Kidney Cancer

Kidney cancer is the cancer of the kidneys, the 2 bean-shaped organs responsible for the removal of waste from our body to be passed out as urine. Kidney cancer is among the top 10 most common cancers affecting men in Singapore.

Kidney cancer is a silent killer. By the time the symptoms are obvious, the cancer is usually in the late stage. It is very important that symptoms are taken seriously when they occur, as further delay in treatment will lessen its effectiveness.

Causes of Kidney Cancer

The causes of kidney cancer remain a mystery. Certain hereditary conditions will make a person more likely to get kidney cancer but they are not common. Cigarette smoking increases kidney cancer risks greatly and long-term use of certain painkillers may also increase these risks. Poorly controlled high blood pressure also seems to be linked to kidney cancer but has never been fully proven.

Although the rates of kidney cancer in Singapore has remained stable in the past decade, there is a rise in the number of the cancer being found and treated early. These are usually picked up during health screening when small kidney masses, which otherwise have no obvious clinical symptoms, are found. These patients are usually healthy individuals, if not for the cancer.

Treatment and prognosis (likely development of the condition) of early and late stage kidney cancers are very different from each other.

Kidney cancers found early during routine health checks have a high cure rate and chemotherapy and radiotherapy are rarely needed. Kidney cancers in their late stages, however, may carry a much poorer outcome and its management is usually focused on providing comfort for the patient.

Systemic Treatment of Kidney Cancer

Chemotherapy has little role in kidney cancers. Other systemic treatments like multi-kinase inhibitors can help with managing late-stage kidney disease. Radiotherapy has a role in preventing the kidney cancer from spreading. In patients with terminal kidney cancer that has spread to the spine or bones, local radiotherapy can reduce the risk of spinal cord compression and fractures caused by the cancer destroying the bones.

Removing Small Tumours

In carefully selected patients, small kidney masses can be removed with techniques like radiofrequency ablation (RFA) and cryoablation. These options use heat and cold respectively to kill cancerous cells while preserving the remaining kidney tissue. When used in carefully selected patients, this can result in good long-term cure rates.

Advanced Techniques to Treat Early Kidney Cancers

Minimally invasive  (laparoscopic) partial nephrectomy has changed the way we manage small, early stage kidney cancers. Traditionally, patients with kidney cancer will have their affected kidney removed through surgery (complete nephrectomy). In a partial nephrectomy, part of the affected kidney is spared as the surgeon removes only the tumour. This procedure can help preserve kidney tissue and reduce the chance of patients with pre-existing kidney failure needing kidney dialysis.

Laparoscopic partial nephrectomy typically involves a shorter hospital stay and reduced post-operative pain as surgical wounds are much smaller than a traditional open surgery. Recovery from the operation tends to be faster than traditional open surgery with the patient returning to normal activities quicker.

Studies have shown that there is no difference in cure rates between laparoscopic partial nephrectomy and radical (complete) nephrectomy.

Prevention of Kidney Cancer

As the causes of kidney cancer remain a mystery, there are no proven ways to prevent it. Maintaining good control of blood pressure and quitting a smoking habit can help reduce the risk of kidney cancer. A balanced diet, regular exercise and adequate sleep are also steps that can possibly help reduce the risk of major cancers.