Kidney cancer is the eighth most common cancer in men and the tenth most common cancer in women. The most common type of kidney cancer is renal cell carcinoma, which consists of parts of the kidneys called renal tubules that filter blood and produce urine. Approximately 85 percent of kidney tumors are renal cell carcinomas. When kidney cancer spreads outside the organ, it can spread to the other kidney, lymph nodes, lungs, bones or liver.
Considering the success of the freezing method (percutaneous cryoablation) performed by interventional radiology, the patient may also choose this method. He may not want to have surgery. Urologists and interventional radiologists should work together to decide whether freezing or burning (percutaneous ablation), a less invasive method, can be performed safely and effectively.
Prevalence and Risk Factors
More than 32,000 Americans are diagnosed with kidney cancer each year, many of whom have no symptoms. Generally, people with kidney cancer are over the age of 40. Kidney cancer is 2 times more common in men than in women.
Other risk factors are as follows:
- Smoking
- Obesity
- High blood pressure
- Long-term dialysis
- Von Hippel-Lindau syndrome
Symptoms
The incidence of kidney cancer is increasing. Thanks to modern imaging technology, small, asymptomatic tumors that are normally difficult to detect can be detected more easily.
Small tumors usually do not cause symptoms. Many are discovered with computed tomography, MRI, or ultrasounds, which are standard imaging studies performed on patients who come to the emergency room for other reasons. These small tumors are the best candidates for nonsurgical treatment options. If the patient has symptoms, these are:
- Blood in the urine
- Persistent side pain
- Mass or lump near the abdomen
- Weight loss
- Fever
- Feeling very tired
Kidney Cancer Diagnosis
Basic health examination, urine test In addition to blood tests and blood tests, some other techniques can be used to diagnose kidney cancer. r. Computed tomography scan, MRI or ultrasound may be performed to see the inside of the body and identify the tumor.
Needle biopsy should be performed with imaging guidance, tissue samples should be taken and examined by pathologists under a microscope.
Pathologists and other experts determine whether the cancer is diagnosed. It can determine what type of cancer it is and whether it is progressing rapidly or slowly. This information is important in deciding the best type of treatment. Open surgery is usually performed to obtain a tissue sample for biopsy. However, in most cases, tissue samples can be obtained without open surgery using interventional radiological techniques. The tumor has spread to other tissues in 25 to 30 percent of patients when first diagnosed.
Needle biopsy
Needle biopsy, also called image-guided biopsy, is usually used to manage the procedure. It is performed using moving X-ray technique (fluoroscopy), computed tomography, ultrasound or magnetic resonance (MR). In most cases, needle biopsies are performed with the help of computer-generated image-generating equipment, allowing radiologists to view the area inside the body from various angles. This “stereotactic” equipment helps them pinpoint the exact location of the abnormal tissue.
Needle biopsy is typically an outpatient procedure that rarely causes complications. Less than 1 percent of patients develop bleeding or infection.
Large Piece Needle Biopsy
In this technique, radiologists use a special technique that allows a larger biopsy sample to be obtained. They use needles. This technique is also preferred to obtain tissue samples from other masses detected during a health examination or mammography or other imaging scans.
A similar technique called
Fine needle aspiration is used to remove suspected cancer. Can be used to extract cells. In addition, samples can be taken from fluids collected in the body in this way.
Kidney Cancer Treatment
In the treatment of cancer patients, interventional radiologists use the procedure without affecting other parts of the body or giving drugs to the whole body. It can interfere with cancer.
Cryoablation (Freezing Treatment)
Incubated lesions appear as dead tissue without recurrence at one-year follow-up after this treatment.
The treatment can be repeated if necessary.
Most patients are treated on the day of the procedure or It is sent home the next day. The most common complication is blood pooling around the kidney. This will heal on its own.
In cryoablation, gas is sent directly to the tumor with a probe through a small hole made in the skin. In cryoablation, an extremely cold gas is used and the tumor is frozen and killed. This technique has been used by urologists in the operating room for many years, but in the last few years the needles have become small enough to be used by interventional radiologists through a small incision in the skin without the need for surgery. The "ice ball" formed around the needle freezes and destroys tumor cells.
Thermal Ablation Applications (Heat Treatment)
Recurrent tumors with serious non-tumor disease. Since patients with kidney disease, impaired renal function, and a single kidney are at risk of surgery, these patients may benefit from minimally invasive renal-protective treatment. There is no incision or stitching in this method. The procedure is performed by entering through a small hole.
Radiofrequency Ablation
For inoperable kidney tumors, radiofrequency ablation (RFA) is a method that kills tumor cells with heat while preserving healthy kidney tissue. It is another non-surgical treatment method. Radiofrequency energy can be administered without affecting the patient's general health, and most people can resume their normal activities within a few days.
In this procedure, the interventional radiologist reaches the tumor through the skin with a small needle and radiofrequency energy is transferred from the needle tip to the tumor. Here, heat is applied to the tumor cells and the tumor cells are killed.
Additional Considerations About RFA
- When the kidney cancer is small in size (5cm or less) It is more effective.
- It can be performed with sedation or general anesthesia.
- It is well tolerated - most patients can continue their normal routine activities the next day and only feel mild fatigue for a few days.
- Can be repeated if necessary.
- Can be combined with other treatment options.
Efficacy
If the tumor is small, RFA can shrink and kill the tumor.
Since it is a local treatment that does not damage healthy tissue, the treatment can be repeated as often as necessary. It is a very safe procedure and has become increasingly used over the last few years. RFA has been approved by the FDA for use in renal cell carcinoma.
LIVER TUMOR TREATED WITH RFADead tissue appears larger and darker than the living tumor. Over time, the tumor shrinks as the body absorbs the dead cells.
Risks
The risks of RFA are localized bleeding and mild pain. Since the heat obtained from radiofrequency energy burns the tissue, it reduces the risk of bleeding. Bleeding requiring intervention is extremely rare. Heating of the tumor may cause heating of the adjacent structure, which may damage some healthy tissues. This can be prevented by carefully evaluating the size and location of the tumor before the procedure. Special procedures (liquid injection) may be required to create safe distances for tumors close to structures such as the intestine.
Non-Surgical Treatment Methods for Advanced Kidney Tumors
Arterial Embolization (Vessel Occlusion Method)
Advanced renal cell carcinoma tumors are usually slightly larger and attack nearby structures and vessels. They can even spread to the vessels in one of the heart chambers. Some patients with advanced tumors may not be able to undergo surgical intervention.
During embolization, the interventional radiologist inserts a small tube (catheter) into the groin artery and directs it to the renal artery, which supplies blood to the kidney and tumor. The doctor injects small solid particles or special liquid agents into the vein to block blood flow to the kidney. The blockage prevents other substances necessary for the growth of the tumor from receiving oxygen, causing them to shrink.
In some patients, arterial embolization can shrink the tumor and make it suitable for surgery.
Arterial embolization is used to provide surgical resection of large tumors. say ku It is used. It prevents blood flow to the tumor, reduces the risk of bleeding and reduces the amount of blood transfusion during surgery. Similarly, arterial embolization helps shrink larger tumors and make them suitable for other closed methods.
Biological Treatment and Immunotherapy
Biological treatment reaches all cells in the body. It is a systemic treatment that uses substances injected into the bloodstream to affect blood pressure. Biological therapy uses the body's natural ability to fight cancer, such as using the immune system. New advances in immunotherapy have significantly improved the survival of patients with inoperable renal cancer.
“Magnetic” Chemotherapy
Interventional Radiologists are investigating a new technique that uses magnets to attract chemotherapy drugs to tumors. Microscopic magnetic particles are added to cancer-killing drugs and injected into the blood vessels feeding the tumor using a catheter. A rare earth magnet is placed directly over the tumor area on the patient's body. The magnet pulls the drug-carrying particles out of the blood vessel so that they settle in the tumor.
Pain Management
Pain control is one of the most important elements of cancer care. Pain not only affects patients' quality of life and ability to function, it can also reduce tolerance for necessary cancer treatments.
In most cancer patients, pain is caused by the spread of the tumor to nerves and other tissues. For example, patients with pancreatic or stomach cancer often experience pain from the tumor spreading into the network of blood vessels and nerves in the abdomen called the celiac plexus. To treat pain, interventional radiologists insert a catheter or needle into the affected area and apply alcohol or other agents that destroy the nerves causing the pain.
In a technique calledTranscatheter embolization, interventional radiologists use sand. It injects fine particles the size of a grain into the vein that supplies blood to the tumor with the help of a catheter. Particles cause clotting. This
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