Causes and Risk Factors of Kidney Cancer

What is kidney cancer?

Renal cancer is malignant abnormal cell proliferation in the kidney, and renal cell cancer (RCC)-renal cell cancer(%) originating from real kidney tissue 85-90) and pelvis renalis cancer (10-15%) originating from the renal pool that collects the urine. The origin, treatment and follow-up of these two groups already differ. In fact, when we say kidney cancer, we mean real renal cell cancers and constitute 2% of all cancers seen in the world. Its incidence has been increasing over the years, that is, more kidney cancer is diagnosed in parallel with technological developments, and the risk of developing kidney cancer is increasing, especially in the population living in the city. Average age of incidence Kidney cancers constitute 2-3% of all cancers diagnosed worldwide, 3-4% can be seen bilaterally (simultaneously or at different times). The average age of occurrence is 50-60 years, and it appears twice more in men than in women. The survival rate has increased with early diagnosis and improved treatment modalities.

Causes and Risk Factors of Kidney Cancers: As with other cancers, the exact cause of kidney cancer is still unknown. In other words, it can talk about some risk factors as in other types of cancer. In addition, kidney cancer can develop without any of the identified risk factors, but it does not necessarily mean that kidney cancer will develop in people with these risk factors. However, not everyone with these risk factors will get kidney cancer, and not every kidney cancer patient has these factors. Among the identified risk factors:

1-Smoking: Kidney cancer is seen twice as often in smokers than in non-smokers, this is the most common type of cancer, as in some other types of cancer. is one of the major risk factors. The higher the amount and duration of smoking cigarettes and tobacco products, the higher the risk. Passive smoking is also considered a risk factor. In case of abandonment of these products, the risk decreases over time.

2- Obesity and Nutrition: Excessive obesity-obesity, especially in women, is associated with kidney cancers. It has been determined that this risk decreases with weight loss. A direct correlation was found between the severity of obesity and kidney cancer. Vitamin D deficiency in obese people also increases this risk. Excessive consumption of meat and dairy products increases the risk of kidney cancer. Processed meat products, excessive red meat and pork, high-calorie diet and fried foods are counted as risk factors for kidney cancers. It has been shown that the risk of kidney cancer in people who consume these products excessively is 1.5 times higher than other people. Excess fat and protein in these products increase the risk of chronic kidney failure and therefore kidney cancer. The risk is relatively low in a vegetarian diet. It has been determined that a one-point increase in the body-mass index increases the risk of developing kidney cancer by one fold

3-Low Physical activity: Low physical activity is associated with kidney cancer It has been found that prevention of obesity, especially with physical activity, reduces this risk. The potential relationship between physical activity and cancer development focuses on insulin resistance, growth factors, endocrinological (hormonal balance) and immune system. Physical activity and sports activities have been shown to reduce the risk of developing cancer.

4-Hypertension: There was a relationship between hypertension and drugs used for this purpose and kidney cancer. It is not clear whether the relationship is due to drugs or only to high blood pressure disease. In fact, the prognosis of high blood pressure kidney cancer patients is relatively not good, it shows a worse course. The higher incidence of kidney cancer in patients with hypertension is explained as the destruction and inflammation caused by hypertension in the kidney tissue, and metabolic and functional changes rendering it immune to carcinogens in the environment.

5-Medicines: Inappropriate and long-term use of painkillers and anti-inflammatories is considered a risk factor for renal cell kidney cancer, but the issue is controversial. In particular, continuous and long-term use of the pain reliever called phenacetin. The relationship between the use of urea and the development of urethral cancer of the renal pelvis rather than renal cell cancer has been known for a long time. It has been found that the risk of developing kidney cancer increases 4-5 times in patients using diuretics (diuretics: Thiazide and Furosemide group), especially in women. It has also been claimed that the use of oral contraceptives and estrogen increases the risk of developing kidney cancer.

6- Occupational factors: Some occupational exposures are accepted as risk factors in the development of kidney cancer. Among these risky business lines, Chemistry, Petroleum, steel, cadmium, lead, aspest, asphalt and fire extinguishing sectors can be counted. Exposure to more than a hundred carcinogenic chemicals (asbestos, lead, cadmium, organic solvents, aromatic hydrocarbons, trichloroethylene, etc.) detected in those working in these sectors has been shown to increase the risk of developing kidney cancer many times over.

7-Radiation and Cancer drugs (Chemotherapy): Patients who have received radiotherapy and/or chemotherapy before may develop second kidney cancer years later. It was found to be -6 times more. Again, those who receive radium-224 treatment for any reason are relatively more likely to develop kidney cancer in the future. failure, kidney cyst disease and some kidney infections are considered major risk factors for kidney cancer. The risk of developing kidney cancer in patients receiving long-term dialysis was found to be 3-4 times higher than normal. Again, chronic infections of the kidney (with or without stones) and some viral diseases are risk factors for the development of cancer. It has been shown that the risk of developing kidney cancer is high in relation to (immunosuppressives and cortisone). There have been some detailed studies on Sirolimus, which is used especially after transplantation.

10- Genetic Factors and Familial Factors: When kidney cancer is evaluated genetically, it can be divided into two forms as familial and sporadic (random). It has been determined that the risk of developing kidney cancer in first and second degree relatives with kidney cancer is 3-4 times higher than the normal population. In other words, there is a familial genetic predisposition and permeability. From a genetic point of view, many genetic mechanisms have been shown to cause a tendency to renal cell cancers. VonHippel Lindau(VHL) disease associated with genetic factors, familial, seen at a relatively young age and progressing with multiple bilateral kidney cancers is a typical example. It has been found that when the VHL gene does not work, HIF accumulates and leads to the start of a series of processes/pathways leading to cancer. These two examples are important in terms of showing the genetic features of renal cell cancers. The general genetic defect in VHL patients and all other kidney cancers is the deletion (loss) of the short arm (3p) of chromosome 3. Apart from these, mutations in chromosome 7, some somatic mutations, and some genetic polymorphism abnormalities are detected. In fact, micro-RNA expression in kidney cancers is used as a marker for the course of the disease.

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