Kidney Cancer

Q1. What are the major functions of the kidneys?
Kidneys are important organs. They work as a big filter, in which metabolic waste, excess fluid, electrolytes, etc. are removed from the blood and excreted via the bladder of the urinary system. Kidneys also have a special but less-mentioned function: to provide a hormone called erythropoietin. Erythropoietin stimulates red blood cell production. Renal failure patients may have anemia due to the lack of erythropoietin.

Q2. What are the types of kidney cancer?
According to the Hong Kong Cancer Registry, there were over 800 new cases of kidney cancer in 2019. Most of them were found in the renal parenchyma and known as renal cell carcinoma. A minority occurred in the renal pelvis as transitional metastatic cell carcinoma, which is similar to the bladder cancer type.

Q3. What are the symptoms of kidney cancer?
Early kidney cancer is mostly asymptomatic. More than 50% of early kidney cancer cases are diagnosed during physical or imaging examination. When kidney cancer develops to a certain stage, the tumour becomes larger or metastatic with symptoms such as haematuria, back pain, etc. Bone pain, weight loss or fatigue occurs when cancer spreads to the bones. 

Q4. How is renal cell carcinoma detected at early stage?
Early renal cell carcinoma is usually found during clinical examination or ultrasound scanning etc., and is very frequently diagnosed by chance during cardiac CT scanning. Most cases are less than 3cm to 4cm in size and predominantly asymptomatic.

Q5. Can kidney cancer be cured?
Early renal cell carcinoma is definitely curable. When found during examination or by chance, it can mostly be treated with partial nephrectomy, either through robot-assisted minimally invasive surgery or laparoscopy. Partial or radical open nephrectomy may be performed if the tumour has grown to a certain size. In advanced or metastatic cases that cannot be cured by surgery, medications may be prescribed to prevent and control cancer progression, such as targeted therapy or immunotherapy.

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