The kidneys are two bean-shaped organs that are located on either side toward the back, just below the rib cage. One of the main functions of the kidneys is to filter the blood.

• Filtering the blood removes wastes and extra water, which are then eliminated in our urine.
• The urine flows down two tubes (ureters) to the bladder. It is stored in the bladder until it leaves the body when you urinate.

The kidneys, and the hormones they produce, have several important functions that include:

• Helping with the maintenance of strong bones
• Controlling blood pressure
• Stimulation of the bone marrow to produce red blood cells
• Controlling the level of electrolytes (such as sodium or potassium) in your blood

Kidney cancer is the growth of abnormal cells in the kidney. The growth of these abnormal cells is known as a malignant or cancerous tumor.

• The type of kidney cancer depends on where the growth is in the kidney.
• In adults, the most common type of kidney cancer is renal cell carcinoma. This type of cancer starts in the part of the kidneys that makes urine.
• Wilms tumors are the most common type of kidney cancer in children. They also form in the part of the kidneys that makes urine.
• Transitional cell cancer forms in the ureters and cavity of the kidney that stores urine.
• Kidney cancer can spread to the lungs and other organs and tissues in the body.

Healthcare providers will look for spread of the kidney cancer to other areas of the body. This process is called “staging.” Metastatic kidney cancer is cancer that started in the kidney and has spread to other organs and tissues. Your healthcare provider will need the following clinical information to decide what type of treatment is right for you.

• What does the cancer look like under the microscope? Does the kidney cancer invade tissues outside the kidney?
• How large is the primary cancer in the kidney? Are both kidneys involved?
• Has the cancer spread outside the kidney?
• Has the cancer spread to lymph glands or anywhere else in the body?

Depending on their location in the kidney, small cancers can sometimes be treated with a minimally invasive procedure. These procedures can be done in a hospitals X-ray department with very little sedation. Some examples include:

• Cryoablation, which is when a freezing probe is placed in the tumor to freeze and kill the cancer cells.
• Radiofrequency ablation, which is when a radiofrequency probe is placed in the tumor to heat and kill the cancer cells.

A nephrectomy, removal of a kidney or part of a kidney, is the most common treatment for large kidney cancers. It can be done through a large incision on the side of the abdomen or several small incisions using small medical instruments and a camera (laparoscopic). There are three different types of nephrectomies. The surgery your healthcare provider recommends will depend on your specific circumstances.

• A partial nephrectomy is when only some of the kidney is removed. This allows for the kidney to still function after surgery. This surgery can be done in many cases, depending on the location and size of the tumor. It may also be recommended if the other kidney has already been removed or is not functioning.
• A simple nephrectomy is when an entire kidney is removed. When this surgery is done in someone with kidney cancer, it is typically done to ease symptoms of a terminally ill patient (palliative care).
• A radical nephrectomy is removal of a kidney, adrenal gland (may or may not be removed depending on the location of the tumor), surrounding tissue and nearby lymph nodes.

The costs associated with this care path are for a laparoscopic radical nephrectomy.

It is not known what causes kidney cancer. However, there are several factors that may increase your risk.

• Smoking - You are a smoker.
• Family history - A family member has a history of kidney cancer.
• Dialysis - You have a history of receiving dialysis.
• Hypertension - You have a history of high blood pressure.
• Certain kidney diseases - You have a history of a horseshoe shaped kidney or polycystic kidney disease.
• Von Hippel-Lindau Disease - You have a history of this disease, which affects the blood vessels.

Some of the symptoms of kidney cancer include:

• Pain in the abdomen, flank area and back
• Blood in the urine
• Swelling in the abdomen and, in men, around the testicles
• Unexplained weight loss

It is important to remember that these symptoms can be caused by other conditions.

Contact your healthcare provider if you have any of the above symptoms. He or she will review your symptoms and perform a physical examination. They may also recommend one of the following tests:

• An intravenous pyelogram (IVP)
• A CT scan or other x-ray
• Lab work and urine tests

A biopsy is sometimes done to determine if an abnormality is cancer or another kidney disorder. (However, for most kidney tumors treatment is done without a prior biopsy.) If your kidney biopsy indicates you have kidney cancer, additional testing (CT scan, PET scan or MRI) may be needed.

The treatment for kidney cancer is based on many factors, including:

• Your age and overall health
• Your symptoms
• The type and stage of the cancer
• Other tests that determine the specific characteristics of the cancer

Although the primary treatment for kidney cancer is surgery, other treatments are available in certain circumstances.

• Some hormone treatments can help shrink a kidney tumor.
• Radiation and chemotherapy have been used to treat some cases of kidney cancer.
• Targeted or biologic therapy interferes with the changes in cells that help sustain cancer. In recent years it has been used in patients with advanced cancer. There have been some excellent results.

To get a full range of opinions and perspectives, you may want to consider input from a variety of doctors. This group may include:

• Your primary care physician
• A medical oncologist (a doctor who specializes in the treatment of cancer)
• A urologist
• In some cases, a radiation oncologist (a doctor who specializes in treating cancer with radiation therapy)

If your healthcare provider recommends a nephrectomy, prior to the surgery you should tell them about any medications you are taking (including over-the-counter medications and supplements). You should also ask about specific instructions you should follow before and after the surgery. These include:

• Medications you should not take before the surgery, such as blood thinners
• Regular medications you should continue to take on the day of your surgery
• What diet should follow the weeks before surgery
• What medicine or prep you will take to clean out your colon for surgery
• How many hours you should stop eating and drinking before the surgery

If you are a smoker, you should quit smoking, as it can interfere with your recovery.

During your surgery, you will receive anesthesia to keep you comfortable and pain free. General anesthesia is the most common type of anesthesia for a nephrectomy.

• With this type of anesthesia, you are put into a deep sleep and are unable to see, hear, or feel anything.
• After your surgery, you may need pain medication and help at home while you recover.

It is important to remember that the total cost of this care path does not include all possible medications, lab work or imaging studies. Those charges can add up. If your healthcare provider recommends any lab work or imaging studies, you may need to search for their costs separately.

Be prepared to discuss your symptoms and how long you have had them.

• Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
• Make a list of your medications (including over-the-counter).
• Write down any questions, symptoms or concerns you want to talk about.
• If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a nephrectomy?

• What is my diagnosis? What type of kidney cancer do I have?
• What tests are you recommending and why? Will the test results change my treatment plan? If not, then why do I need them?
• What is the reason for the surgery? Are there any alternatives to surgery?
• What will happen if I don't go through with the surgery?
• Are any of the limited forms of surgery (partial nephrectomy) appropriate for me?
• What are the possible complications for this surgery?
• Will I have to modify my activity?
• What is your experience in doing this type of surgery? What is your complication rate?
• Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
• Will I be receiving other treatments before or after my surgery?
• Will my diet change after surgery?

Do not forget to arrange for transportation to and from the facility and for help at home.

Before you go home, make sure you understand all home care instructions (including medications and side effects), what symptoms you should report to your healthcare provider after discharge and follow-up plans. Your surgeon should also communicate with your primary care physician.

Source UHC.com

Also known as:

Removal of Kidney

Nephrectomy

Kidney Removal

Kidney Cancer

Cancer of Kidney

Cancer - Kidney Removal

Cancer