stent tubes), abnormal bladder function and prior urinary surgery (e.g. ileal conduit formation)
Symptoms
Kidney stones may cause little or no symptoms while they lie within the kidney, even if they are relatively large. Severe pain (described as renal colic) results when kidney stones cause blockage to the kidney, most typically when a small stone passes down into the tube draining the kidney (the ureter).
Some kidney stones cause repeated infections, and resulting urinary symptoms. With serious infections, especially when the kidney is blocked, high fevers and life-threatening illness may result. On occasion stones may cause vague symptoms such as nausea or tiredness, or be found incidentally on scans done for other reasons.
Treatment
Stones within the kidney: Small stones (less than 5mm) within the kidney usually do not need treatment if they are not causing any symptoms, but should be followed up by X-rays every year or two to check their size. Larger stones, or those causing symptoms or infections usually need treatment. This can be done by various techniques: external shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) or laser treatment through flexible ureteroscopy.
The choice of best treatment may be complex and depends on factors such as number, size and nature of stones, structure and abnormalities of the kidney, patients state of health and preferences.(top)
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