What are the early symptoms of kidney cancer?

Written by Yan Chun
Oncology
Updated on December 16, 2024
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Kidney cancer is a common malignant tumor in the urinary system. Many patients with early-stage kidney cancer do not show any symptoms clinically and are incidentally discovered during medical examinations. Many patients in the early stages may also present with painless hematuria, sometimes as gross hematuria and sometimes as microscopic hematuria. Some patients may experience pain in the kidney area due to blood clots formed after hematuria, mainly presenting as intermittent episodes of mild back pain. Additionally, some patients in the early stages might show symptoms of paraneoplastic syndrome, such as hypertension and fever, but these clinical symptoms generally occur at a very low frequency. When patients present with obvious clinical symptoms, it often indicates that the kidney cancer has metastasized, leading to a clinical presentation of mid-to-late stage kidney cancer.

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The difference between benign and malignant kidney cancer.

The incidence of kidney cancer is also considered relatively high, with over 95% of kidney tumors being malignant, and benign tumors being less common. The distinction between benign and malignant tumors is determined by their symptomatic expression and growth patterns, and they have different impacts on the body. Generally, benign tumors grow expansively or exophytically, have a slower growth rate, and have clearer boundaries with often a capsule surrounding them. The texture and color of the tumor are close to that of normal tissues. Malignant tumors, on the other hand, exhibit the opposite characteristics.

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Post-nephrectomy care for renal cancer

Postoperative care measures for kidney cancer primarily include observing the patient's vital signs. After a radical nephrectomy for a large renal tumor, a significant amount of tissue is removed including the kidney, surrounding adrenal fat, and lymph nodes at the renal hilum, which results in larger surgical wounds and potentially more bleeding. Therefore, it is crucial to closely monitor for signs of bleeding and ensure that transfusions and fluid administrations are unobstructed. Secondly, careful observation and management of the wound drainage tubes are required. Thirdly, for radical nephrectomies, once the patient is past the anesthesia phase and the blood pressure is stable, a semi-reclined position can be adopted. Patients who have undergone partial nephrectomy should remain in bed for one to two weeks to prevent further bleeding, and kidney functions should be monitored. Additionally, attention should be paid to symptoms such as breath holding and difficulty in breathing. Postoperative feeding should commence once gastrointestinal function is restored; thereafter, nutrition should be enhanced to boost bodily resistance. Calming medications may be appropriately used to ease pain, facilitating movement, effective coughing, and expectoration.

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Clinical manifestations of renal cancer

The clinical manifestations and staging of kidney cancer are related to the most common early-stage kidney cancer, late-stage kidney cancer, or metastatic kidney cancer. Generally, early-stage kidney cancer exhibits few clinical symptoms and is often detected during physical examinations, through ultrasonography of the urinary tract, or kidney ultrasonography, where tumors are the most commonly found. Additionally, later stages of kidney cancer often present as swelling pain in the waist area or occasional hematuria. More serious conditions involve feeling a mass in the upper abdomen upon palpation, which is a clinical manifestation. Nowadays, with heightened awareness for health checks, such conditions are generally discovered through these examinations. When major clinical manifestations like hematuria and abdominal masses occur, it indicates that the kidney tumor has already progressed to the mid or late stages.

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Difference between Renal Cancer and Renal Pelvis Cancer

First, the sites of the disease are different; renal pelvis cancer usually occurs in the epithelium of the renal pelvis or calyces, while renal cancer typically originates from the epithelial cells of the renal tubules. Second, the presentations are different; hematuria is a common symptom of both renal pelvis cancer and renal cancer. However, in renal pelvis cancer, hematuria can occur early, while in renal cancer, hematuria may not be seen until the tumor has invaded the renal pelvis or calyces. Third, the diagnostic tests are different; the clinical diagnosis of renal cancer heavily relies on CT scans, whereas renal pelvis cancer primarily depends on excretory or retrograde urography, that is, CT urography. Fourth, the CT appearances are different; on CT scans, renal cancer typically shows as a multicystic lesion with more pronounced enhancement during contrast than that seen in renal pelvis cancer. Fifth, the results of cytological examinations are different; cytology of renal pelvis cancer may show positive tumor cells, but renal cancer might test negative.

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Is stage II kidney cancer considered early stage?

The staging of kidney cancer is primarily based on the size of the tumor, whether there is lymph node metastasis, involvement of adjacent organs or lymphatic vessels, and metastasis to distant organs. The TNM staging system is commonly used in clinical settings to stage kidney cancer, where "T" represents the depth of tumor invasion, "N" represents the status of lymph node metastasis, and "M" represents distant metastasis. Stage II refers to a tumor with a maximum diameter greater than seven centimeters but confined to the kidney. Stage II is further divided into stage IIA and stage IIB. Stage IIA refers to a tumor with a maximum diameter greater than seven centimeters but less than ten centimeters, confined to the kidney. Stage IIB refers to a tumor with a maximum diameter greater than ten centimeters, but still confined to the kidney. In the case of stage II kidney cancer, although it is an early stage, curative treatment can be achieved through surgery. Therefore, if diagnosed with stage II kidney cancer, it is vital to pursue aggressive treatment.