Characteristics

Kidney tumour is usually located in one of the kidneys and in 90% of cases it develops in the cells of the tubules that form the nephrons, the functional unit of kidney. This type of cancer is twice as common in men as it is in women.

In Italy:

• every year, 13,500 cases of kidney tumours are diagnosed (9,000 in men and 4,500 in women),
• 144,400 people are living after the diagnosis of this kind of cancer,
• 5-year survival is 71%,
• 60% of kidney tumours are diagnosed in Patients >65 years of age.

How does kidney tumour evolve?

Metastases can form through the lymphatic and blood vessels and most commonly occur:

• in the lungs (50-60% of cases),
• in the liver (30-40% of cases),
• in the bones (30-40% of cases).

The adrenal glands, brain, spleen, bowel, skin, and the other kidney are less common metastasis sites.

Risk factors

Certain risk factors that increase the probability of developing kidney tumour have been identified:

• smoking, which is responsible for 40% of cases among men. The risk increases with the number of cigarettes smoked and the years of exposure. Giving up smoking reduces the risk, albeit only in the long term (after 10 years),
• obesity triples the risk compared to normal weight and plays an important role in women,
• hypertension,
• kidney disease, especially when requiring dialysis,
• chronic exposure to materials or substances, including
  • cadmium,
  • asbestos,
  • phenacetin,
  • arsenic and its inorganic compounds,
  • trichloroethylene,
  • printing processes.

A small proportion of kidney tumours can develop as a consequence of genetic syndromes.
Lastly, there are familial forms, and the risk of developing the disease is doubled in Patients’ first-degree relatives.

Prevention and screening

The only way to prevent kidney tumour is to avoid its risk factors.
There are currently no institutional screening programmes dedicated to this cancer.
Having abdominal ultrasound scans after middle age can facilitate the early diagnosis of kidney tumour: however, this annual screening measure should be recommended by general practitioners, based on their Patients’ risk factors.

Symptoms

In 8 out of 10 cases, kidney tumour is asymptomatic and is diagnosed incidentally, during investigations the Patient has for other reasons.

Anyone who notices one or more of these symptoms should consult their doctor, while bearing in mind that they are common to other kidney conditions.

There are currently no validated markers for diagnosing kidney tumour, or specific prognostic and/or response-predicting markers.

Identikit

The diagnostic work-up makes it possible to construct a true identikit of kidney tumour that is fundamental for the therapeutic decision-making processes.
What are its distinctive characteristics?

Treatment

Patient support and follow-up

Patients may feel the need to discuss their perplexities and share how they are feeling at any point of their journey living with kidney tumour.
Who can they contact in these cases?

They can talk to people who are living the same experience through Patient Associations or ask for psycho-oncological counselling to help them cope with their emotions and the impact the cancer has on their everyday life.

Once they have completed their treatment programme, Patients have to attend regular follow-up appointments depending on the stage of the tumour and the therapy used.
Kidney tumour requires a very long follow-up, which can last for more than 10 years. After the 5th year, these appointments are usually reduced to an annual frequency, depending on a programme that is individualised to each Patient.