In the past, the typical treatment for kidney cancer was the removal of the entire kidney, called total nephrectomy. However for smaller tumors it is no longer necessary to remove the whole kidney. For select patients with small kidney tumor it is now possible to undergo a procedure called laparoscopic partial nephrectomy. This is a minimally invasive procedure wherein the tumor is removed in its entirety alongwith a rim of normal kidney tissue. This allows the patient to keep a sizeable portion of the affected kidney which is specially a boon for hypertensive and diabetic patients. For patients with larger kidney tumors the entire kidney is removed laproscopically.
What is kidney cancer?
As with all cancers, kidney cancer and benign tumors evolve from a disruption in one or more genes in a cell's DNA. Loss of control of normal genetic cell multiplications leads to uncontrolled mass of tissue that is a tumor.
Approximately 85% of all kidney cancers are renal cell carcinoma (RCC). Transitional cell cancer (TCC) of the renal pelvis is less common accounting for about 8% of diagnosed cancers.
1. Symptoms
Kidney cancer is typically asymptomatic during much of the initial period. Individuals may notice a persistent pain in their back just below the ribs. General symptoms may include persistent fatigue, unexplained weight loss, recurrent fevers, high blood pressure (hypertension), swelling (edema) in the ankles, a feeling of poor health, and blood in the urine (hematuria).
2. Causes
The majority of the cancers appear in people between the ages of 40 and 70 and in men about twice as frequently as women. Smokers are far more likely to develop cancer than non-smokers. High fat diets, excessive weight and hypertension are risk factors. People who have a history of kidney cancer in their immediate families are at higher risk.
3. Diagnosis
Diagnosis begins with a thorough physical examination followed by a series of laboratory tests and imaging procedures to identify the location and extent of the tumor.
Lab Tests
- Urinalysis : Urinalysis is a common test to detect microscopic blood that might not be seen on visual examination.
- Blood tests : Blood tests are conducted to detect anemia (loss of blood cells caused by internal bleeding), polycythemia (excessive blood cells caused by hormones released by the tumor), and hypercalcemia (high calcium levels).
Imaging studies
- One or more procedures may be conducted to identify abnormalities in the kidneys. Among these are computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, intravenous pyelogram, chest x-ray, and bone scan.
4. Treatment
Dr. Amit Goel is Laparoscopic Pyeloplasty Specialist. Dr. Amit Goel decides on Kidney Cancer Treatment based on many factors, which include age, co-morbidities, size of tumour, presence of metastasis and other factors.
Surgery:
- The gold standard surgery for kidney cancer is removal of the affected kidney. Removal of a single kidney is a simple nephrectomy while removal of the kidney and accompanying adrenal gland (atop the kidney) is a radical nephrectomy. This procedure is now performed laparoscopically. Open Surgery is reserved for highly advanced cases.
In the standard open procedure an incision is made in the side and the kidney is removed. During laparoscopic nephrectomy, incisions no more than an inch are made and narrow tubes are inserted into the abdomen near the kidneys. A Laparoscope is inserted through the tubes to allow the surgeon to conduct the procedure. Dr. Amit Goel is a Kidney Cancer Surgeon who is specialize in Laser and Laparoscopic Surgery in particular Laparoscopic Radical Nephrectomy & Laparoscopic Partial Nephrectomy. UPJ obstruction treatment is today’s era is done with Laparoscopic Surgery & it’s called Laparoscopic Pyeloplasty Surgery.
The advantages of a laparoscopic kidney removal:
- Minimal trauma
- Minimal pain
- Reduced blood loss
- Less hospital stay
- Faster recovery and return to work