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Kidney tumors are increasingly diagnosed as “incidental tumors” because these tumors are often found when patients are being evaluated for other unrelated conditions such as gall stones, kidney stones, and non-specific or difficult-to-explain abdominal or pelvic pain. These incidentally-found tumors are usually seen during testing by an ultrasound examination or a CT scan examination.
These tumors are usually small (less than 4 centimeters), and often do not cause any symptoms and may not explain the patient’s presenting symptoms or problems. Unless a patient had a prior imaging study (ultrasound and/or CT) to use for comparison, it is difficult to know ‘how old a tumor is?’ or ‘how long a patient has had a tumor?’ It is equally difficult to predict whether a tumor will grow and how fast or slow a tumor will grow.
‘What do we do?’ about these “incidental tumors” depends on a number of factors such as the size and location of the tumor, the patient’s age and health status, and the patient’s kidney function.
As discussed in the section on kidney cancer, most kidney tumors are cancers that may grow and spread. Surgery, either by total removal of the involved kidney or by removal of a part of the kidney containing a tumor, has been the most effective treatment. It is the treatment to which new treatments (new form of surgery or chemotherapy) must be compared.
Deciding on a treatment plan for a patient with an “incidental tumor” is not always easy or straight-forward. Many patients with these tumors are relatively older, possibly not so healthy because of chronic medical conditions like high blood pressure, diabetes, heart disease, and emphysema, and have abnormal or less-than-normal (insufficient or weaker) kidney function. Some of these patients may not be able to tolerate major and invasive surgery. In cases of patients with abnormal or insufficient kidney function, treatment may need to be less invasive in order to minimize the risk of further loss of kidney function as a result of treatment.
Minimally-invasive treatment for small “incidental” kidney tumors has been provided at Bay Area Urology (by Dr. Robert Q. Hoang) since 2004. Surgery has been performed via laparoscopy through small “keyhole” incisions to minimize invasiveness. Instead of removing these tumors, cryosurgical ablation (freezing to destroy tumors) has been equally effective. This treatment has been particularly appealing for older patients, especially those who may have difficulty tolerating more-invasive surgery, and for patients with abnormal or insufficient kidney function.
Recent report at the 2006 Annual Meeting of the American Urological Association (AUA at www.auanet.org) gives reassurance of treatment effectiveness with follow-up data showing a 98% cancer-specific survival rate after 5 years. The large study series provides important information to help us counsel patients.
At present, cryosurgical ablation of kidney tumors is a legitimate option for patients with small “incidental tumors.” For more information, we invite you to come for a consultation with Dr. Robert Q. Hoang.
Glossary Terms
abdomen - also referred to as the belly or stomach;
ablation - to remove or destroy unwanted tissue such as
a tumor;
adrenal gland - one of a pair of small glands, each of which
sits on top of one of the kidneys. These glands produce hormones
that help control heart rate, blood pressure, the way the body uses
food and other vital functions; it also produces adrenaline;
adrenaline - vital hormone secreted by the adrenal gland;
artery - blood vessel that carries blood from the heart
to various parts of the body;
benign - not cancerous, not malignant;
dialysis - an artificial replacement for the kidneys used
to remove waste products from the blood and excess fluid from the
body;
flank - the area on the side of the body between the rib
and hip;
immunotherapy - medical treatment aimed to stimulate or
restore the ability of the immune system to fight infection and
disease (including cancer);
metastasis - the spreading of a cancerous tumor to another
part of the body;
nephrectomy (-ies) - surgical removal of a kidney;
neurologic - pertaining to the nervous system;
partial nephrectomy - surgery to remove the part of the
kidney involved with tumor;
radical nephrectomy - complete removal of a kidney involved
with tumor;
renal vein - blood vessel which returns blood from the kidneys
to the blood system;
vena cava - large vein through which blood is carried to
the heart;
* This information is not intended to substitute for a consultation with a urologist. It is offered to educate patients on the basis of urological conditions in order to get the most out of their office visits and consultations. Please see our web page disclaimer for addition information. |
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