Definition
Clear cell renal carcinoma (so called because it is rich in glycogen and lipids) is the most violent and common form of kidney cancer (65%): this neoplasm involves numerous cell alterations located in the renal tubule. Among other frequent forms of kidney cancer, we cannot forget the papillary carcinoma of type I and II, and the carcinoma of the collecting ducts. Still, kidney cancer can originate in the renal pelvis and at transitional cell level.
Causes
What the statistics highlight is that kidney cancer is strongly influenced by smoking, obesity and hypertension; consequently, smokers, overweight subjects and hypertensives are the most possible and probable targets of kidney cancer. Males are more affected by kidney cancer than women, especially if they are elderly and genetically predisposed. Finally, it also appears that exposure - for work reasons - to substances such as heavy metals and petroleum derivatives may favor kidney cancer.
Symptoms
Also this neoplastic form begins in an almost asymptomatic way, or however with aspecific and vague symptoms; as a result, cancer tends to be diagnosed when it is in the advanced stage. In the advanced phase, the most recurrent symptoms are: anemia, asthenia and general malaise, weight loss, loss of appetite, back pain, presence of a solid mass in the abdomen, dark and / or bloody urine.
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drugs
The treatments used in therapy for the treatment of kidney cancer are different depending on the stage of progress of the cancer and the location of the diseased cells:
- Surgical excision of the tumor: indicated for the treatment of clear cell carcinoma. This procedure increases life expectancy in patients with kidney cancer in the metastasis stage. The surgical option is considered in 90% of patients with kidney cancer; clearly, the removal of a part or the whole organ depends on the expansion of the diseased cells.
- Radiotherapy or cryotherapy: procedures little used to treat kidney cancer; in general, the patient is subjected to these treatments exclusively for palliative purposes, since they do not lead to the complete destruction of the tumor.
- Immunotherapy: involves the administration of cytokines, interleukin 2 or interferon. In general, this therapy fully exercises its therapeutic activity for kidney tumors without distant metastases or invasion of diseased cells in the lymph nodes.
- Chemotherapy: reserved for kidney tumors of the renal pelvis. In fact, chemotherapy has no therapeutic effect for the complete resolution of kidney cancer.
- Sunitinib (eg Sutent): this drug appears to be the most used for the treatment of kidney cancer. Its therapeutic action is enhanced when combined with bevacizumab and interferon. Generally, the recommended dosage is 50 mg orally, once a day, with or without food, for 4-6 weeks.
- Bevacizumab (eg Avastin) administer 10 mg / kg intravenously every 2 weeks in combination with interferon alfa.
- Sorafenib (eg Nexavar): second choice drug for the treatment of kidney cancer (class: protein kinase inhibitor). Take two 200 mg tablets twice a day, preferably between meals or with a hypolipidic meal. The pharmacological treatment should be prolonged until evident improvement of the symptoms without too many side effects. The drug performs its therapeutic action by slowing the growth of diseased cells, as well as hindering the supply of blood to malignant cells (which would serve to grow and cause damage).
- Medroxyprogesterone (eg Farlutal, Provera G, Filena) belongs to the class of hormonal contraceptives and antineoplastics. It should be taken at a dose of 400-1, 000 mg intramuscularly once a week. Then reduce the dose to 400 mg via IM once a month. Consult your doctor.
- Erlotinib (eg Tarceva): although used mainly for the treatment of pancreatic and lung cancer, the drug is also used in therapy for kidney cancer, especially in an advanced or metastatic stage. The dosage must be established by the doctor.
- Temsirolimus (eg Torisel) indicated for the treatment of renal cell carcinoma at a dose of 25 mg, to be taken by IV infusion of 30-60 minutes, once a week. The drug is an inhibitor of rapamycin (mTOR) and works by slowing the growth and expansion of cancer.
- Capecitabine (eg Xeloda): this drug is widely used in therapy for the treatment of breast and colorectal cancer. However, it is sometimes used in the treatment of kidney cancer.
- Aldesleukin: the drug belongs to the class of interleukins and is used in therapy for the treatment of kidney cancer at a dose of 0.037 mg / kg for a slow infusion of 8 hours, for a maximum of 14 doses. Consult your doctor.
- Interferon alpha 2 (eg Pegasys, Roferon-A): administer the drug subcutaneously 3 times a week at a dose of 4.5 million units; it is possible to increase the dosage up to 18 million units (when tolerated) during the first month of treatment. The maintenance dose - based on the tolerability of the side effects - is generally estimated around three weeks, but can continue up to two years if the patient with kidney cancer responds positively or otherwise if the disease stabilizes.
