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Renal tumors

Renal tumors are a significant problem in modern oncology. The trouble is that this disease often progresses without symptoms in the early stages. In this section, we discuss the diagnosis and various treatment methods for benign and malignant kidney tumors, as well as share personal experiences.

What to do if you or your loved one is diagnosed with kidney cancer?

What exactly is kidney cancer?

What are the signs and symptoms of kidney cancer?

How is kidney tumor diagnosed, and how to understand the stage of kidney cancer?

Treatment for kidney cancer: nephrectomy, partial nephrectomy, radiation therapy, or chemotherapy?

How effective is chemotherapy for kidney cancer? What to do if kidney cancer metastases are detected?

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What to do if a person or their close one is diagnosed with kidney cancer?

Well, let's say they went to the polyclinic, had an ultrasound, and were immediately given the diagnosis.

This is quite a common situation, where kidney tumors are found either during routine examinations or when a patient complains of "blood in the urine." In such cases, it's crucial to urgently schedule a consultation with an oncologist-urologist.

One simple truth needs to be acknowledged: tumors do not wait. A week, two, or three spent pondering or waiting in queues can often be fatal. Understanding this, we've organized the work of the Dilanyan Clinical Center in such a way that all examinations (kidney ultrasound, computerized tomography of the kidneys, the full set of necessary tests and consultations) take no more than two days.

After that, we hold a consultation and offer the patient various treatment methods for kidney cancer.

The onset of kidney cancer.

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play icon The Development of Kidney Cancer.

Kidney cancer arises from the influence of carcinogenic substances on kidney cells: starting from one cell, the tumor proliferates, initially affecting the kidney itself, and then infiltrating the kidney's bloodstream and metastasizing, spreading its cells to distant organs.

In this video, the onset and development of kidney cancer are demonstrated.

So, what exactly is kidney cancer? Who should be concerned about this disease?

Kidney cancer... It's an enemy.

Smoking, obesity, high blood pressure, exposure to various chemicals, and in some cases, uncontrolled intake of diuretic medications - these are the factors that fuel our enemy's army.

Essentially, it's the accumulation of cells whose ancestor at some point acquired characteristics typical of a tumor: the ability to divide uncontrollably, lack of specialization, the property to spread through blood and lymphatic vessels (metastasis), and poisoning, killing the organism.

How can a person recognize this disease in themselves?

What are the signs and symptoms of kidney cancer

Well, in the modern stage of medical development, we rarely see the so-called classical symptoms of kidney cancer:

- Palpable mass in the abdomen,

- Blood in the urine (especially when it comes out in worm-like clots),

- Development of varicose veins in adults,

- Unexplained swelling of the legs, and so on.

More often than not, our patients experience elevated blood pressure or a body temperature persistently hovering around 37.0 - 37.1 degrees Celsius without clear reasons. Concerning these symptoms, the patient visits a polyclinic, where routine ultrasound reveals... a kidney tumor. Moreover, worse still, over half of the patients present no complaints whatsoever.

How is kidney tumor diagnosed, and how to understand the stage of kidney cancer?

Essentially, diagnosing kidney cancer is about determining the stage of the tumor.

The effectiveness of various kidney cancer treatment methods directly depends on the stage.

The Dilanyan Clinic possesses a full spectrum of diagnostic capabilities in accordance with the latest recommendations of the European Association of Urology. These include:

- High-quality contrast-enhanced computed tomography (CT) of the kidneys;

- Examination of the lungs;

- Examination of the liver and bones (osteoscintigraphy) to exclude metastases;

- Magnetic resonance imaging (MRI) for patients who cannot undergo CT scans of the kidneys for various reasons.

Naturally, we also utilize standard tests to assess kidney function. In cases where there is doubt, we perform kidney biopsies, allowing us to distinguish between benign and malignant tumors. Additionally, in situations where surgery is not possible for the patient, this helps us determine the possibility of kidney tumor ablation or therapeutic treatment.

What treatment options are available for kidney cancer: kidney removal, partial kidney removal, radiation therapy, or chemotherapy?

In my opinion, it's not as simple as that.

For one patient with a kidney tumor, let's say 3 cm in size, we might perform laparoscopic kidney resection (removing only the tumor while preserving the organ) and discharge them healthy within 3-4 days after the surgery. For another patient with a tumor of the same size, we might suggest traditional open nephrectomy(complete kidney removal). And for a third patient, we might perform radiofrequency ablation (destroying the kidney tumor without surgery, through a puncture) with a prior kidney biopsy, followed by dynamic monitoring by an oncologist and a chemotherapy specialist.

Why is that? Why isn't there a single standard operation, considering that the tumors are the same size in all three patients?

In oncology, more than in other medical fields, there's a demand for an individualized approach to patients.

In the same example, our choice can be explained by the fact that for the first patient, the tumor is located on the upper or lower pole of the kidney, making kidney resection feasible, while for the second patient, the tumor invades the kidney's blood vessels, and there are contraindications for laparoscopic surgery. And for the third patient, surgery is completely contraindicated due to concomitant diseases. However, in any case, we will select the most effective treatment method possible for each patient.

How effective is chemotherapy for kidney cancer?

Chemotherapy for kidney cancer, traditionally speaking, unfortunately, isn't very effective. However, there are immunotherapy and targeted therapy options for kidney cancer, which represent new directions in chemotherapy for kidney tumors. It can be said that these methods are quite effective.

What should be done if kidney cancer metastases are detected?
Treat them.

Metastases of kidney cancer are most commonly found in the bones, lungs, and liver. In such cases, we recommend systemic polychemotherapy: a course of drugs aimed at metastatic disease, along with targeted therapy and immunotherapy.

It's important to discuss "cytoreductive surgeries"further. In some cases, even with distant metastases present, we offer surgical treatment to the patient with the aim of removing the primary tumor. The rationale behind these interventions is to achieve the greatest possible removal of tumor tissue, thereby increasing the chances of successful treatment for patients with metastases.

I'd like to highlight the possibility of surgically removing solitary liver metastases and performing radiofrequency ablation.

What should a patient do if they don't have the morale for either surgery or prolonged treatment? It's very difficult, isn't it?

Very difficult indeed.

I would say, often unbearably so. A patient diagnosed with cancer may feel utterly alone with their illness, which can be overwhelming. If your loved one is facing such a situation, simply being there for them is crucial. If you're unsure how to support them, what to say, or how to help, don't hesitate to reach out to us. In establishing the Dilanyan Clinical Center, we've included an experienced psychologist who successfully assists both patients and their relatives and loved ones. Being present and knowing how to be present is incredibly important.

Dr. Oganes E. Dilanyan
Urology-oncology surgeon, Ph.D. of Medical Sciences
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