เนื้องอกที่ไต (Kidney Tumors) อาการ สาเหตุ การตรวจวินิจฉัยและการรักษา

Kidney Tumors

Kidney tumors are becoming more common in today's society due to modern diagnostic radiological instruments and easier access to health check-ups. Screening and diagnosis are, therefore, more accurate.

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Kidney tumors

Kidney tumors are becoming more common in today's society due to modern diagnostic radiological instruments and easier access to health check-ups. Screening and diagnosis are, therefore, more accurate. Kidney tumors can be non-cancerous and malignant tumors. An accurate understanding of kidney tumors is essential for the most accurate and effective treatment.

The most common type of benign kidney tumor is a kidney cyst, most of which is not dangerous and is usually accidentally found during an ultrasound examination. No treatment is required, but the size and smoothness of the walls should be monitored periodically as there are minimal chances of complications. In addition, it is necessary to assess the risk of hidden kidney cancer.

An ultrasound and computed tomography scan can distinguish several types of kidney cysts and can clearly identify a lump.

เนื้องอกที่ไต (Kidney Tumors)

Type 1 – 2  Smooth cysts. The risk of kidney cancer is low. Periodic monitoring is required.

Type 3 – 4 Rough cysts with walls. The risk of kidney cancer is high. A biopsy or surgical removal is required.

A common type of benign kidney tumor is angiomyolipoma (AML), which is a tumor of fat, blood vessels, and smooth muscle cells. This type of tumor usually is accompanied by a tear of blood vessels when larger than 4 cm, causing harm and complications. Therefore, treatment must be done by shrinking or surgically removing. If a tumor is small, monitor the size periodically through an ultrasound.

Malignant kidney tumors or "kidney cancer" are rare when compared to other cancers. There were 1.6 cases of kidney cancer per 100,000 people. The disease is more common in males than females and is more common in patients aged 50-70 years. Although kidney cancer is not highly prevalent, it is still fatal. It is important to understand it more.

Risk factors for kidney cancer

Risk factors for kidney cancer include avoidable factors, such as smoking, obesity, and high blood pressure, and an unavoidable factor, which is genetics. Those with a parent, a sibling, or a relative who has cancer are at greater risk. It has been found that the use of certain herbs, such as Aristolochia sp., can cause cancer, in addition to prolonged use of certain painkillers.

Symptoms of Kidney Cancer

Early-stage kidney cancer usually is asymptomatic until the cancer becomes much larger. The patient will have lumbar pain. A lump will be found in the lumbar area. Other symptoms include blood in urine, loss of appetite, and unexplained weight loss. It was found that about half of kidney cancer patients recognize cancer during annual check-ups or physical examinations for other medical conditions that are not directly related to kidney cancer.

Diagnosis

The doctor will take a history and physical examination to assess the severity of the disease and physical fitness. Blood and urine tests will be conducted for kidney function and body strength assessment. Finally, a computed tomography (CT) scan will be used for a more efficient and accurate diagnosis.

Treatment

Noninvasive kidney cancer that is diagnosed early is easier to treat. A suitable treatment modality will depend on the size and the spread of cancer cells. Surgical removal is the first treatment option, often used in almost all cases. Unlike other cancers, chemotherapy is not as effective as it should be in treating kidney cancer. However, other non-surgical treatments, such as radiotherapy or medications, are often used to kill cancer cells in an advanced stage where the cancer cells spread away from the kidney.

Surgery is the only treatment that can cure stage 1-3 kidney cancer. Nowadays, kidney cancer surgery has become very advanced and effective.

The principle of kidney cancer surgery is to remove all malignant tumors from a patient. However, an assessment needs to be made first. If the malignant tumor is small, only remove it and stitch the kidney. If the lump is very large, more than 4 cm, the whole kidney must be removed. A human has 2 kidneys. If one is removed, a human can still survive with the other.

  • Open surgery is a traditional treatment that removes cancer in the ribs. The lesion will be quite long. The patient will lose a lot of blood and after surgery, it may cause shortness of breath due to pain in the rib area. The wound may heal slowly. This slows down recovery. The advantage of open surgery is affordability.

  • Laparoscopic surgery involves inserting a laparoscope into the abdomen for kidney surgery. A pneumoperitoneum will be created to provide space for surgery. The advantage of this type of surgery is a small incision, lower blood loss, fast recovery, and little post-operative pain because the kidney can be removed from the lower abdomen incision.

    In laparoscopic surgery, the surgeon must have a certain level of expertise. Unlike normal human hands, the device used will look like an elongated rod. In addition, the image will be displayed on a monitor. Therefore, there must be consistent hand-eye coordination.

Prevention

Since the causes of kidney cancer are still unknown, there is no cure for the disease yet. However, a healthy lifestyle may help reduce the likelihood of developing cancer. Eating a healthy diet and exercising regularly can help avoid being overweight or obese, which are very important risk factors for kidney cancer. If you are overweight or obese, you can lose weight and maintain a healthy weight by exercising regularly along with a calorie-controlled diet.

Prognosis of kidney cancer

The prognosis of kidney cancer usually responds well to treatment. If kidney cancer is diagnosed at an early stage when cancer cells are still confined to the kidneys, it be cured by removing part of the kidney or entirely, as people can live healthily even with one kidney. About a third of detected kidney cancer patients are diagnosed at an early stage. About 65-90% of patients can survive for at least five years after being diagnosed with early-stage kidney cancer. Many patients can live longer. The life expectancy of kidney cancer patients with invasive cancer is not good. Only about 40-70% of patients with advanced kidney cancer can survive for at least five years after diagnosis. In case kidney cancer has advanced and spread to other parts of the body, only about 10% of patients are able to live at least five years after being diagnosed.

When to see a doctor

Seek medical attention immediately if you experience pain, swelling, or a lump in the kidney area, generally found on only one side of the body at the lower edge of the ribs. Moreover, it is advised to see a doctor if you notice blood in your urine. Although it may not be due to kidney cancer, it may be caused by other less serious diseases that require treatment, such as urinary tract infections, kidney stones, bladder stones, or urothelial tumors.

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Published: 15 Nov 2020

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