Treatment of kidney cancer
This article is the result of the collective efforts of urologists and oncologists at the Dilyanian Clinic.We have attempted to convey to our patients, who are faced with kidney cancer, information about modern methods of diagnosis and treatment of this disease in a clear and accessible language.
"Nothing hurt"
An eternal story. Please remember: kidney
tumors in the early stages do not cause pain at all, and it's not pain that
leads a person to see a doctor. Suddenly, I repeat, without any pain, the urine
turns red. A visit to the doctor, an ultrasound – and a thunderbolt out of the
blue: the diagnosis is "kidney tumor".
More often there are no complaints at all: no blood in the urine, no pain, no discomfort – just a kidney ultrasound in a clinic or a computer tomography for some other disease reveals this condition.
Kidney
cancer is a malignant tumor of kidney tissues. It is very important to
understand what makes it malignant and why it is dangerous for life. Firstly,
tumor cells divide and multiply uncontrollably. Secondly, they can spread
through the bloodstream or lymphatic system to other organs – metastasize.
Ultimately, cancer cells poison and kill the body.
What to do?
A dire situation: You or your relative
have been diagnosed with "Malignant kidney tumor." Question: what to
do? Answer: competent diagnosis and timely treatment. Urgently.
Tumors don't like to wait. Time works against the patient.
Diagnosis of kidney cancer
What do we consider competent diagnosis? According to any modern recommendations, it is determining the stage of the tumor, assessing its spread, and understanding the risks of various types of treatment accurately.
Since the treatment of kidney cancer is
mainly surgical, we always examine the patient for contraindications to
anesthesia and surgery.
Finally - treatment of kidney cancer
Requirement, law, dogma - call it what you
want, but the decision about any oncological treatment must be made by a
multidisciplinary team. We are obligated to consider all possible options, even
though surgery is the first-line treatment for kidney cancer. But, for
understanding: the surgeon, the best, the most wonderful, after removing the
tumor or the kidney with the tumor, gets the patient back on their feet and...
that's where their role ends. Can they monitor the patient for 5 years to
exclude recurrences or metastases? Certainly, they can, but it's not their
role.
That's why a multidisciplinary team exists. For the treatment of kidney cancer, a typical team includes a surgical oncologist, a medical oncologist, a radiation oncologist, and a general oncologist.
NB!!! The multidisciplinary team determines: the stage of treatment, based on the greatest benefit to the patient, the order and frequency of follow-up to monitor for cure, the necessity of chemotherapy (targeted or immune therapy) or radiation therapy (for metastases).
Kidney cancer surgery
Essentially, the surgeon has only two
interventions in their arsenal: removal of only the tumor - resection, or
removal of the kidney - radical nephrectomy.
Yes, our unequivocal advantage is performing these operations laparoscopically or using the DaVinci robot. Yes, it's minimal trauma, painlessness, absence of a large incision, and rapid rehabilitation. But... What exactly will be proposed? Is it possible not to lose the kidney?
Kidney
resection
Removal of only the tumor while preserving the organ is possible only in stage 1 kidney cancer when the tumor size does not exceed 7 cm (ideally 4 cm), if the tumor does not penetrate the kidney capsule, and if there are no metastases. In all other cases, unfortunately, it is better to sacrifice the organ.
Radical nephrectomy
Radical removal of the kidney. Essentially, the surgeon removes the kidney along with all its coverings and the fatty layer. Often, lymph nodes are also removed. We use this method when it's impossible to preserve the organ, or when organ preservation is associated with the risk of disease progression and death.
Life with one kidney doesn't turn into hell, as
it's sometimes portrayed online. If you're faced with the need for kidney
removal, please know this.
Our Results
Treatment in our clinic
During the consultation, we evaluate
available test results and examinations, such as contrast-enhanced computer
tomography findings, and gather data on hidden and concomitant diseases. All
this information is discussed on the same day during the oncological team
discussion.
In the
shortest possible timeframe, we conduct preoperative tests and examinations to
ensure the safety of the surgical procedure. This includes consultations with a
cardiologist and an anesthesiologist. On the same day, the patient can be
admitted to the hospital.
Day of the surgery. On this day, we
recommend not eating or drinking in the morning. The night before the surgery,
we provide the patient with a sedative to alleviate anxiety and promote good
sleep. Additionally, preoperative antibacterial therapy is administered.
Inpatient observation and treatment
involve careful monitoring of the patient's health to prevent complications.
Early patient mobilization is crucial at this stage.
It is important to understand that
oncological diseases require 5-year follow-up and monitoring. In the first year
after surgery, we invite the patient for follow-up visits every three months,
then every six months. This allows for immediate and effective treatment in
case of recurrence.
