“There is an increasing prevalence of kidney cancer in Pakistan due to lifestyle choices and genetic factors. The most common type of kidney cancer is renal cell carcinoma, which accounts for 90 percent of cases. Renal cell carcinoma (RCC) can have serious consequences for patients who withdraw from society, as renal cell carcinoma can limit their ability to carry out everyday activities. “
These facts shared Dr. Abdul Qayyum, Consulting Clinical Oncologist and Assistant Professor at Dr. Ziauddin University Hospital, Karachi, at a virtual meeting held by the Neurospinal and Cancer Care Institute, Karachi, entitled “Kidney Cancer – A Silent Killer” on Saturday.
The causes of kidney cancer are largely unknown but appear to be multifactorial in nature. Various risk factors have been studied, some of which are modifiable, creating an opportunity for primary prevention.
“Notable risk factors are tobacco smoking including cigars and sheesha, obesity, alcohol consumption, sedentary lifestyle, high blood pressure, chronic kidney disease, kidney stones and diabetes mellitus. Environmental and occupational exposures including trichlorethylene, aflatoxins, hormones, lead compounds, radiation, certain viruses, and aristolochic acid (aristolochic acids are a group of acids naturally found in many plant species known as aristolochia and in wild ginger) and genetic risk factors. Acquired cystic disease, which is common in end-stage kidney disease, is also linked to a high incidence of RCC, ”said Dr. Qayyum further.
“Middle-aged adults who ate the most red meat were 19 percent more likely to be diagnosed with kidney cancer than those who ate the least. A higher intake of chemicals in grilled or grilled meat was also linked to an increased risk of disease; People should limit their intake of red and processed meat and prepare meat through cooking methods such as baking and grilling, ”he advised.
“Kidney cancer is about twice as common in men as it is in women. The lifetime risk of developing kidney cancer is 1 in 46 for men and 1 in 80 for women. This is more common among African Americans and Native Americans. About 5-8 percent of kidney cancer cases are related to family genetics, ”said Dr. Qayyum.
“Most people with kidney cancer are older, with 55 being the average age at diagnosis. Kidney cancer is becoming more common. Recent statistics show that it is the 10th most common cancer worldwide, causing more than 131,000 deaths and 413,000 new cases each year. About 30-40 percent of patients have metastatic disease, another 30-40 percent of patients with localized or locally advanced disease subsequently develop metastases. “
The expert’s projections show kidney cancer cases will increase another 26 percent by 2035, which would make it one of the fastest growing cancers.
Dr. Iqbal Shehzad, Consultant Urologist and Assistant Professor at Liaquat National Hospital, gave a urologist’s view of kidney cancer and shared his experience in dealing with such patients.
According to the health expert, kidney cancer is a type of cancer that is difficult to detect because the organs are deep in the body, and most cases of kidney cancer are discovered accidentally through common imaging such as ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) from others Establish.
Kidney cancer or kidney cancer shows symptoms similar to those of a urinary tract infection (UTI), so it’s important to test even the smallest symptoms for early detection. “Blood in the urine, loss of appetite and rapid unexplained weight loss, non-injury lower back pain, swelling of the ankles and legs, mass or lump in the side or lower back, fatigue, recurrent fever that was not or was caused by a cold Flu, ”said Dr. Shehzad, highlighting the signs and symptoms.
“People with kidney cancer often only have blood in their urine once. For this reason, the cause of blood in the urine needs to be investigated immediately by your family doctor. Early detection of kidney cancer is key to successful treatment, so it is important to monitor symptoms closely and have them examined by a doctor. “
Kidney cancer usually does not respond to radiation or chemotherapy, ”said Dr. Shehzad. “The only way to deal with this is to have a full or radical nephrectomy (resection of the entire kidney). RN is still performed in about 35 percent of kidney tumor cases. “
“The most popular surgical treatment option is nephron-sparing surgery (NSS) through partial nephrectomy (PN). This procedure has been extensively studied and is the standard in treating smaller kidney tumors, ”said Dr. Shehzad.
“PN was reserved for patients with solitary kidney function, bilateral kidney tumors, hereditary kidney tumors (e.g. von Hippel-Lindau disease), patients with kidney dysfunction and those with comorbidities who predispose to future kidney damage. In patients with small tumors and healthy contralateral kidneys, PN is now performed routinely and electively. “
Dr. Shehzad added that kidney tumors removed at an early stage rarely recurred and the patient had an excellent prognosis after surgery. “People with malignant tumors that grow outside the kidney and underwent stage I surgery had a 93 percent survival rate over the next five years.”
“There are several new and exciting therapies on the horizon that have the potential to treat metastatic RCC and eventually improve current dismal survival statistics,” said Dr. Lubna Saleem, Consultative Medical Oncologist at Cancer Foundation Hospital in Karachi. .
“Kidney cancer is not a single disease, but a heterogeneous group of at least five different histological types. This malignancy occurs both in a sporadic, non-inherited form and in a hereditary form, the latter being associated with clear, known genetic mutations and thus identifiable diseases or syndromes. “
Treatment options and recommendations depend on several factors including cell type and cancer stage, possible side effects, and the patient’s preferences and general health.
Kidney cancer is most commonly treated with surgery, targeted therapy, immunotherapy, or a combination of these treatments. Radiation therapy and chemotherapy are used occasionally. People with has spread of kidney cancer, also called metastatic cancer, often receive multiple lines of therapy.
Sometimes the doctor may recommend closely monitoring the tumor with regular diagnostic tests and clinic appointments. This is known as “active monitoring”. Active surveillance is effective in older adults and people with a small kidney tumor and other serious medical conditions such as heart disease, chronic kidney disease, or severe lung disease.
Today, immunotherapy is becoming the new standard approach based on clinical studies showing that it has greater benefits than targeted therapy. “Immunotherapy works by stimulating your immune system to fight cancer. This approach can cure some people and allow others to control their disease for years to come. More information is needed from clinical trials on how patients are doing after treatment, but in the next few years most patients with advanced kidney cancer are likely to receive immunotherapy as part of their first treatment regimen, “said Dr. Lubna.
Targeted therapy is still important, as it is now combined with immunotherapy and can be useful if immunotherapy does not work. Compared to traditional forms of cancer medicine such as chemotherapy and radiation therapy, immunotherapy causes far fewer side effects. In addition, it can only target cancer cells without damaging other healthy tissue, as is often the case with chemotherapy.
Patients who respond to these drugs achieve remissions that are measured not in additional weeks or months of life, but in lifetimes.
“Such transformative, enduring responses are the unique value proposition of the immunotherapeutic approach to cancer,” said Dr. Lubna continues.
Adeel Ahmed, Manager Marketing at NCCI, thanked and paid tribute to the speakers and the medical community.
At the NCCI, he said, “We are committed to helping patients get the information they need about kidney cancer and qualified resources for their conditions.”
“We are also focusing on local research and advocacy programs, not only to develop treatments to meet unmet medical needs, but also to raise awareness of disease prevention, cancer screening and treatment options at the community level,” Ahmed said, calling on NGOs and Industrial companies are looking for help and coordination with cancer treatment facilities to provide more comprehensive and comprehensive support for these patients.