Renal Cancer
Original Editors -Jason Larimore & Olivia Tefera from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
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Prevalence[edit | edit source]
Characteristics/Clinical Presentation[edit | edit source]
Common symptoms of kidney cancer include:Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
- Blood in your urine (which may make urine look rusty or darker red)
- Pain during urination
- Pain in the side that doesn’t go away
- A lump or mass in the side or abdomen
- Weight loss for no known reason
- Fever
- Feeling very tired
- Breastbone pain (renal cancer is the most common tumor to spread to the sternum)
The classic triad of symptoms includes: blood in the urine, pain in the side, and a palpable mass in the abdomen.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title However, renal cancer typically goes undetected, especially in the early stages, although nonspecific symptoms like feeling fatigued or unexplained weight loss may be present.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Thus, it is imperative that the physical therapist take a thorough history and ask follow-up questions should a patient present with any of these symptoms. It should be noted that although these are symptoms of renal cancer, they could also be symptoms of some other pathology such as an infection, bladder cancer, or a kidney cyst.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title If a patient is experiencing these symptoms, he or she should contact their primary care physician as soon as possible for a complete examination.
About 25-30% of patients have metastatic disease at the time of diagnosis.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Renal cancer most often spreads to the lungs (75%), regional lymph nodes (65%), bones (40%), and liver (40%).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title The patient may complain of a cough or bone pain secondary to metastasis to the lungs or bone, respectively.
Associated Co-morbidities
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An associated co-morbidity is a disorder or disease that predisposes a person to develop renal cancer.
Studies have found the following co-morbidities associated with renal cancer:Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
- Von Hippel-Lindau (VHL) syndrome: VHL is a rare disease that runs in some families. It’s caused by changes in the VHL gene. People with a changed VHL gene have an increased risk of renal cancer. They may also have cysts or tumors in the eyes, brain, or other parts of the body. Family members of those with VHL can have a test to check for a changed VHL gene.
- Hereditary papillary renal carcinoma: This is a genetic condition that increases the risk of developing the papillary type of renal cancer, which is the second most common subtype of renal cancer.
- Birt-Hogg-Dubé Syndrome: This is a rare hereditary disease that affects the skin and is characterized by multiple non-cancerous tumors of the hair follicles, particularly on the face, neck, and upper chest. These bumps will typically appear when someone is between the ages of 20-40 years old. Having this disease increases a person’s susceptibility to developing renal cancer.
Medications[edit | edit source]
When possible, surgical treatment to remove the tumor is a preferred treatment method of renal cancer. However, if a person has a metastatic tumor (i.e. cancer that has spread to other organs) the primary care physician will most likely recommend additional treatment. The most commonly used treatments for kidney cancer are various forms of medication from two categories: targeted therapiesor immunotherapy.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Targeted therapies, which work by targeting the cancer at a cellular level, have expanded the options for the treatment of kidney cancer. Targeted treatments block specific abnormal signals present in kidney cancer cells that allow them to grow. These medications have shown promise in treating kidney cancer that has spread to other areas of the body. The targeted medications Axitinib (Inlyta), Bevacizumab (Avastin), Pazopanib (Votrient), Sorafenib (Nexavar) and Sunitinib (Sutent) block signals that play a role in the growth of blood vessels that provide nutrients to cancer cells and allow cancer cells to spread. Temsirolimus (Torisel) and Everolimus (Afinitor) are targeted medications that block a signal that allows cancer cells to grow and survive. Targeted therapy medications can cause serious side effects, such as: a severe rash, diarrhea, and fatigue.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Anyone experiencing these symptoms should contact their doctor immediately.
Whereas targeted therapies specifically block the renal cancer cells from growing and spreading, immunotherapy works in a more general way by using the body's immune system to fight the cancer. Immunotherapy medications include Interferon and Aldesleukin (Proleukin), which are synthetic versions of chemicals made in your body. Side effects of these medications include: chills, fever, nausea, vomiting and loss of appetite.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Again, anyone experiencing these symptoms should contact their doctor immediately.
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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