The incidence of kidney cancers has definitely increased in last ten years. It is possible that we are picking up more and more early stage renal cancers due to wide spread use of ultrasound and other imaging. Obesity, smoking, over use of analgesics, tobacco chewing and exposure to cadmium, leather and rubber chemicals are important causes of developing the kidney cancers.
Removal of the entire kidney (Radical nephrectomy) was thought be the most appropriate treatment in the past. However, it has been found that the remaining kidney may lead to hypertension, nephrosclerosis and renal failure in the long run. Therefore in cases of small renal tumors size less than 6 cm, nephron sparing surgery is carried out. The kidney is cooled in the ice slush, the blood supply to the kidney is occluded for shortest possible time, the tumorous portion is removed with clear margins and the kidney is repaired. With this, not only the cancer cure is achieved, but the kidney is saved thus avoiding further complications of renal insufficiency.
The 10 year disease free survival rates for renal cancer are – for stage I -80 -85 % , Stage II -75-80% , stage III -55% and stage IV – less than two years. Surgery is the main stay for the renal cancers, radiotherapy and chemotherapy is not required in these patients, however for stage IV disease the newer drugs such as tyrosine kinase inhibitors (TKIs) have shown a great promise.