2023-09-29 09:00:00
Some people may be spending quality time with their families during the Chuseok holiday, while others may enjoy a comfortable break alone. At this time, why not take a look at the health of myself and my loved ones? Abnormal symptoms that we inadvertently overlook in our busy daily lives may turn out to be serious signals from our body. JoongAng Ilbo, with the help of experts in the field at Asan Medical Center in Seoul, identified the five most common cancers among Koreans last Lunar New Year. This time, we have compiled four cancers that require attention among the top ten cancers. The second is kidney cancer. With the help of Professor Seo Jun-kyo of the Department of Urology at Asan Medical Center, we learned regarding the symptoms of kidney cancer, the importance of early detection, and treatment and prevention methods.
Kidney cancer has a high incidence, consistently ranking among the top 10 most common cancers in Koreans. However, awareness is relatively low. Kidney cancer usually refers to cancer that occurs in the renal parenchyma, which filters blood and produces urine among the various parts of the kidney. According to statistics from the Central Cancer Registration Headquarters, 5,946 new patients occurred in 2020 alone, ranking 10th in terms of cancer incidence in Korea. It is known to occur mainly in people in their 60s and 70s, but recently, as imaging equipment has developed and health examinations have become more common, the rate of detection at younger ages has been significantly increasing. The cure rate has also gradually improved to 85.7% (2016-2020), making it a relatively ‘good cancer’.
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Risk doubles when smoking
The most representative risk factor for kidney cancer is smoking. If you have a smoking history, your risk of developing kidney cancer increases by 1.5 to 2 times compared to a non-smoker. Even if you quit smoking, the effect is not immediate, and you need to quit smoking for 10 to 15 years to reduce the risk by regarding 15 to 30%. The relationship between excessive intake of certain nutrients in food, such as carbohydrates, proteins, and fats, and kidney cancer is unclear. However, if you become obese by consuming high-calorie foods, the risk of kidney cancer increases. Fruits, vegetables, and foods that are generally considered good for the body lower the risk of occurrence. High blood pressure is also known to increase the risk of kidney cancer. It is presumed that kidney cancer occurs secondary to pathological changes occurring in glomeruli exposed to long-term high blood pressure, secondary secretion of various growth factors, and changes in glomerular sensitivity to carcinogens. When blood pressure is lowered by controlling blood pressure, the risk of kidney cancer also decreases.
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If symptoms are severe, partial resection is required if the size is small.
Because the kidneys are separated behind the peritoneum, there are usually no symptoms until the cancer has progressed significantly. Symptoms such as pain in the side area, blood in the urine, and feeling a lump in the abdomen, which are known as representative symptoms of kidney cancer, are symptoms observed only in patients with very severe kidney cancer whose cancer size is 10 cm or more. Kidney cancer does not respond well to radiation or chemotherapy, so early diagnosis is very important. For early diagnosis, abdominal ultrasound is the most efficient method. In fact, as health checkup programs and abdominal ultrasound became more common, the early diagnosis rate of kidney cancer increased significantly. If an abnormally shaped lump is observed through ultrasound, computed tomography (CT) is used to accurately evaluate the size, location, number, relationship with surrounding organs, and presence or absence of metastasis of the lump suspected to be kidney cancer.
Fine needle aspiration biopsy, which involves suctioning a portion of tissue from the body with a needle and examining it under a microscope, is rarely performed. Kidney cancer is a heterogeneous mass on the inside, so it is difficult to obtain sufficient and accurate tissue during biopsy, and if the capsule surrounding kidney cancer is ruptured by a needle, tumor cells may flow out and spread along the needle.
In the past, when kidney cancer occurred, only ‘radical nephrectomy’, which completely removes one kidney, was considered effective and safe. However, as many research results on cancer recurrence and metastasis rates are accumulated, ‘partial nephrectomy’, which removes only part of the cancerous area, is also being actively performed. In particular, partial nephrectomy has been shown to lower the risk of chronic renal failure and significantly lower secondary cardiovascular disease and mortality, making partial nephrectomy a standard treatment for patients with small kidney cancer. Depending on the location and size of kidney cancer, relationship with blood vessels, relationship with surrounding organs, etc., open, laparoscopic, or robotic surgery methods are selected. For small early stage kidney cancer, robotic partial nephrectomy with a small incision and quick recovery is known to be effective.
If the kidney cancer is small and has not metastasized, is elderly, or has other serious systemic diseases that make surgery through general anesthesia difficult, a non-surgical method called ‘acupuncture ablation using radiofrequency’ can be performed. This is a method of inserting a needle capable of transmitting high frequencies and using high frequencies to dissolve the cancer. Although the recurrence rate is slightly higher than complete surgical resection, it is relatively safe and effective.
In the past, there were reports that radiation treatment was not effective for kidney cancer, but recently, Stereotactic Radiation Therapy technology enables effective local control of primary cancer and metastatic kidney cancer and is being effectively used in elderly patients. Ultimately, it is necessary to select the most appropriate method considering the patient’s overall condition at the time the cancer is discovered. Targeted therapy is used to treat kidney cancer that has metastasized, and first, second, and third treatments are being attempted using various methods combined with surgical treatment. Continuous research and development is underway on new targeted treatments and immunotherapies as a way to increase treatment effectiveness and reduce side effects compared to existing anticancer drugs. Recently, immunotherapy drugs have been shown to be effective in patients with metastatic kidney cancer and are being actively used.
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90% survival rate when diagnosed early
The most important thing in determining the prognosis of kidney cancer is the stage at the time of diagnosis. Depending on the stage, the prognosis, cure rate, and survival rate vary greatly. If discovered in the early stage, stage 1, the 5-year survival rate is approximately 90%, but if discovered in stage 4, the prognosis is very poor, with a maximum of 20% and an average survival of approximately 2 to 3 years even if all various treatments are administered. After kidney cancer treatment, recurrence usually occurs 1 to 2 years later, but metastasis or recurrence can occur even 10 to 15 years later, so long-term follow-up of 5 years or more is necessary. To prevent kidney cancer, it is important to quit smoking if you smoke, avoid high-calorie foods, and eat a balanced diet. Regular exercise is also essential to avoid losing your normal weight. Additionally, since kidney cancer has no clear symptoms, it is most important to have regular abdominal examinations once a year to detect and treat it early.
Kim Nahan ([email protected])
1695982135
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