Kidney cancer is often overlooked, but with over 200 new cases diagnosed annually in Singapore, it’s becoming impossible to ignore. Many don’t realise they have it until it’s too late. Could you be at risk?
It starts quietly. A bit of fatigue, some discomfort in your lower back, maybe a little blood in your urine. Nothing alarming, just everyday nuisances. Until one day, it isn’t.
For over 200 people in Singapore every year, what seemed like nothing turns out to be kidney cancer. And by the time symptoms appear, the disease is often in an advanced stage.
Kidney cancer is the 14th most common cancer worldwide. It has steadily increased over the recent years, at a rate of 2-3%. The most common type of kidney cancer is renal cell carcinoma (RCC), which accounts for about 90% of the cases, with the risk rising significantly after age 60.
“Kidney cancer tends to affect older people aged over 60 years old. 90% of kidney cancer patients are men,” shared Dr Shang Yeap Heng Oon, Senior Consultant Medical Oncologist from Icon Cancer Centre.
What Is Renal Cell Carcinoma (RCC)?
RCC develops when cancerous cells grow abnormally from the kidneys, particularly in the tubules. The tubules are tiny tubes that filter waste products in the kidneys.
RCC often starts from the kidneys and can spread to other nearby organs such as lungs, bones, liver and brain.
What Can Cause Kidney Cancer
The exact cause of RCC is not known. It may be attributable to several risk factors such as:
- Smoking
- Strong family history of kidney cancer
- Exposure to cancer-causing substances (e.g. asbestos, heavy metals)
- High blood pressure
- End-stage kidney failure requiring dialysis
- Obesity
- Prolonged use of certain painkillers (e.g. paracetamol, ibuprofen, diclofenac)
- Hereditary kidney cancer due to faulty genes
What Are the Symptoms?
RCC is usually diagnosed in advanced stages due to less prominent symptoms in the early stages.
See a doctor immediately if you have symptoms including:
- Pink urine or blood in urine
- Persistent lower back pain
- Lump in the abdomen
- Unexplained weight loss
- Fever
- Fatigue
- Night sweats
How To Diagnose Kidney Cancer
Imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasound are typically used for diagnosis. These imaging scans produce images of the kidneys to detect abnormal masses.
In some cases, a biopsy may be required. This involves taking a small tissue sample from the kidney to confirm the presence of cancerous cells.
However, biopsies aren’t always necessary.
“Biopsies are not needed if the scan results are definitive of kidney cancer,” shared Dr Shang Yeap.
What Are the Available Treatments?
The early stage of kidney cancer, including RCC, is highly curable. The cure rate of stage 1 kidney cancer can be up to 90%. Hence, early detection is imperative for treatment.
The types of treatments for RCC are:
- Surgery
- Radiation therapy
- Immunotherapy
- Targeted therapy
The doctor will recommend a treatment plan based on the cancer stage, overall health, and medical history.
Surgery
Surgery removes part or all the affected kidneys. This surgery is called nephrectomy and can be divided into several types:
Partial nephrectomy
Partial nephrectomy removes the cancerous tumours within the kidney and some of the tissue around it. It is done to preserve the kidney functions.
Simple nephrectomy
Simple nephrectomy removes the affected kidney only.
Radical nephrectomy
Radical nephrectomy removes the kidney, the adrenal gland, surrounding tissues, and usually nearby lymph nodes.
Radiation therapy
Radiotherapy uses high-energy radiation such as X-rays to kill cancer cells and stop their growth. A machine emits and delivers the radiation towards the affected area.
Radiation therapy may be given after surgery to kill any cancerous cells left. Additionally, it may also be used in palliative care to relieve symptoms and improve quality of life for patients in advanced stages of RCC.
Immunotherapy
Immunotherapy uses medicines to stimulate the immune system to fight cancer. Biomarkers tests may be necessary to predict response of certain immunotherapy drugs against the cancer cells.
Examples of immunotherapy drugs include:
- Pembrolizumab
- Nivolumab
- Ipilimumab
Targeted therapy
Targeted therapy uses drugs to identify and attack specific cancer cells. This treatment option is more accurate in treating the cancer and has fewer side effects.
Examples of targeted therapy drugs are:
- Bevacizumab
- Everolimus
- Pazopanib
- Cabozantinib
Early Detection of Kidney Cancer Saves Lives
Early cancer detection is critical to catching it in the early and more curable stage. The progressive advancement in oncology also gives promising hopes to curing more advanced stages of kidney cancers soon.
Important key takeaways:
✅ Lead a healthy lifestyle and quit smoking to reduce the risk of getting RCC.
✅ Know the warning signs, pay attention to unusual symptoms and do not ignore persistent back pain or blood in urine.
✅ See a doctor immediately if you recognise these warning signs, as detecting RCC early can save lives.
Want to learn more? Visit our dedicated page on kidney cancer for in-depth resources and expert insights.
Dr Shang Yeap Heng Oon is a Senior Consultant Medical Oncologist practising at Icon Cancer Centre, Singapore.
