Kidney cancer!

Renal cell cancers, whose incidence has increased in recent years, are mostly seen in the 50-60s. It is more common in men and although the exact cause is not known, environmental factors, genetic and familial factors play an important role. There may be complaints of weight loss, bleeding in the urine, flank pain, and sometimes a palpable mass. However, in advanced kidney cancers, they also apply with complaints such as shortness of breath, cough, bone pain, and headache.

Anemia can be seen in one third. In patients with suspected kidney cancer (RCC), urinalysis, blood tests, and then urinary system ultrasonography and contrast-enhanced computer tomography are the first methods we apply to establish the diagnosis. With these examinations, it can be understood whether there is a kidney tumor, whether the kidney cysts are simple or complex, whether the tumor is limited to the kidney, if the tumor has spread to the renal vessels, inferior vena cava or adrenal gland, or whether it has spread to more distant organs. Tumor staging can be done according to all these evaluations. Accordingly, the size of the tumor (whether it is less than 7 cm), spread to the adrenal gland and the fat layer around the kidney (perinephric), spread to the renal artery and vein, vena cava, past the fascia around the kidney (gerota), spread to the lymph nodes (glands) It is very important and helps both in estimating the course of the disease and in determining the type of treatment (surgery).

In the treatment, a route is chosen according to whether the disease is localized (limited to the kidney). Surgical removal of the early-stage tumor (radical nephrectomy) is currently the only treatment with therapeutic potential for RCC patients. Our goal in this treatment is to remove the tumor and surrounding normal tissue. If the tumor is large and difficult to separate from the collecting system, the tumor kidney and surrounding fat tissue are also removed. This is an extended nephrectomy. If the tumor is small, if the patient has only one functioning kidney and if both kidneys have tumors, then we perform partial (nephron-sparing-kidney-sparing) nephrectomy. Radiotherapy has little place in kidney tumors. Again, the place of chemotherapy is limited. For a long time, the application of immunotherapy (interferon-interleukin) treatment in both advanced and metastatic kidney tumors has been common. In the last few years, a glimmer of hope has emerged in kidney tumors that have spread with agents such as sorafenib, sunitinib, and temsirolimus under the name of targeted therapy, or in patients who no longer have a cure for treatment.

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