One in four kidney masses are benign. Smaller masses are more likely to be benign. Larger masses are more likely to be cancerous. Some tumors may grow slowly while some can be faster growing — or more aggressive.
Aggressive tumors may form, grow and spread very quickly. Localized means that the tumor has not spread - from where it first started. The main classes of tumors are:.
Kidney cancer is one of the top 10 most common cancers in the United States, with more than 76, new cases diagnosed each year. More men than women are diagnosed with kidney cancer. Kidney cancer can be seen in anyone but is more common in African Americans, American Indians and Alaskan Native people. You can get kidney cancer at any age but it is more common in older people those greater than 75 years old.
The earlier kidney cancer is diagnosed—the better your chances of survival. See More See Less. There is no known cause for developing a kidney mass.
But there are a number of things that can increase your risk for kidney tumors such as:. Most kidney masses have no symptoms in the early stages. If there are symptoms, they will most likely be:.
Over half of kidney masses are found by chance. Often they are found during generic screening or when you see a doctor about some other problem. If your doctor thinks you may have kidney problems, they might send you to a urologist. A urologist is a doctor who specializes in the urinary system. There are no routine laboratory tests to find kidney masses.
Your health care provider may use many tests to help learn more about your kidneys. Here are some tests and procedures you might expect:.
A tumor grade tells how aggressive the cancer cells are in your body. A tumor stage tells how much the cancer has spread. A higher grade and more advanced stage usually come with larger tumor size and more aggressive tumors.
Tumor size helps in assessing risk for cancer developing. Spread is most common to the lungs, bones, liver, brain, and far off lymph nodes. Stage I and II tumors include cancers of any size that are confined to the kidney.
Stage IV tumors have spread beyond the kidney into organs nearby T4 or distant metastases M1. The main goals in treating kidney masses is to cure you of the cancer and to protect kidney function where possible.
Back pain is also less commonly a symptom of kidney cancer. About 41 percent of people with RCC report back pain. The pain can range from a dull ache to a sharp stab on one side of your flank or below the ribs on your back.
Your flank is the area between your lower back and the bottom of the backside of your ribs. It may also feel like side pain to some people. The type of pain associated with RCC can vary. Some people report pressure instead of an ache or sharp pain. See a doctor if you have any sudden pain that is persistent and lasts more than a few days.
Mention any other symptoms during your visit to help your doctor determine the likely cause. A mass or lump in the abdomen, side, or back can also be a sign of kidney cancer. It can feel like a hard, thickening, or bulging bump under the skin. About 45 percent of people with RCC have an abdominal mass. But kidney lumps are hard to feel, especially in the early stages. You may not even see or feel the lump as the tumor grows.
If a lump is discovered, your doctor will likely order diagnostic tests. Usually an ultrasound or a CT scan. These tests may help determine the cause of the lump.
In most cases a biopsy will be needed to confirm the diagnosis. Keep in mind that not all lumps are cancer. Fatigue is one of the most common symptoms of any type of cancer, especially during treatments. About 70 to percent of people who undergo cancer treatments report fatigue. Many people with cancer say fatigue is one of the most difficult symptoms to manage. Fatigue from cancer is different than just feeling tired from lack of sleep.
Cancer-related fatigue is persistent and interferes with daily activities. Engel, but only in cases where laparoscopic partial nephrectomy is precluded due to the location of the tumor.
The contemporary mainstay of surgery for renal masses is laparoscopy, the act of performing abdominal surgery by inflating the abdomen with carbon dioxide, inserting a camera and several instruments that allow for surgery through small incisions with a rapid recovery. Once it is determined that treatment of a kidney mass is necessary, the next step is to review the actual films, usually a contrast CT, to determine if removing only the tumor is feasible. This is always the desired approach, and in Dr.
In cases however where the tumor is in a central location, invades deeply into the center of the kidney, or if negative margins cannot be assured in the operating room, the entire kidney will be removed.
One only needs one healthy kidney, so in such a circumstance the patient is not usually adversely affected. There are several laparoscopic tools that Dr. Engel employs to perform laparoscopic kidney surgery.
Robotic surgery is often used to dissect out the tumor from the kidney and perform reconstruction Robotic partial nephrectomy. Hand-assisted laparoscopy is a style of laparoscopy where one hand is inside the abdomen and one hand outside.
Engel performs hand-assisted laparoscopy when it is known ahead of time that the entire kidney is to be removed Hand-assisted laparoscopic nephrectomy , or in high risk cases such as chronic kidney failure where it is desirable not to clamp the blood vessels to the kidney Hand-assisted partial nephrectomy. Sometimes only standard laparoscopy is used such as for a very small kidney. The patient will consent to all approaches so that Dr.
Engel is free to use whatever tools are required to fit the particular circumstance found at the time of surgery. The most common cell type found in kidney cancer is called clear cell renal cell carcinoma, but variants such as papillary, sarcomatoid, medullary and others are seen. Transitional cell carcinoma TCC is not uncommon, is typically found in smokers, and arises from the lining of the kidney rather than the functioning kidney tissue itself.
Experience is critical in being able to save the kidney. In our section regarding treatment one can find details regarding these options. These are CT scans for two people found to have a left kidney tumor. The patient on the left has a poorly defined mass radiologists typically describe it as infiltrative while the one has the right has a well defined solid tumor.
The tumor on the left was biopsied and found to be lymphoma. The patient was treated with chemotherapy and did not need surgery. The patient on the right had a robotic-assisted partial nephrectomy and was found to have a clear cell kidney cancer.
At Johns Hopkins our surgeons are experts on all approaches and will help tailor the treatment to the patient. One size does NOT fit all. As the tumor size increases, the likelihood it represents cancer increases as well. Large oncocytomas, which are benign, are sometime impossible to distinguish from kidney cancer and thus there is still hope that a large kidney tumor is benign!
Prompt attention to these tumors is a must and a detailed evaluation is critical to making the best decision. A biopsy may be in order if the tumor looks atypical as there are rare mimickers of kidney cancer that would be treated differently. Three such scenarios are:. Treatment options for these tumors include active surveillance, partial nephrectomy, and total nephrectomy.
Ablation is less attractive for larger tumors. You may have been told that the kidney cancer has spread. This could be to lymph nodes, the lungs, liver, bone, or even the vena cava — the largest vein in your body. For those with symptoms, you may have experienced abdominal or back pain, blood in the urine, bone pain, seizures, or even bad headaches.
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