Traditionally, patients with kidney cancer presents with blood in the urine and / or flank pain. However, in recent years, many cases are detected during health screening and the patients do not have any symptoms. The diagnosis is then confirmed on radiologic imaging such as computerised tomography (CT scan).
As in the management of prostate and bladder cancers, it is necessary to stage the kidney cancer. In this regard, the CT scan is able to provide important information including the size of the kidney cancer, involvement of the renal vein (blood vessel that transport blood from the kidney to the heart), inferior vena cava (main blood vessel that transport blood from lower part of the body to the heart), surrounding lymph nodes and liver.
In cases where the cancer is confined to the kidney, the main treatment modality is surgery. The surgery involves removing the whole kidney together with surrounding tissues. In selected cases, only the cancerous growth is removed and the rest of the kidney is preserved. This is possible only for some cases of kidney cancer and depends on factors such as the size and location of the cancer in the kidney. Surgery is done with general anaesthesia and requires hospitalisation, Besides the traditional method of open surgery (cutting through skin and muscles), the surgery can also be carried out via laparoscopy (key hole surgery).
In cases where the cancer has spread beyond the kidney, for example to the lungs, one option is combination therapy. This involves both surgery and immunotherapy. Surgery entails removing the kidney, as alluded to, whilst immunotherapy targets the kidney cancer cells that have spread to other organs. Immunotherapy is usually administered via oral medication. This is an area where, in the past decade, great advances have been made and it has radically changed the treatment of advanced stages of kidney cancer.