A prevalent global health problem with a significant rise in incidence over the past two decades, kidney cancer is the ninth most common cancer among men in Singapore.
Also called renal cancer, it originates in the kidneys and its most common form is renal cell carcinoma (RCC), a solid tumour cancer, which accounts for around 90 per cent of cases in adults.
In conjunction with March being World Kidney Cancer Awareness Month, Dr Ravindran Kanesvaran, senior consultant and deputy head of the division of medical oncology at the National Cancer Centre Singapore, talks about the risk factors for kidney cancer, how it can be detected and the treatment options available.
WHO IS MOST AT RISK?
Men are most at risk - roughly two-thirds of RCC occur in males. There are also two kinds of risk factors: modifiable and non-modifiable.
Modifiable risk factors are ones that can be addressed with lifestyle changes. The main ones are obesity, smoking and hypertension; the risks they pose can be modified by losing weight, quitting smoking and managing your blood pressure.
We cannot do anything about non-modifiable risk factors. Age is one; the risk of developing RCC rises with age, with the average patient being around 65.
Genetics play a role, so a family history of RCC in close relatives like parents, grandparents or uncles and aunts is a risk factor. Having advanced renal disease, like being on dialysis, is another risk factor.
WHAT SYMPTOMS SHOULD PEOPLE LOOK OUT FOR? AND HOW IS KIDNEY CANCER DIAGNOSED?
Some common ones include blood in the urine, weight loss, loss of appetite or a bulge or pain in the flank.
If your doctor is actively looking for kidney cancer, he would use blood and urine tests, imaging tests and biopsies of anything suspicious.
It can also be picked up through diagnostic imaging such as computed tomography (CT) and ultrasound scans.
WHAT ARE SOME OF THE TREATMENT OPTIONS?
For early stage kidney cancer when the tumour is within the kidney and has not spread to other parts of the body, surgery is conducted to remove the tumour, but some patients do experience a recurrence of the cancer after a period of time.
However, new types of drugs have been developed and significant advances made in the last decade.
We now have novel treatments such as targeted therapy and immunotherapy. These treatments, used individually or in combination, have improved the prognosis dramatically.
CAN RCC BE CURED?
The prognosis is quite good for operable early stage RCC. The patient would have to be monitored and have regular check-ups in case of re-occurrence after a successful operation.
For advanced inoperable RCC, the prognosis is three to 31/2 years with immunotherapy and targeted drugs.
Although around 30 per cent of RCC is detected at a late stage, advanced kidney cancer is not as aggressive as some other late stage cancers such as pancreatic or liver cancer.
With the right treatment, patients can have a good quality of life and a comparatively good prolongation of life too.
Source: The New Paper © Singapore Press Holdings Limited. Reproduced with permission.
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