According to the latest data published by the European Urology Association, kidney cancer constitutes 3% of all cancers and is one of the top ten most common cancers.
It is seen more frequently in men than in women (twice),and its incidence increases with age. Apart from genetic predisposition, smoking, obesity and high blood pressure are known risk factors that our patients can get rid of these habits.
Symptoms of kidney cancer are blood in the urine, mass detected with physical examination and pain in the flank. In advanced stages, weight loss, fatigue, anorexia and high blood pressure can also be detected.
However, the number of patients presenting with symptoms is very small today. Since imaging methods such as ultrasonography, computed tomography and MR are easily accessible, this cancers are diagnosed incidentally, without any complaint, as a result of these films, which are often requested for other reasons.
This gives us the advantage of reaching more low-grade and non-metastatic patients.
In the diagnosis of kidney cancer, as in every disease, the patient's history and physical examination are essential for the diagnosis. Some laboratory tests may also be helpful, but the accurate diagnosis is made by radiological examinations. Ultrasonography, computed tomography and MR imaging guide us both in the diagnosis and staging of the disease.
Especially the treatment of organ-confined, non-metastatic kidney cancer is surgery. The contribution of radiotherapy and chemotherapy is very limited and may rarely be required. In metastatic disease, there is a treatment model based on the removal of cancerous tissue as much as possible (cytoreductive surgery) if possible, and then cancer cell destruction by stimulating the immune system, called immunotherapy.
Kidney cancer surgery can be performed with open, laparoscopic and robotic techniques. This may vary according to the experience of the surgeon, the stage of the disease and the facilities of the hospital. Laparoscopic surgery is superior to open surgery because of less bleeding and faster recovery. Considering the low cost of surgery, laparoscopic surgery is advantageous over robotic surgery.
With exceptions, I prefer laparoscopic nephrectomy, which is my special interest in the surgical treatment of kidney cancer. Considering the size of the tumor and its location in the kidney, I also perform laparoscopic partial nephrectomy (removal of only the tumor, preserving the non-cancerous tissue of the kidney) if possible.
The urologist surgeon makes 3-4 small incisions (about 1-2 cm) in the abdomen. Surgical tools are inserted by these incisions. The abdomen inflated with gas. After the dissection of the adjacent organs the kidney or the tumor is removed. Thanks to the small incision, laparoscopic nephrectomy is less painful than open nephrectomy.
Yes it is a major surgery but it is the gold standart treatment of kidney cancer. If it is performed by experienced surgeons, its majority also decreases.
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