Kidney & Bladder Cancer
Introduction :
Kidney Cancer
Kidney cancer is the abnormal growth of cells in your kidney tissue. In time, these cells form a mass called a tumor. Cancer begins when something triggers a change in the cells, and they divide out of control.
Bladder Cancer
Bladder cancer or Urinary Bladder cancer is a relatively rare form of cancer that starts in the lining of your bladder. Your bladder is a small hollow organ that holds your pee (urine).
Kidney Cancer
Kidney cancer may not produce any noticeable symptoms in its early stages. But as the tumor grows, symptoms may begin to appear. For that reason, kidney cancer often isn’t diagnosed until it has begun to spread.
Kidney cancer symptoms may include:
- Blood in your pee (hematuria).
- A lump or mass in your kidney area.
- Flank pain.
- Tiredness.
- A general sense of not feeling well.
- Loss of appetite.
- Weight loss.
- Low-grade fever.
- Bone pain.
- High blood pressure.
- Anemia.
- High calcium.
Bladder Cancer
Blood in your pee (urine) is the most common bladder cancer symptom. That said, simply having blood in your pee isn’t a sure sign of bladder cancer. Other conditions cause this issue, too. But you should contact a healthcare provider whenever you spot blood in your pee. Other bladder cancer symptoms include:
Visible blood in your pee (hematuria): Healthcare providers can also spot microscopic amounts of blood in pee when they do a urinalysis.
- Pain when you pee (dysuria): This is a burning or stinging sensation that you may feel when you start to pee or after you pee. Men and DMAB may have pain in their penises before or after peeing.
- Needing to pee a lot: Frequent urination means you’re peeing many times during a 24-hour period.
- Having trouble peeing: The flow of your pee may start and stop or the flow may not be as strong as usual.
- Persistent bladder infections: Bladder infections and bladder cancer symptoms have common symptoms. Contact your healthcare provider if you have a bladder infection that doesn’t go away after treatment with antibiotics.
Kidney Cancer
The exact cause of kidney cancer isn’t known, but there are certain risk factors that may increase your chances of getting the disease. These include:
- Smoking: People who smoke are at greater risk for kidney cancer. In addition, the longer a person smokes, the higher the risk.
- Obesity: Obesity is a risk factor for kidney cancer. In general, the more overweight a person is, the higher the risk.
- High blood pressure: Also called hypertension, high blood pressure has been linked to an increased risk of kidney cancer.
- Family history: People who have family members with kidney cancer may have an increased risk of developing cancer themselves.
- Radiation therapy: Women who have been treated with radiation for cancer of their reproductive organs may have a slightly increased risk of developing kidney cancer.
- Gene changes (mutations): Genes contain instructions for a cell’s function. Changes in certain genes can increase the risk of developing kidney cancer.
- Long-term dialysis treatment: Dialysis is the process of cleaning your blood by passing it through a special machine. Dialysis is used when a person’s kidneys aren’t functioning properly.
- Tuberous sclerosis complex: Tuberous sclerosis is a disease that causes seizures and intellectual disabilities, as well as the formation of tumors in many different organs.
- von Hippel-Lindau disease (VHL): People with this inherited disorder are at greater risk for developing kidney cancer. This disorder causes noncancerous tumors in your blood vessels, typically in your eyes and brain.
Bladder Cancer
Healthcare providers and researchers don’t know exactly why certain bladder cells mutate and become cancerous cells. They’ve identified many different risk factors that may increase your chance of developing bladder cancer, including:
- Cigarette smoke: Smoking cigarettes more than doubles your risk of developing bladder cancer. Smoking pipes and cigars and being exposed to second-hand smoke may also increase your risk.
- Radiation exposure: Radiation therapy to treat cancer may increase your risk of developing bladder cancer.
- Chemotherapy: Certain chemotherapy drugs may increase your risk.
- Exposure to certain chemicals: Studies show that people who work with certain chemicals used in dyes, rubber, leather, paint, some textiles and hairdressing supplies may have an increased risk.
- Frequent bladder infections: People who have frequent bladder infections, bladder stones or other urinary tract infections may be at an increased risk of squamous cell carcinoma.
- Chronic catheter use: People who have a chronic need for a catheter in their bladder may be at risk for squamous cell carcinoma.
Kidney Cancer
If you have kidney cancer symptoms, your healthcare provider will perform a complete medical history and physical exam. They also may order certain tests that can help in diagnosing and assessing cancer. These tests may include:
- Urinalysis: A sample of your urine (pee) is tested to see if it contains blood. Even very small traces of blood, invisible to the naked eye, can be detected in tests of urine samples.
- Blood tests: These tests count the number of each of the different kinds of blood cells, as well as look at different electrolytes in your body. A blood test can show if there are too few red blood cells (anemia), or if your kidney function is impaired (by looking at the creatinine).
- CT scan: This is a special X-ray that uses a computer to create a series of images, or slices, of the inside of your body. This test is often done with intravenous contrast (dye). People with impaired kidney function may not be able to receive the dye.
- Magnetic resonance imaging (MRI): This is a test that produces images of the inside of your body using a large magnet, radio waves and a computer.
- Ultrasound: This test uses high-frequency sound waves that are transmitted through body tissues to create images that are displayed on a monitor. This test is helpful in detecting tumors, which have a different density from healthy tissues.
- Renal mass biopsy: During this procedure, a thin needle is inserted into the tumor, and a small sample of your tissue is removed (biopsy). A pathologist will look at the tissue under a microscope to see if there are any cancer cells. Because biopsies for kidney cancer aren’t always completely reliable, your healthcare provider may or may not recommend this test.
Bladder Cancer
Healthcare providers do a series of tests to diagnose bladder cancer, including:
- Urinalysis: Providers use a variety of tests to analyze your pee. In this case, they may do urinalysis to rule out infection.
- Cytology: Providers examine cells under a microscope for signs of cancer.
- Cystoscopy: This is the primary test to identify and diagnose bladder cancer. For this test, providers use a pencil-sized lighted tube called a cystoscope to view the inside of your bladder and urethra. They may use a fluorescent dye and a special blue light that makes it easier to see cancer in your bladder. Providers may also take tissue samples while doing cystoscopies.
If urinalysis, cytology and cystoscopy results show you have bladder cancer, healthcare providers then do tests to learn more about the cancer, including:
- Transurethral resection of bladder tumor (TURBT): Providers do this procedure to remove bladder tumors for additional tests. TURBT procedures may also be a treatment, removing bladder tumors before the tumors can invade your bladder’s muscle wall. This test is an outpatient procedure done under spinal or general anesthesia. This helps in determining early stage non-invasive (confined to the lining of your bladder) or invasive (penetrating your bladder wall and possibly spreading to nearby organs or lymph nodes) disease.
- Magnetic resonance imaging (MRI) test: This imaging test uses a magnet, radio waves and a computer to take detailed images of your bladder.
- Computed tomography (CT) scan: Providers may do this test to see if cancer has spread outside of your bladder.
- Chest X-ray: This test lets providers check for signs bladder cancer has spread to your lungs.
- Bone scan: Like a chest X-ray, bone scans check for signs bladder cancer has spread to your bones.
Kidney Cancer
Kidney cancer treatment depends on the stage and grade of the tumor, as well as your age and overall health. Options include surgery, ablation, radiation therapy, targeted drug therapy, immunotherapy and sometimes chemotherapy.
Surgery
Surgery is the treatment of choice for most stages of kidney cancer. Several surgical options may be considered, including:
- Partial nephrectomy: Your surgeon removes the part of your kidney that contains the tumor.
- Radical nephrectomy: Your surgeon removes your entire kidney and some of the tissue around it. They may also remove some lymph nodes in the area.
When one kidney is removed, the remaining kidney is usually able to perform the work of both kidneys.
Ablation
Sometimes, heat and cold can destroy cancer cells. People who aren’t candidates for surgery may benefit from cryoablation or radiofrequency ablation.
- Cryoablation: During this procedure, your healthcare provider inserts a needle through your skin and into the kidney tumor. The cancer cells are then frozen with cold gas.
- Radiofrequency ablation: Your healthcare provider inserts a needle through your skin and into the kidney tumor. Next, an electrical current is passed through the cancer cells to destroy them.
Radiation therapy
Your healthcare provider may recommend radiation therapy if you only have one kidney or if you’re not eligible for surgery. Radiation therapy is most often used for easing kidney cancer symptoms, such as pain.
Targeted drug therapy
Targeted drug therapy blocks certain characteristics that help cancer cells thrive. For example, these drugs can stop the growth of new blood vessels or proteins that feed cancer.
Targeted drug therapy is often used when surgery isn’t an option. In some cases, these medications may be given after surgery to reduce the risk of cancer coming back.
Immunotherapy
Immunotherapy uses certain medications to boost your own immune system. In turn, this helps your body recognize and destroy cancer cells more effectively. Immunotherapy may be given as a standalone treatment or along with surgery.
Chemotherapy
Chemotherapy isn’t a standard treatment for kidney cancer. But it can be helpful in some cases — usually only after trying immunotherapy and targeted drug therapy. Chemotherapy medications are taken by mouth or given through a vein (intravenously) and are generally well tolerated.
Bladder Cancer
There are four types of bladder cancer treatment. Providers may use any or all of these treatments and may combine treatments.
Surgery
Surgery is a common bladder cancer treatment. Providers chose surgical options based on the cancer stage. For example, many times, TURBT, the procedure used to diagnose bladder cancer, can treat bladder cancer that hasn’t spread. Healthcare providers either remove the tumor or use high-energy electricity to burn it away with a process known as fulguration.
Radical cystectomy is another treatment option. This surgery removes your bladder and surrounding organs. It’s done when people have cancer that’s spread outside of their bladder or there are several early-stage tumors throughout their bladder.
In men and people DMAB, this surgery removes prostates and seminal vesicles. In women and people DFMB, providers may remove ovaries, their uterus and part of their vagina. Providers also do surgery known as urinary diversion so people can still pass pee.
Providers may follow surgery with chemotherapy or radiation therapy to kill any cancer cells surgery may have missed. This is adjuvant therapy.
Chemotherapy
These are cancer-killing drugs. Providers may use intravesical therapy to deliver chemotherapy drugs directly to your bladder via a tube inserted into your urethra. Intravesical therapy targets cancer without damaging healthy tissue.
Immunotherapy
Immunotherapy is a treatment that uses your immune system to attack cancer cells. There are different types of immunotherapy:
- Bacillus Calmette-Guérin (BCG): This is a vaccine that helps boost your immune system.
- PD-1 and PD-L1 inhibitor therapy: PD-1 and PD-L1 are proteins found on certain cells. PD-1 is on the surface of T-cells that help regulate your body’s immune responses. PD-L1 is a protein found on the surface of some cancer cells. When these two proteins connect, the connection keeps T-cells from killing cancer cells. In inhibitor therapy, the two proteins can’t connect, leaving the way clear for T-cells to kill cancer cells.
Radiation therapy
Radiation therapy may be an alternative to surgery. Healthcare providers may combine radiation therapy with TURBT and chemotherapy. This treatment is an alternative to bladder removal surgery. Healthcare providers consider factors such as tumor growth and tumor characteristics before recommending this treatment
Targeted therapy
Targeted therapy focuses on the genetic changes that turn healthy cells into cancer cells. For example, drugs called FGFR gene inhibitors target cells with gene changes that help cancer cells grow.
The stage wise 5-year survival percentages
Kidney (Renal Cell) Cancer
- Stage 1: ~93%
- Stage 2: ~74%
- Stage 3: ~53%
- Stage 4: ~12%
Urinary Bladder Cancer
- Stage 1: ~88–90%
- Stage 2: ~63%
- Stage 3: ~46%
- Stage 4: ~15%
Kidney Cancer
Because the exact cause of kidney cancer is unknown, there isn’t a way to prevent it altogether. However, you may be able to reduce your risk by not smoking and managing certain conditions like high blood pressure, diabetes and obesity.
Bladder Cancer
You may not be able to prevent bladder cancer, but it may be helpful to know the risk factors that may increase the chance you’ll develop bladder cancer. Bladder cancer risk factors may include:
- Smoking cigarettes: Cigarette smoking more than doubles the risk of developing bladder cancer. Smoking pipes and cigars or being exposed to second-hand smoke also increases that risk.
- Cancer treatments: Radiation therapy is the second-most common risk factor. People who have certain chemotherapy drugs may also develop an increased risk of bladder cancer.
- Exposure to certain chemicals: People who work with chemicals, such as aromatic amines (chemicals used in dyes), are at an increased risk. Extensive exposure to rubber, leather, some textiles, paint and hairdressing supplies, typically related to occupational exposure, also appears to increase the risk.
- Infections: People who have frequent bladder infections, bladder stones or other urinary tract diseases may have an increased risk of developing bladder cancer.
- Past bladder cancer: People with a previous bladder cancer are at increased risk to form new or recurrent bladder tumors.