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Renal Cancer Explainer

RENAL CANCER (Kidney Cancer) 1. Definition Renal cancer is a malignant tumor arising from the kidney tissues, most commonly from the renal tubules of the renal cortex. The most common type is Renal Cell Carcinoma, which accounts for about 85–90% of all kidney cancers in adults. It is also called hypernephroma. 2. Anatomy and Physiology of Kidney (Brief Review) The kidneys are paired organs located in the retroperitoneal space on either side of the vertebral column. Functions of Kidney Filtration of blood Formation of urine Regulation of fluid and electrolyte balance Acid-base balance Hormone production: Erythropoietin Renin Activation of Vitamin D Cancer interferes with these functions. 3. Epidemiology Occurs mostly in adults aged 50–70 years More common in men than women Accounts for 2–3% of all adult cancers Increasing incidence worldwide 4. Types of Renal Cancer 1. Renal Cell Carcinoma Most common type Originates from proximal renal tubules 2. Transitional Cell Carcinoma Develops in the renal pelvis 3. Wilms Tumor Occurs mainly in children 4. Renal Sarcoma Rare tumor arising from connective tissue 5. Risk Factors / Etiology 1. Smoking Strongest risk factor. 2. Obesity 3. Hypertension 4. Occupational Exposure Exposure to chemicals such as: Cadmium Asbestos Petroleum products 5. Genetic Factors Examples: Von Hippel–Lindau Disease Family history 6. Long-term Dialysis 7. Male Gender 6. Pathophysiology Mutation occurs in renal tubular epithelial cells. Abnormal cells proliferate and form a tumor mass. Tumor invades: renal tissue renal vein inferior vena cava Cancer may metastasize to: lungs bones liver brain Tumor cells may produce hormones causing paraneoplastic syndrome. 7. Clinical Manifestations Classic Triad (Rare but Important for Exams) Hematuria Flank pain Palpable abdominal mass Other Symptoms Weight loss Fever Fatigue Anemia Hypertension Night sweats Loss of appetite Varicocele in males Metastatic Symptoms Bone pain Chronic cough Dyspnea Pathological fractures 8. Paraneoplastic Syndromes Common in Renal Cell Carcinoma. Examples: Hormone Produced Effect Erythropoietin Polycythemia Parathyroid hormone-like Hypercalcemia Renin Hypertension ACTH Cushing syndrome 9. Diagnostic Evaluation 1. Urinalysis Findings: Hematuria Proteinuria 2. Blood Tests CBC Renal function tests Liver function tests 3. Imaging Studies Ultrasound First screening test. CT Scan Most accurate test for kidney tumor detection. MRI Scan Used when CT is contraindicated. Intravenous Pyelogram (IVP) Chest X-ray To detect lung metastasis. 4. Biopsy Confirms diagnosis. 10. Staging of Renal Cancer Stage I Tumor limited to kidney (-7 cm) Stage II Tumor -7 cm but confined to kidney Stage III Spread to: renal vein nearby lymph nodes Stage IV Metastasis to: lungs liver bones brain 11. Medical Management Targeted Therapy Drugs used include: Sunitinib Sorafenib Pazopanib Immunotherapy Uses immune-boosting drugs: Interleukin‑2 Interferon‑alpha Chemotherapy Less effective in renal cell carcinoma. Radiation Therapy Used mainly for metastatic pain relief. 12. Surgical Management Surgery is the main treatment. 1. Radical Nephrectomy Removal of: kidney adrenal gland surrounding fat lymph nodes 2. Partial Nephrectomy Removal of tumor only. 3. Simple Nephrectomy Removal of kidney only. 13. Nursing Management Preoperative Nursing Care Assess vital signs Monitor renal function Manage pain Provide psychological support Educate patient about surgery Maintain hydration Postoperative Nursing Care 1. Monitor Vital Signs Especially: Blood pressure Pulse Respiratory rate 2. Monitor Urine Output Normal output: 30 ml/hour 3. Pain Management Administer analgesics. 4. Prevent Infection Maintain sterile dressing Monitor temperature 5. Fluid Balance Strict intake and output charting. 6. Respiratory Care Deep breathing exercises Incentive spirometry 7. Early Ambulation Prevents: DVT pneumonia 14. Nursing Diagnoses Acute pain related to surgical incision Risk for infection Impaired urinary elimination Anxiety related to cancer diagnosis Fatigue related to disease process 15. Nursing Interventions Monitor renal function tests Observe for hematuria Assess surgical wound Encourage fluid intake Provide emotional support Educate patient about lifestyle changes 16. Complications Hemorrhage Infection Renal failure Metastasis Deep vein thrombosis 17. Prevention Stop smoking Maintain healthy weight Control blood pressure Avoid toxic chemical exposure Healthy diet and exercise 18. Prognosis Prognosis depends on stage of cancer. Stage Survival Rate Stage I 90% Stage II 70–80% Stage III 50–60% Stage IV -20% Early diagnosis improves survival.