What is Renal Cell Carcinoma? Know causes, risk factors, treatments of the most common Kidney Cancer

RCC (Renal Cell Carcinoma) is one of the most prevalent forms of kidney cancer, known as Renal Cell Carcinoma. RCC accounts for over 90% of cancer cases worldwide. It is a medical challenge that affects thousands of people each year. We spoke to Dr. Bhuvanesh N. Aradhya - Consultant Urology & Transplant Surgeon, who gave us insightful guide to cancer, where we discovered and learned more about cancer, its causes, risk factors, the treatments available and, most importantly, the developments in terms of research.

What exactly is Renal Cell Carcinoma?
RCC originates in the renal tubular cells of the kidney; they are tiny tubules present in the organ. Though the cause of cancer has not been determined, numerous risk factors are linked with the growth and development of RCC.

Risk Factors to Keep in Mind:

· Smoking and tobacco usage have been associated with an increased risk of many cancers, including RCC. Compared to non-smokers, people who smoke regularly are known to develop cases of RCC more frequently.  

· Obesity is another risk factor to keep in mind. Individuals with a higher body mass index (BMI) have a greater susceptibility to developing renal cell carcinoma.

· Uncontrolled high blood pressure has also been identified as a potential risk factor for kidney cancer.

· Occupational Exposures to chemicals like asbestos, cadmium, and organic solvents can also increase the likelihood of developing the disease.

Signs and Symptoms to be aware of:
RCC is a silent killer with no obvious symptoms in its early stages. Though, as the disease develops in the body, individuals suffering from the illness may experience these symptoms:

· Hematuria: which is bloody urine or passing blood in urine is an important symptom. Though it is a common symptom of RCC there can be other causes as well. 

· Weight loss that is rapid and unexplainable

· Tiredness without any apparent reason can accompany kidney cancer

· A decrease in red blood cell count that may lead to anemia in individuals with RCC

· Incidentally, more often than not these cancers are detected when scans are done for some other reasons: For eg: Health check-ups, Employment screenings etc. 

How do you diagnose?
There are many approaches via which one can accurately diagnose RCC, these include the following:

· Computed tomography (CT) scans, magnetic resonance imaging (MRI), and ultrasound play pivotal roles in visualizing the kidneys and detecting abnormalities.

· CT scans is the gold standard investigation to diagnose and stage RCC. 

·        Biopsy of the tissue: biopsy is not recommended to diagnose RCC. 

·        Staging: Staging helps categorize the extent of cancer spread. The TNM staging system, based on tumor size, lymph node involvement, and metastasis, is widely used for RCC staging.

Treatment Modalities:
Various factors determine the treatment of RCC, including the disease's staging, the individual's overall health, and the patient's individual preferences. Common treatment modalities include:

·        Surgical removal of the tumor and affected kidney through partial or radical nephrectomy is the primary treatment for localized RCC. 

·        Minimally invasive techniques like laparoscopic or robotic-assisted surgery are also employed in some instances.

·        Targeted Therapy: Targeted therapies have revolutionized the treatment of advanced or metastatic RCC. These medications specifically target cancer cells and inhibit their growth, improving patient outcomes.

·        Immunotherapy: Immunotherapeutic agents, such as immune checkpoint inhibitors, boost the body's immune system to recognize and attack cancer cells and also, Radiation Therapy: While less commonly used, radiation therapy may be employed to control localized RCC or alleviate symptoms in advanced disease.

RCC is a peculiar form of cancer that needs thorough understanding, accurate diagnosis, a detailed treatment plan and a strong plan of action when it comes to the treatment. As research continues to shed light on this disease, the horizon of possibilities expands, promising a brighter future for individuals battling renal cell carcinoma.

So to summarize, the incidence of RCC is increasing due to life style changes and also due to increase in tobacco consumption/smoking. 
We know more about this cancer and can be treated successfully is diagnosed early. Stage I patients have a survival of more than 10 years if treated early. 
Laparoscopic radical nephrectomy or Robotic or open removal of the kidney with the tumor is warranted in cases of tumors more than 7 cm.
Partial nephrectomy (either open/lap/Robotic) is the standard of care for tumors between 4-7 cm. 
We can improve the longevity of the patient through targeted therapies which are most often can be consumed orally.