When the first complaints to palpate the tumor fails in 50-60%
patients. Features palpation depends on the size of the tumor,
its localization and state of the anterior abdominal wall. Pain in the upper quadrant
on the affected side often observed with large tumors that
with increasing stretch or compress the kidney capsule nerve
trunks. The combination of all these symptoms that reveal
10-20% of patients, usually indicates far come
process. Because fever is more common extrarenal symptoms
hypertension, polycythemia, anemia, hypercalcemia,
Diagnosis of Kidney Cancer
Diagnosis of renal cancer, the presence of
modern methods of research, presents no particular difficulties.
Laboratory methods are of secondary importance. Diagnosis
It is primarily based on the results of ultrasound,
X-ray, computed and magnetic resonance imaging. how
Generally, the study begins with kidney excretion (iv) urography,
which allows you to get an idea of renal function and, in some
cases, establish the presence of the bulk process. On tomograms reveal
the scope and contours of the kidney, its relationship with the surrounding organs
and tissues. At the same time, you can set the degree of spread
tumor, i.e. to identify the spread of cancer in the region
gate kidney, lymph nodes affected by the presence of thrombus and the bottom
vena cava, liver metastases. Angiography (X-ray examination of the vessels with the introduction of contrast vesch Islands) should be performed
Only if there are doubts in the diagnosis or surgeon
interested in the blood supply to the tumor. Cavagraphy (contrast administration into the inferior vena cava through a femoral vein) is used for
establishing the degree of tumor dissemination, wherein
detect thrombi in the inferior vena cava and its compression and displacement of the tumor.
and the only radical method of treatment is surgical
intervention. Radiation and chemotherapy are of secondary importance.
With regard to the indication nephrectomy cancer patients I, II and III stages
There is a common opinion that if there is no generally accepted contraindications
to surgical treatment, it is necessary to remove a kidney from fatty tissue
and lymph nodes with metastasis. With regard to cancer patients
Stage IV, in each case requires individual approach.
Stage IV kidney cancer patients whose condition remains
satisfactory, should operate if they have a single
It argued the feasibility of nephrectomy in patients with metastatic disease the following considerations:
- nephrectomy (removal of the affected kidney) It allows to eliminate the painful symptoms of the disease -
stop pain, debilitating chills, appetite appears and many
the patient's condition improved so that they can begin
to work. Remission can last from 3-4 months to a year or more;
- operation eliminates the complications associated with the collapse of the tumor, including massive bleeding and intoxication;
- removing the bulk of the tumor and reducing the volume of the tumor mass, we are
This increases the opportunities held in the subsequent chemotherapy
and radiation treatment.
for surgery are extreme exhaustion of the body, swelling, massive
multiple metastases, impaired function of the remaining kidney, heavy
related diseases in which any contraindicated
surgical intervention. The risk of surgery should not be higher
normal. It should be emphasized that in determining readings
for surgery in patients with metastatic disease, it is necessary to take into account the limited
the possibility of subsequent drug and radiation therapy.
In recent years, thanks to the improvement of
diagnostic techniques in patients with small tumors became
apply partial nephrectomy (partial excision of the affected organ). The direct indication for the implementation of this
surgery is functional insufficiency of the remaining kidney or
a tumor in the only functioning kidney. You can run
kidney resection with good function of both kidneys, if the tumor is less than 3
cm. However, it should be remembered that there is a probability of recurrence (recurrence, resumption)
Drug treatment of kidney cancer
Medicinal treatment of kidney cancer and its metastasis to the present
time remains low. The most effective should be recognized
immunotherapy. Use of a-interferon drugs (Nitron-A,
IFN, Roferon, vellferon) allows you to get up to 30-35% of the total
and partial tumor regressions. Regression exposed, as a rule,
single, small lung metatazy sizes. The effect of
a drug interferon can sometimes manifest itself in a few
months after initiation of therapy.
Treatment should be carried out continuously,
without interruption and after the regression. interferon preparations
have side effects such as hyperthermia, muscle pain,
sometimes - loss of weight. On the effectiveness of interferon at
kidney cancer metastases may compete only IL-2 but
the drug has severe side effects and high cost.
From cytostatics in renal cancer are effective
drugs like vinblastine, vincristine, CCNU (lomustine), bleomycin,
cisplatin, etoposide, adriamycin, cyclophosphamide, hydroxyurea.
The effectiveness of combination therapy - 15-20%.