Kidney cancer is a disease that starts in kidney and happens when healthy cells in kidney change and grow abnormally and form a lump known as tumour / mass. Renal Cell Carcinoma is mostly found in adults. A tumour can be benign or malignant.
- A benign tumour grows but will not spread in body, whereas a malignant tumour is cancerous and it grows and spread across body parts.
TYPES OF KIDNEY CANCER :
- Renal Cell Carcinoma : It is the most common type of kidney cancer found in almost 85% cancer cases.
- Urothelial Carcinoma: It si also called as transitional cell carcinoma and accounts to 10% of kidney cancers in adults. It begins in renal pelvis area.
- Sarcoma: It is one of the rare carcinoma, develops in soft tissues of kidney. It is usually treated with surgery.
- Wilms Tumour: Mostly found in children and accounts upto 1% of kidney cancers. Usually treated with radiation therapy and chemotherapy.
SYMPTOMS OF KIDNEY CANCER :
In early stages, signs and symptoms are not prevalent. Kidney cancer in later stages include :
- Pain in back side
- Loss of appetite
- Blood in urine
- Weight loss
- Intermittent fever
- Basic blood & urine tests
- Imaging tests include and USG, MRI or CT scan to rule out an abnormality in kidney
- Kidney tissue biopsy, to rule out signs of cancer.
- STAGE-1: At this stage, tumour size might vary between 6-7 cms and is confined to kidney only.
- STAGE-2: This stage defines a large tumour bigger than 6-7 cms and still confined to kidney.
- STAGE-3: This stage defines that the tumour has reached beyond kidney to surrounding areas and has spread to lymph nodes.
- STAGE-4: At this stage, cancer has already spread outside kidney, lymph nodes and to various parts of body, viz, bones, lungs and liver etc.
LINE OF TREATMENT :
To treat kidney cancers surgical line of treatment is the ideal choice with a goal to remove tumour and prevent kidney functions.
- Radical Nephrectomy : In this procedure, entire kidney, lymph nodes, adrenal glands are removed. Radical Nephrectomy is performed through a single incision in abdomen if done open or few incisions in case of Lap Nephrectomy or Robotic Assisted lap nephrectomy.
- Partial Nephrectomy : In this procedure, the tumour is removed along with some healthy tissue along with tumour and instead of removing entire kidney. It can be done as open surgery and laparoscopically. It is basically performed to preserve the kidney function and minimize further risks or complications.
- Robotic & Laparoscopic Surgery for Kidney Cancer : Robotic surgeries are less painful but requires long hours of surgery and requires special set of training. Over all, laparoscopic surgeries are best selected by maximum surgeons to either removed the specific tumour or entire kidney depending on the disease. Small incisions are required to perform the procedure, taking lesser time in surgery thereby faster recovery and better results.
- Chemotherapy: Though, chemotherapy is useful for treating most of the cancer, research reveals that kidney cancer are resistant to chemotherapy and only Urothelial & Wilms tomour are successfully treated with chemotherapy.
- Radiation Therapy : High energy X Rays are used in radiotherapy. It is not an effective line of treatment for kidney cancer and rarely used to treat cancer patients because of the damage it makes to kidney. Radiotherapy is performed on patients who cannot undergo surgery and to ease symptoms such as bone pain and swelling.
Prostate cancer is formed when healthy cells in prostate grow out of control and form a tumour. It can be benign or cancerous. It is one of the most common cancer found in men. This type of cancer is somewhat different as compared to other types of cancer and do not spread quickly to other parts of the body.
It grows slowly and remain confined to prostate gland initially causing less harm. If detected early has better chances of successful treatment.
SYMPTOMS OF PROSTATE CANCER
Patient shows no signs and symptoms in initial stages, but causes symptoms in later stages, such as :
- Frequent urination
- Blood in urine
- Blood in semen
- Trouble in urination
- Erectile Dysfunction
- Pain and burning during urination
- Urge for urination in night
CAUSES & RISK FACTORS
The reasons and cause of prostate cancer are still not clear. Medical experts says prostate cancer begins if some cells in prostate becomes abnormal. They grow more rapidly than normal cells do and form tumour. Some abnormal cells break and spread to other parts of the body.
- Family history
- Age, as you age chances of prostate cancer increases
- Obesity – Men who are obese and having prostate cancer are more likely to have other advance diseases and are more difficult to operate.
COMLICATIONS OF PROSTAE CANCER
- Spreading of cancer to other body parts / organs and difficult to be cured with treatment.
- Incontinence – Prostate cancer treatment can cause urinary incontinence and the same can be cured either by medications, catheterization or surgery.
- ED – Surgical treatment or Radiotherapy for prostate cancer may result in ED ( Erectile Dysfunction). The same can be further treated with medications, vaccum devices and penile implant surgery, if required.
DIAGNOSIS OF PROSTATE CANCER
- Prostate screening tests, which include :
- DRE ( Digital Rectal Examination)
- SPSA test ( blood test)
- If SPSA / DRE detects abnormality, Urologist may recommend:
- TRUS ( Transrectal Ultrasound) – It helps to further evaluate the prostate by inserting the probe in rectum and pictures are taken of entire prostate gland.
- Prostate Biopsy : Urologist may recommend a prostate biopsy if initial tests reveal prostate cancer. Biopsy is done with a needle inserted into prostate to collect multiple tissues and then sent to laboratory for checking cancer cells.
- MRI Fusion : MRI Fusion is done along with biopsy to diagnose prostte cancer.
STAGES OF PROSTATE CANCER:
- Once its diagnosed that patient has prostate cancer, Urologist works to determine the stage of cancer : Following tests are done to determine the spread of cancer :
- Bone scan
- PET scan
- CT scan
- Stages range from I to IV, the lowest one indicate that the cancer is confined to prostate only, whereas the last stage reveals that it has spread to other organs of the body beyond prostate gland.
TREATMENT OF PROSTATE CANCER :
- 1ST line of treatment recommended by Urologist is active surveillance for those who are being diagnosed with low-risk cancer.
- SURGERY - To treat prostate cancer a Urologist or Uro-Oncologist should be involved. Type of surgery depends on the stage, nature of disease and over all condition of patient.
- Radical Prostatectomy : In this procedure, entire prostate and seminal vesicles are removed. Lymph nodes may also be removed, however there are several complications ( viz, urinary incontinence, ED etc. )
- Robotic assisted Lap Prostatectomy : This is a minimally invasive procedure with quick recovery. Small keyhole incisions are made in patients abdomen to remove prostate gland. However, the side effects are almost similar to those of a radical or open prostatectomy.
- Bilateral Orchidectomy: In this procedure, both the testicles are removed surgically. This surgery is performed for treating testicular cancer and sometimes to treat advanced prostate cancer.
- HIFU ( High Intensity Focussed Ultrasound): HIFU is a heat-based focal therapy. During HIFU, an USG probe is inserted in rectum and sound waves are directed on cancerous part of gland. Main advantages of HIFU is that it destroy cancer cells while limiting damage to entire prostate gland. The procedure is already US FDA approved in year 2015 and is best option for prostate cancer treatment. Diyos Hospital have experts that perform HIFU on a regular basis.
STAGEWISE TREATMENT OF PROSTATE CANCER :
- STAGE (I & II) : At this stage, prostate cancer grows at a slower pace and takes years to cause symp0tioms or other health issues. As discussed earlier active surveillance and waiting is recommended. For men with high gleason scoring, radical prostatectomy and radiation therapy is recommended. Uro-Oncologist is the ideal person to suggest on treatment plan after evaluating the patient.
- STAGE III : At this stage, external-beam-radiation therapy and testosterone suppression therapy is recommended. Combination of treatment is given for better results. Normally, 24 months of testosterone suppression therapy is needed to control the disease.
- STAGE IV : Advanced Prostate Cancer, also known as metastatic cancer, it spreads to another parts of body. In case where it is already metastatic, we need to consult experts who have rich experience in treating the same.
Testosterone therapy followed by other drugs, cryosurgery or radical prostatectomy, HIFU (Focal therapy) are ideal choices of treatment for Stage IV prostate cancer.