What are the known Risk Factors for Kidney Cancer (Renal Cell Carcinoma – RCC)

 

Smoking

smoking and tobacco exposure (passive smoking) is known as a major risk factor for the RCC (Renal Cell Carcinoma). Meta-analysis (outcomes of a big amount of different independent studies put together) show almost doubled risk (about 1,38) in the group of a people smoking for a long time compared to the group of the people, who never had been exposed to this risk factor.

Risk also is very much positively correlated to how long and how much person smokes – the more and longer – the higher is a risk and the more aggressive are the cancer cells. Negatively correlated (the more and longer smoking, the lower) are also cancer survival rates. In the former smokers group, the risk factor lowers with the growing time free of smoking

 

Obesity 

Studies show an increase of risk of RCC for the people, whose BMI (Body Mass Index) higher than 30 kg/m2. Risk is growing with every unit increase of BMI. At the highest risk (about 71% higher compared to the persons with the normal weight) are the people of the “mortal obesity” (BMI higher than 35). Increased risk is also show adolescence obesity or near obesity groups.

! important note – BMI does not reflect obesity in a perfect way. It has some disadvantages as: does not distinguish between fat, muscle, visceral and subcutaneousfat. That is why it is possible to be "overweight" according to BMI, but have proper levels of fatty tissue

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High blood pressure (hypertension)

Systolic blood pressure of higher than 130 mm Hg is associated with relatively higher risk of developing a RCC. Some studies show Increased risk only for female population, but majority does not show the difference related to gender

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ACKD (Acquired Cystic Kidney Disease)

Increased risk of RCC appears in patients with ACKD, developed due to the longer time dialysis treatment

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Family history

About 4% of RCC is considered as inherited. Such diseases as von Hippel–Lindau (VHL), Birt–Hogg–Dube syndrome, tuberous sclerosis may be at higher risk of developing benign or malignant kidney tumors

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Certain medicines

There are some studies showing the increased RCC risk due to the consumption of certain medical preparates, at the same time other studies deny this connection. Analgesics (pain killers) phenacetin‐containing,acetaminophen, ibuprofen, non-aspirin (in some groups also aspirin) nonsteroidal anti-inflammatory drugs as well as diuretics (often used to treat the high blood pressure), but with this association not clear is, if high pressure as a primary risk factor or medicine controlling it, is a risk factor itself

 

Diet

The results of the studies on the relation between the kind of food intake to the risk of RCC very a lot. Some of them show a decrease of risk with the increased fruit and vegetable consumption, some acknowledge only vegetables, not finding the connection with fruit. Some also associate increased risk with heavy meat and fat dairy products consumption

 

Certain substances exposure

Some studies find the increased risk of RCC with the exposure to:

• organic solvents (particularly trichloroethylene)

• pesticides

• copper sulphate 

• very long exposures in the chemical, rubber, and printing industries 

• high exposure to cadmium 

• substantial exposure to lead

• solder fumes

• paints, mineral oils, cutting fluids, benzene, polycyclic aromatic hydrocarbons, and asbestos

• some herbicides

 

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What to do to lower the risk

• quitting smoking

• control of a blood pressure

• sports, other physical activities 

• maintaining healthy body weight, losing weight in case of overweight

• caring for the quality, quantity of food

 

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Possible symptoms of renal cancer

• blood in urine

• bump or lump under the skin on the side or abdominal area

• a loss of appetite

• pain in the area of kidney, that doesn’t go away

• weight loss, that doesn’t have a known reason

• fever that doesn’t go away and is not caused by known infection

• extreme fatigue, much stronger than normal tiredness

• anemia

• leg swelling

• bone pain

• persistent cough

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Diagnosis

to understand the source of the symptoms doctor may decide to do:

• physical examination (has limited possibilities, since kidneys are located deep in the abdominal cavity, however, if doctor would detect palpable abdominal mass or abnormal size of the cervical lymph nodes – it may suggest further radiological (image) investigation

• blood and urine tests

• imaging investigation – abdominal US (ultrasonography), CT scan or MRI

• biopsy –for some patients doctor may recommend to perform a tissue sample analysis

 

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Treatment of Kidney Cancer

• surgical treatment– most studies show a significantly lower cancer specific mortality for the patients treated with surgery compared to non-surgical treatment

• active surveillance 

• ablative therapies