Kidney Tumors With Poor Prognosis
In children, the most common kidney tumor is the Wilm’s tumor. It is also the third most common tumor in children. It can grow very large in size, and in 5 to 7 percent of cases can occur bilaterally, or affect both kidneys. In the latter case, children may develop renal failure. If only one kidney is involved, surgery may improve renal function, but if the tumor recurs in the other kidney, renal failure may ensue.
In adults, the most common kidney tumor is renal adenocarcinoma, which affects about 32,000 people in a year, according to the Kidney Cancer Association. It affects more men than women with a predilection for people aged 50 to 70 years. The cause is unknown. When the kidney cancer spreads, it may affect nearby lymph nodes and blood vessels, the lungs, bones, liver and the other kidney.
An inoperable kidney tumor is one which cannot be removed by surgery because of its size and the fact that it may be impinging, lying too close, or attached to, an important organ or blood vessel. Added to these, the general health of the patient may be compromised. A nephrectomy or surgical removal of the kidney may cause more damage to the surrounding tissues or complications such as uncontrollable bleeding. If both kidneys are involved, the tumors may not be removed, because an individual cannot survive the loss of both kidneys.
The prognosis of a patient with an inoperable cancer of the kidney seems grim, but some therapeutic alternatives to surgery are available.
Non-surgical Treatment of Kidney Tumors
Approaches to kidney cancer therapy that eliminate the need of surgery in inoperable tumors include:
- Chemotherapy, using drugs like consisting of vincristine, dactinomycin and doxorubicin, is often done to shrink tumor size before possible surgery. It is usually affects the general health of the patient adversely with its complications.
- Radiation shrinks the tumor and may be done after surgery which has not completely removed the tumor. However, surrounding tissues may be involved and complications ensue. Radiation and chemotherapy are not very effective in the treatment of advanced kidney tumors.
- Dr. Josef M. Issels’ immunotherapy, which is carried out only at Issels Treatment Centers, claims to strengthen the body’s normal immune system, and restore its ability to fight cancer cells. The treatment program includes vaccines, intravenous therapies using natural substances, autohemotherapy, oxidative therapy, enzymatic therapy, nutritional immunotherapy, antioxidants, massage, lymph drainage, and more.
- Cryoablation on the other hand delivers extremely cold gas to the tumor using a needle. Urologists and interventional radiologists cooperate to target the tumor cells and deliver the gas, forming a frozen ball of destroyed tumor cells. Like RFA, cryoablation is localized, safe, and effective in smaller tumors.
- At the Georgetown University Hospital, another innovative intervention called the CyberKnife uses radiosurgery by delivering highly focused beams of radiation to the tumor. It is done in two to three sessions per week to destroy the tumor.
- A new type of non-surgical localized treatment of inoperable kidney tumors involves radiofrequency ablation (RFA) which destroys cancer cells using heat, while preserving the remaining healthy kidney cells. In this procedure, an interventional radiotherapist and a urologist work together to target the tumor with a needle which transmits radiofrequency energy to it, resulting in shrinkage of the tumor. Since it is a localized procedure, the patient’s general health is not affected, and no complications occur. It can be repeated as often as necessary. However, since the procedure is relatively new, studies have to be done to determine long term survival. The risks involved in this procedure are few and similar to those encountered in doing biopsies such as bleeding and pain. Heating of tissues might involve adjacent organ, so careful mapping and radiologic studies have to be done.
Of these alternatives to nephrectomy, RFA seems to have the best promise for better results because of its localization, ease of procedure, lesser cost, fewer complications, and effectiveness in shrinking tumor size. However, since it is relatively new, its effect on long-term survival rate still has to be determined.
Issels Treatment: Inoperable Kidney Tumor
Cedars-Sinai Medical Center, “Kidney Tumors Can’t Stand the Heat:New Radio Frequency Ablation Vaporizes Inoperable Tumors”, https://www.cedars-sinai.edu/Patients/Programs-and-Services/Imaging-Center/Documents/Julien-KidneyTumorRFA-58581-154345.pdf