The number of cancer cases has been rising steadily in recent years. While this may be a result of lifestyle changes seen all over the world, the availability of advanced diagnostic techniques has also contributed. Bladder and kidney cancer are among the commonest malignancies seen in hospitals. Men are three times more likely to suffer from bladder cancer when compared to women. The median age of those affected is about 68 years.
Several predisposing factors have been identified. Cigarette smoking has featured prominently with some studies concluding that smokers are four times likely to contract bladder malignancies as compared to non-smokers. Some of the harmful chemicals found in cigarettes include naphthalene, nitrosamine and aminobiphenyl. Other significant factors include exposure to radiation, aromatic amines and the intake of some sweeteners such as saccharin and cyclamate.
The cause of renal tumors is unknown. Scientists have established that there are some genetic mutations in a majority of people affected. However, there are a number of risk factors that have been identified. Hypertension, older age, smoking, obesity and some forms of inherited syndromes are just but a few examples.
Typically, patients will not have any symptoms in early stages. The passage of bloody urine is the first symptom reported by many of the patients. In the case of renal tumors there may be additional complaints that include generalized fatigue, weight loss and back pain.
Several investigative tests are needed to get a definitive diagnosis. Renal function tests and urinalysis are easy to perform and serve a screening function. CT scans and MRI are used to locate the tumor and to stage. When metastasis is suspected, other imaging studies such as radionuclide imaging will be required. Taking a biopsy specimen for histological examination remains the gold standard of diagnosis.
There are two main categories of the cancer; invasive and non-invasive disease. The non-invasive category has better outcomes since less tissue is involved. The large categories are subdivided into adenocarcinoma, squamous cell carcinoma, and primary lymphomas. Just as is the case with the bladder, there are many types of tumors that affect kidneys. The commonest is known as renal cell carcinoma.
The staging of cancers is important as it used in choosing the type of treatment modality to be used. Staging involves the assessment of a disease to establish how far it has spread. Tumors that have spread beyond the organ are usually much advanced. Grading is also done to determine how badly the constituent cells have been damaged. The techniques used for staging and grading differ depending on the type of tumor.
Tumors are treated using different modalities depending on the extent of disease. Low grade tumors are managed with both surgery and chemotherapy. The surgery removes the tumor and chemotherapy kills off any residual tumor cells. High grade tumors are usually very advanced at the time of diagnosis. They tend to recur and progress even with the best forms of treatment. Renal tumors may be managed by either surgery or radiotherapy.
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