The kidneys are two bean-shaped organs located toward the back of the body beneath the rib cage. Their primary function is to filter blood that circulates throughout the body and to excrete the waste products into urine. The kidneys are composed of millions of microscopic tubules that function as filtering units. As the kidneys filter the blood, urine accumulates and exits the kidneys via long tubes called ureters, which carry the urine to the bladder. Urine is stored in the bladder until it is expelled from the body.
Kidney cancer (called renal cell carcinoma) is a cancer of the cells that line the tubules. Kidney cancer is one of the less common forms of cancer in the United States, accounting for only three percent of all cancer cases. In 2007, the American Cancer Society estimates that 51,000 new cases will be diagnosed. A malignant tumor may be found in the organ's filtration system or in the renal pelvis, the urine-collecting system attached to the kidney. Cancer of the filtration system accounts for 80 percent of all kidney tumors.
At The Cancer Center at Hackensack University Medical Center, our chief of the Division of Urologic Oncology, Ihor S. Sawczuk, M.D., is one of the country's foremost authorities on kidney cancer. A board-certified urologist, Dr. Sawczuk has been involved in treating and researching the disease for more than 25 years. He is highly skilled in the various methods to treat kidney cancer, including laparoscopic radical and partial nephrectomy (removal of all or part of a kidney), immunological management using cancer vaccines, laparoscopic cryoablation that uses extreme cold to destroy tumors, and nephron-sparing kidney surgery. Dr. Sawczuk is conducting a number of clinical trials to study new methods to treat kidney cancer.
Risk FactorsKidney cancer occurs more often in men than women. The majority of people with kidney cancer are aged 70 and above. Other risk factors include:
- cigarette smoking (one-third of all cases)
- high blood pressure
- occupational exposure to petroleum products, heavy metals, or asbestos
- hormonal imbalances
- having a genetic disorder, such as Von Hippel Lindau disease or polycystic disorders
- having tuberous sclerosis, a systemic disorder
Treatment ServicesOur chief of the Division of Urologic Oncology, Ihor S. Sawczuk, M.D., and our team of board-certified urologists are highly skilled in the various treatment methods used for kidney cancer. Treatment may include surgery, radiation therapy, chemotherapy, hormonal therapy (by pill or injection), cryosurgery (freezing tissue to destroy cancerous cells), and immunotherapy, which enhances the ability of the body's own immune system to fight cancer.
Surgery is often the first treatment method used. The surgery may be a traditional "open": procedure or a minimally invasive laparoscopic procedure. A laparoscope is a slender scope containing a light source and a tiny camera that enables the surgeon to view internal organs and perform a variety of procedures using delicate instruments. For kidney surgery, the laparoscope and instruments are inserted into the body through several keyhole incisions made in the patient's abdomen. After the procedure is completed, the incision sites are covered with small bandages. Laparoscopic procedures hasten recovery time, and they reduce pain, blood loss, hospital stay, and the risk of infection.
The following laparoscopic procedures may be used to treat kidney cancer:
- laparoscopic radical nephrectomy to remove a cancerous kidney
- laparoscopic partial nephrectomy to removal a part of the kidney that contains cancer
- laparoscopic nephroureterectomy to removal an entire kidney and ureter for patients with certain types of kidney cancer and cancer of the ureters
- laparoscopic renal cryoablation to freeze and destroy small kidney tumors
Radiation therapy may be used alone, before or after surgery, and/or in combination with chemotherapy to treat selected sites involved with kidney cancer. For patients with stage IV cancer or recurrences, radiation therapy may be used to shrink the tumor or treat areas where the cancer has spread, and/or to relieve pain in these areas.
Chemotherapy alone is usually not successful in treating kidney cancer, but new medications are being tested throughout the United States. Patients with stage IV kidney cancer may be treated with chemotherapy in combination with other methods.
Laparoscopic renal cryoablation is a minimally invasive treatment that uses extreme cold to freeze and destroy small kidney tumors. Cryosurgery is sometimes used in combination with other methods to treat kidney cancer.
Immunotherapy harnesses the power of the patient's own immune system to fight cancer. Kidney cancer may be treated with Interleukin-2 and interferon. Researchers at The Cancer Center are also testing the use of cancer vaccines that boost the ability of the body's own immune system to fight the kidney cancer