<i>Kidney cancer</i>

Dr. Robert Drake

The kidneys are two bean shaped organs the size of your fist on each side of the spine near the level of the lower ribs. The kidneys maintain fluid and electrolyte balance, remove waste products, clean the blood, control blood pressure, and produce hormones to make blood and maintain strong bones

Kidney cancer is one of the 10 most common cancers in the United States making up 4 % of all cancers and about 62,000 new cases a year. Renal cell carcinoma accounts for 90% of all kidney cancers. It is more common in men especially black men and is usually found between the ages of 60 and 70. About 30% of patients will have metastatic spread at time of diagnosis and treatment is more complicated and challenging because of the cancer cells resistance to treatment.

Risk factors for renal cell carcinoma include;

*Tobacco use

*Obesity

*Patients on long term dialysis

*Occupational exposure to trichloroethylene (Most commonly encountered by mechanics, dry cleaners, oil processors, polyvinyl chloride manufacturers and low nicotine tobacco products. Also exposure to asbestos and cadmium.

* Hereditary and familial syndromes.

*Old age

*Hypertension

*Men twice as common as women

More than 50% of patients with renal cell carcinoma have no symptoms and are diagnosed incidentally during imaging for other unrelated issues. For example found on CT scan being done for other reasons. The kidney cancer may grow quite large without causing pain or problems. There are no recommended screening tests. The kidneys are unable to be seen or felt on physical exam due to their location.

Signs and symptoms of kidney cancer may include;

* Blood in the urine

*Loss of appetite and unexplained weight loss 28%

*Anemia in 21%

*Tiredness

*Mass in the side or lower back

*Fever

*Back pain that won't go away and feeling of pressure when in later stages

Solid tumors are managed according to size and the age and health of the patient. Different surgical options may be considered including partial nephrectomy, radical nephrectomy, thermal ablation, cryoablation or radiofrequency ablation. Active surveillance is acceptable in some patients when the mass is less than 2 cm with repeat CT scans every 3 to 6 months.

Treatment may include surgery, radiation and chemotherapy.

Dr. Drake is board certified by the American Board of Family Medicine and is a past president of the Kentucky Academy of Family Physicians and a member of the American Academy of Family Physicians. Dr Drake had practiced in Somerset since 1984.

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