What is Kidney Cancer?
Kidney cancer is a condition in which cells in the kidneys multiply uncontrollably and form an abnormal, malignant tumor. The kidneys are organs located in the lower back that produce and remove urine from the body. Kidney cancer can develop in one or both of these organs and spread to neighboring organs or other parts of the body over time.
There are several different types of kidney cancer, but the most common is renal cell carcinoma (RCC). RCC begins in the filtering cells of the kidneys and accounts for about 90% of kidney cancers in adults. Other less common types of kidney cancer include urothelial carcinoma (which starts in the cells lining the kidneys' urine-collecting system) and Wilms tumor (a type most often seen in children).
Which Patients Get Kidney Cancer Surgery?
Kidney cancer surgery is a method commonly used to treat kidney cancers, such as renal cell carcinoma (RCC). Surgical intervention can vary depending on the stage of the cancer, the size and location of the tumor, and the patient's general health. In large masses, the entire kidney is usually removed. Kidney-sparing surgery (partial nephrectomy) can also be performed based on these criteria. Here are the main situations in which kidney cancer surgery is performed:
1. Stage of Cancer and Size of Tumor
Localized Kidney Cancer: Surgery is usually the primary treatment for localized kidney cancer (when the cancer is limited to the kidney). Cancers at this stage can be completely removed with surgery, which can significantly increase disease-free survival rates.
Small Tumors (4 cm or smaller): In patients with small tumors, kidney-sparing surgery (partial nephrectomy) may be preferred. This procedure aims to remove only the cancerous part of the kidney and preserve healthy kidney tissue.
2. Spread of Cancer
Locally Spreading Cancer:If the cancer has spread to neighboring tissues or affected major blood vessels, radical nephrectomy may be performed. This procedure involves the entire affected kidney and surrounding fatty tissue, and sometimes surrounding lymph nodes.
Metastatic Kidney Cancer:Surgery can also be performed for palliative purposes in some cases of metastatic (spread) kidney cancer to control symptoms or slow the progression of the disease. However, systemic treatments (such as immunotherapy or targeted therapies) are usually recommended for these cases.
3. General Health Status of the Patient
The patient's physical fitness for surgery is assessed. Elderly patients or patients with serious comorbidities may not be suitable for major surgery. In such cases, other treatment methods or less invasive surgical options may be considered.
3. Patient Preferences
The patient’s treatment preferences and quality of life goals also play a role in the decision to have surgery. Some patients may prefer less invasive treatments because of the potential complications or long-term effects of surgery.
Kidney cancer surgery is usually evaluated by a team of oncologists, urologists, and other healthcare professionals as part of the treatment plan. After a thorough evaluation of the patient’s condition and treatment options, the most appropriate treatment method is recommended. Patients are encouraged to be informed about treatment options and potential outcomes and to take an active role in the process.
Kidney Cancer Surgery Types, Success Rates, and Complications
Kidney cancer is usually treated with surgery, and the type of treatment varies depending on the size, location, and stage of the cancer. The success rates and complications of surgical methods also vary depending on these factors.
1. Radical Nephrectomy
Radical nephrectomy involves removing the entire affected kidney, along with surrounding fat, the adrenal gland, and sometimes nearby lymph nodes. This method is usually used for tumors that are large or in strategically difficult locations.
Radical nephrectomy has high success rates for localized and some advanced kidney cancers. If the cancer is only in the kidneyIf the tumor is limited to the lung and can be completely removed, disease-free survival rates increase significantly.
Bleeding, infection, risk of damage to adjacent organs, prolonged pain, and, rarely, anesthesia-related complications may occur.
2. Partial Nephrectomy
Partial nephrectomy involves removing only the cancerous tumor and some healthy tissue. This method aims to preserve the remaining part of the kidney and thus preserve kidney function at maximum.
Partial nephrectomy is ideal for early-stage kidney cancer and preserves kidney function while minimizing the risk of cancer recurrence if the tumor is small and well-positioned.
Bleeding, infection, temporary or permanent decrease in kidney function, and kidney damage during surgery may occur.
3. Laparoscopic and Robot-Assisted Surgery
These minimally invasive techniques are performed using smaller incisions and are usually performed with the help of robotic technology or laparoscopic equipment. These methods allow the patient to recover faster and experience less pain.
Laparoscopic and robot-assisted surgical methods have similar success rates in partial and radical nephrectomy if the surgeon is experienced.
Anesthesia-related risks, infection, bleeding, and rarely technical complications can be seen.
Success rates and complications may vary depending on the surgeon's experience, the patient's general health status, and the stage of the cancer. It is important for patients to be carefully evaluated and monitored before and after surgery. When making a surgical decision, the patient's quality of life, potential survival time, and side effects of other treatment options should be taken into consideration.
Since each patient's condition is unique, the most appropriate treatment method should be decided by carefully evaluating the treatment options, potential benefits, and risks. Patients should have open communication with their healthcare providers to receive comprehensive information about their treatment options and to take an active role in the process.
Patient Questions and Answers
Kidney cancer surgery brings important questions for patients and their families. Frequently asked questions and answers to these questions are detailed below, according to the type of surgery:
Question: How will my life be affected after radical nephrectomy?
Answer: Since radical nephrectomy removes the entire affected kidney, the remaining healthy kidney will take over the functions the body needs. Most people can live a normal life with only one kidney. However, in some cases, long-term health problems such as fatigue or protein/electrolyte imbalances may occur.
Question: Does cancer recur after radical nephrectomy?
Answer: The risk of cancer recurring depends on whether the tumor was completely removed during surgery, the stage and type of cancer. Regular follow-ups with your doctor can help you spot any signs of recurrence early.
Question: How will my kidney function be affected after partial nephrectomy?
Answer: A partial nephrectomy aims to preserve most of the kidney function because it removes only the cancerous part of the kidney. After the procedure, the remaining kidney tissue usually functions normally. However, depending on your preoperative kidney function, you may experience some functional changes.
Question: What is the risk of cancer recurrence after partial nephrectomy?
Answer: Partial nephrectomy is an effective treatment method, especially if the tumor is small and well-established. However, there is a risk of cancer recurrence depending on whether the margins of the tumor are clear. Therefore, regular follow-up is very important.
Question: How long does recovery take after laparoscopic or robot-assisted surgery?
Answer: These minimally invasive methods offer faster recovery times than open surgery. Patients are usually discharged from the hospital within a few days and can return to normal activities within a few weeks. Full recovery and pain relief vary from person to person, but are usually shorter.
Question: What are the complications of laparoscopic or robot-assisted surgery?
Answer: These methods are generally associated with less pain and a lower risk of complications, but bleeding, infection, and, rarely, technical complications can still occur. Also, as with any surgical procedure, there are risks associated with anesthesia.
Question: Kidney cancer surgeryWhat kind of follow-up is needed after surgery?
Answer: Follow-up after surgery varies depending on the type and stage of your cancer and your response to treatment. It usually includes regular physical exams, blood tests, and imaging tests (for example, CT or MRI scans). It is important to discuss your follow-up plan and schedule with your doctor in detail.