Oncological diseases are by far the second most common cause of death among the world's population. Many factors affecting a person on a daily basis, such as radiation from household appliances, carcinogens in food, smog and cigarette smoke stimulate the development of malignant tumors in the human body. Kidney cancer, which is one of the most life-threatening urological pathologies, also claims the lives of many people every day. Nevertheless, a properly selected and timely treatment regimen for kidney cancer can save a person's life for many years.
Modern methods of kidney cancer treatment
The treatment of kidney cancer is not a one-time process, but rather a long and psychologically and physically difficult process for the patient. But a competent and individual selection of a therapeutic regimen helps to make the treatment process as comfortable as possible with minimal side effects. Early detection and removal of the primary tumor focus is the key to the most successful treatment. To date, the treatment regimen for kidney cancer is combined: surgery, chemotherapy and radiation therapy are used.
Kidney Cancer Treatment:
- nephrectomy – radical surgery to treat kidney cancer;
- surgical interventions for bilateral cancer or cancer of a single kidney;
- radiotherapy and chemotherapy in the treatment of kidney cancer.
Neprectomy – radical surgery for kidney cancer
The only radical treatment for kidney cancer today is nephrectomy – removal of the kidney with near the renal fat body, behind the peritoneal tissue and regional lymph nodes. If a malignant lesion of the upper pole of the kidney is observed, it is recommended to remove the adrenal glands as well. Most often, transabdominal and thoracoabdominal approaches are used to ensure maximum atraumaticity and radicalness of surgical intervention.
The tactics of surgical intervention is as follows: first of all, a nephrectomy is performed, and if the operation is radical, decide on the possibility of re-intervention. With a good general condition of the patient and the presence of no more than a single metastasis, the operation is repeated after 2 weeks. Contraindications for nephrectomy for kidney cancer are as follows:
- severe patient cachexia;
- multiple metastases;
- massive tumor invasion into adjacent tissues;
- significant decrease in the function of the second kidney.
Surgical interventions for bilateral cancer or cancer of a single kidney
If the cancer process affects both kidneys, or the only kidney in a patient who has previously lost the second kidney, the following surgical interventions are performed:
- partial or complete removal of a single kidney with the transfer of the patient to a renoprival state;
- if both kidneys are affected – removal of one of them and partial resection or removal of the tumor node of the second;
- bilateral nephrectomy;
- extracorporeal tumor removal and kidney autotransplantation.
The renoprival state after surgery implies the application of an arteriovenous shunt at the end of surgery and the appointment of systematic hemodialysis in order to prepare the patient for kidney transplantation. Organ-sparing surgery for bilateral kidney cancer or cancer of a single kidney is not radical, but helps to maximize the patient's life expectancy.
Radiation therapy and chemotherapy in the treatment of kidney cancer
Radiation therapy for kidney cancer is used in the palliative care of patients with severe symptoms, as a stand-alone treatment for kidney cancer metastases, or for the purpose of preoperative patient preparation. Preoperative irradiation is recommended to be carried out at a dose of 4 Gy throughout 5 days, after which, after 24-48 hours, surgery is necessary. Postoperative irradiation is used in case of doubtful radicalness of the performed operation or with large tumor sizes. In such cases, the dose is 45-50 Gy for 5 days. Among the chemotherapy drugs, the biological activators alpha-interferons and interleukin-2, to which the greatest sensitivity of malignant neoplasms is observed, have received the greatest prevalence.
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