The Renal pelvic cancer is a relatively rare tumor disease; just one percent of all tumors that form in the urogenital area affect the renal pelvis. The prognosis depends on the discovery of the tumor; surgical methods are the only way to defeat the tumor.
What is renal pelvic cancer?
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Under the Renal pelvic cancer is - as already mentioned in the name - a tumor formation directly in the renal pelvis. Renal pelvic carcinoma is a relatively rare tumor; just one percent of all urogenital tumors are caused by carcinoma of the renal pelvis. The tumor forms mainly in people who have passed the age of 60.
It should be noted that several types of tumor are possible in renal pelvic carcinoma, which can be differentiated on the basis of the histology. 90 percent are so-called papillary eoithelial tumors; 10 percent are [[Spinalioma (squamous cell carcinoma) squamous cell carcinoma.
causes
In the course of various studies, doctors have found that renal pelvic carcinoma can sometimes occur as a result of work. People who work primarily in mining or chemical plants are more often affected than people who are not employed in those industries. Aromatic amines and nitrosmines are said to promote tumor formation. However, there are also tumor formations that arise due to mutations in the apoptosis gene. Chronic urinary tract infections also promote tumor formation.
Symptoms, ailments & signs
Even if hematuria (blood visible in the urine) occurs relatively early, renal pelvic cancer can go unnoticed for a long time. The patients also repeatedly complain of pain, with accumulations of blood - clots - being the reason because the patient's urinary tract is blocked.
The pain is described as colic and sometimes radiates into the back. For this reason, many doctors assume urolithiasis at the beginning of the examination. Other symptoms, which only appear as the disease progresses, include nausea, weight loss, fever, and night sweats or loss of appetite.
Diagnosis & course of disease
Based on the medical history and the complaints of the patient, the doctor suspects that a tumor may be present. At the beginning, the focus is on whether it is a renal pelvic carcinoma or a ureter or kidney tumor.
By means of an ultrasound examination, the doctor can determine any changes in the structures. An X-ray also provides information about whether a tumor is present. Occasionally, bone metastases can also be detected in the X-ray. If the suspicion of renal pelvic cancer is confirmed, further tests will be carried out. These examinations serve to determine the stage or extent.
Computed tomography can be used to determine whether daughter tumors (metastases) are already present. Tumor staging must be carried out so that targeted therapy can be started. The doctor assesses the tumor according to the TNM classification, which is made up of the tumor size (T), the lymph node involvement (N) and the metastases (M):
- T1 N0 M0 = stage I. There are neither metastases nor involvement of the lymph nodes.
- T2 N0 M0 = stage IIA. Although the tumor has grown into the surrounding tissue layers, there are no metastases or lymph node involvement.
- T1-2 N1 M0 = stage IIB. Comparable to stage IIA; the lymph nodes are already affected.
- T3-4 N1 M0 = Stage III. The tumor has already grown into the organ tissue; the lymph nodes are also affected, but no metastases have formed.
- T3-4 N1 M1 = stage IV. As stage III, but metastases have formed.
The prognosis depends primarily on the stage at which renal pelvic cancer was diagnosed. If the tumor was detected at a very early stage, the chances of recovery are significantly better. However, early diagnosis is extremely difficult; mainly because there are no symptoms at the onset of the disease that would suggest that a tumor has formed.
Only at an advanced stage do symptoms appear which clearly indicate that a carcinoma has formed. For this reason, it is essential that the first symptoms that may indicate a tumor be consulted by a doctor.
Complications
Renal pelvic cancer is a very serious condition. Unfortunately, in most cases this leads to the death of the patient or to considerable restrictions. The further course of this disease depends very much on the time of diagnosis and the spread of the tumor, so that a general prognosis cannot be given. Those affected primarily suffer from bloody urine.
Blood in the urine can sometimes lead to a panic attack. Severe pain in the kidneys or on the flanks can also occur due to renal pelvic cancer and can also spread to the back. Those affected also suffer from weight loss and fever. Renal pelvic carcinoma also gives rise to a general feeling of illness and leads to a significantly reduced quality of life for those affected. The patients look exhausted and also suffer from night sweats.
The renal pelvic cancer can usually be removed by surgery. However, those affected are still dependent on chemotherapy or radiation afterwards. This can lead to various side effects. Renal pelvic cancer significantly reduces the patient's life expectancy.
When should you go to the doctor?
There is cause for concern if there is blood in the urine, which in sexually mature women is not due to menstrual bleeding. A doctor's visit should take place to clarify the cause. In the event of weight loss, indifference or a loss of exercise capacity, a doctor should be consulted. If there is a fever, nausea, vomiting or general weakness, the person concerned needs help. Sweating or heavy night sweats are indications of an illness.
A doctor's visit is necessary. Pain, discomfort or a feeling of illness should be clarified by a doctor. Since renal pelvic carcinoma is fatal if left untreated, a visit to a doctor is urgently recommended as soon as the first signs of an irregularity appear. The prognosis depends on when treatment is initiated. Therefore, participation in regular cancer screening examinations is generally recommended in adulthood. In this way, early detection is possible even before symptoms have manifested.
If you have complaints such as loss of appetite, back pain or colic, you should see a doctor. If the person concerned suffers from abnormal urination, a change in the urine or the odor, the observations must be examined by a doctor. If participation in leisure activities decreases, behavior changes or mood swings occur, increased vigilance should prevail. Often these are the first signs of illness.
Therapy & Treatment
The therapy focuses primarily on the surgical removal of the renal pelvic carcinoma, whereby - since the entire kidney is usually affected - the entire kidney must be removed. However, not only the kidney, but also the bladder and ureter are surgically removed. In individual cases, which means that there is only an extremely small tumor, a partial resection or partial removal of the renal pelvis is sufficient.
Chemotherapy is then prescribed. The goal of chemotherapy is that the patient receives a drug that is supposed to inhibit cell growth. A very thin catheter is inserted directly into the vicinity of the tumor. Radiation therapy is also recommended, but after the renal pelvic cancer has been surgically removed.
It is important that the radiation therapy only "irradiates" the affected area; in this way any damage to the surrounding organs can be prevented. If metastases are found, the patient's entire body must be treated with systemic chemotherapy. The drug is passed directly through the bloodstream. The aim should be to free the affected regions from the daughter tumors.
Outlook & forecast
The further outlook for patients with renal pelvic cancer depends on the stage of the disease at the time the tumor was discovered and treated. In addition, it must be clarified whether the tumor is malignant or benign. With an early diagnosis, the patient has a good chance of recovery. The later the unwanted tissue changes are noticed and the more intense the growth of the tumor, the more unfavorable the further course of the disease.
When making a prognosis, it must be taken into account that renal pelvic cancer usually occurs in people over the age of 60. In many of those affected, the organism is weakened at an advanced age. In addition, there are often other diseases that can have an impact on further development. The general state of health of the patient is therefore decisive for the further course.
Surgical intervention and tumor treatment are necessary to alleviate the symptoms.The carcinoma must be completely removed for any prospect of relief. The operation and subsequent therapy are associated with numerous side effects and physical and emotional stress. There is a possibility of secondary diseases.
With a fundamentally healthy immune system and good health, the outlook is significantly improved. If there are no further complications during the surgical procedure, you can be free of symptoms.
prevention
It is important that renal pelvic cancer is prevented in such a way that the patient can treat any urinary stones and urinary tract infections quickly. If these diseases are not treated, a chronic irritation occurs, which can also promote tumor formation.
Aftercare
If the renal pelvic carcinoma has been successfully treated, follow-up care will then take place. Follow-up treatment in a rehab or spa clinic is considered helpful. There the patient also receives psychological support and valuable knowledge about a conscious and healthy lifestyle.
One of the most important points of follow-up care is preventing renal pelvic cancer from recurring. For this purpose, a check-up is carried out every three months for the first two years after therapy. The doctor asks how his patient is and carries out a physical examination.
The controls include urine and blood tests. A sonography (ultrasound examination) also takes place. The abdominal region can be checked using computed tomography (CT) or magnetic resonance imaging (MRI). In order to rule out possible metastases in other parts of the body such as the lungs, chest x-rays are taken.
From the 3rd year after the end of renal pelvic cancer treatment, check-ups take place every six months. From the 5th year onwards, only one examination per year is necessary. The examinations are carried out by the family doctor, a urologist or in the clinic where the therapy was carried out. However, the number of examinations also depends on the course of the disease and the individual health status. If there are recurrences of cancer, sequelae or accompanying diseases, these are treated immediately.
You can do that yourself
Once diagnosed with renal pelvic cancer, those affected need the support of friends and family. Doctors, psychologists and counseling centers are also available with tips on how to cope with everyday life more easily. The return to work is particularly important. Vocational rehabilitation is achieved with the help of various advisory services that the family doctor can provide information about.
Since carcinoma of the renal pelvis is usually treated with chemotherapy or radiation therapy, the sick suffer from side effects that affect both the internal organs and their appearance. Problems such as hair loss or scars can be treated with both medical preparations and natural remedies. In the area of sexuality, sufferers can also turn to a specialist in order to effectively treat typical problems such as erectile dysfunction. Last but not least, dealing with a cancer diagnosis is also important. Those affected have many questions and fears, especially in the early days. These can be dealt with in a self-help group or in conversation with a psychologist.
All of these measures can gradually improve the quality of life. In connection with comprehensive medical therapy, the self-help measures mentioned offer a perspective for the patient to maintain a higher standard of living despite the difficult diagnosis.
