kidney cancer Flashcards
name 5 radical txs for kidney cancer
nephrectomy
partial nephrectomy
cryotherapy / HIFU
TKI
immunotherapy
explain the role of nephrectomy
for large but local tumours to improve local control - surgical removal of whole kidney, ureter and blood supply for 1 or both kidney +/- adrenal glands and +/- regional LNs
explain role of partial nephrectomy
for smaller tumours < 3cm - removal of cancerous part of kidney for 1 or both kidneys
explain role of cryotherapy/HIFU for kidney cancer
can be used as alternative to surgery for small tumours if elderly or unfit
explain role of TKIs for kidney tx
tyrosine kinase inhibitor (sunitinib) - block growth enzymes preventing cells growing
explain role of immunotherapy for kidney cancer
Nivolumab - a systemic tx used as radical approach for local control
give 2 palliative options for kindney cancer
EBRT - not directly tx to kidneys as radio resistant but EBRT to mets in bones, vertebra etc.
Immunotherapy - Nivolumba can be used palliatively for advanced disease.
give the TNM staging for kidney cancer including N stages
T1a = <4mm + T1b= 4-7mm
T2=7mm confined to kidney
T3a= invades adrenal glands and perinephric tissue T3b= invades vena cava above
T4= extends beyond renal capsule
N0=no nodal involvement
N1= 1 LN
N2=>1LN
give any 4 aetiological factors for kidney cancer
smoking
under - men
age - older
cadmium exposure
kidney stones
chronic kidney disease
main cell type of kidney cancer
renal cell carcinoma
common routes of spread for kidney cancer
local= renal vein + inferior vena cava
lymph = renal hilar nodes + para-aortic nodes
blood = lung + bones
signs of kidney cancer
haematuria - blood in urine
pain
hemorrhage - internal bleed
hypercalcimia
palpable mass
investigations for kidney cancer
FBC - anemia specifically
CT
FNA - biopsy
Clinical trial for kidney cancer
WIRE - looking at drugs prior to surgery to reduce tumour size (Olaparib).
