[Fat Bear Science] It is a "model worker" but also "careful with words". This cancer is found in more than 90% of physical examinations. Nine groups of people need to be vigilant. The way to reduce the risk is.

Our body has such a "model worker" organ, which filters out the body's "garbage" at all times and works tirelessly to "excrete".

It is the kidney.

Since 2006, the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations have jointly proposed to designate the second Thursday of March each year as World Kidney Day.

Living a good life with kidney disease

——Kidney Day 2021

This year's Kidney Disease Day is on March 11, with the theme "Living Well with Kidney Disease". It aims to be patient-centered, empower patients and caregivers, live happily with the disease, and improve the quality of life.

As the body's excretion organ, kidney cells will inevitably be damaged in the long-term excretion work. Damaged kidney cells may turn into cancer cells. Cancer cells will form lumps through continuous growth and division, which is what we call kidney cancer.

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Li Jun

Deputy Chief Physician and Master's Supervisor of the Department of Urological Oncology, Affiliated Cancer Hospital of Chongqing University, Doctor of Medicine, and Postdoctoral Fellow.

Expert in comprehensive treatment of urinary tract tumors.

Clinic hours: Thursday morning

Kidney cancer: be careful when talking about it

More than 90% of physical examinations found

Kidney cancer is one of the most common tumors in the urinary system. Currently, kidney cancer ranks second among urogenital tumors in my country, second only to bladder cancer, accounting for 2% to 3% of adult malignant tumors and about 20% of childhood malignant tumors.

Kidney cancer has a preference, and there is a relatively obvious difference in the incidence rate between men and women. According to statistics, the male-to-female ratio is 2:1. In recent years, the incidence rate of kidney cancer has increased year by year. From 1998 to 2009, the incidence rate of kidney tumors in my country increased at an average annual rate of 6.5%, reaching 4.5-5.6/100,000.

Kidney cancer is also a "silent killer." Early kidney cancer has basically no obvious symptoms, and more than 90% of kidney cancer patients are discovered accidentally during physical examinations or other disease examinations.

The "silence" of kidney cancer is closely related to the physiological mechanism of the kidney. Each kidney of the human body is composed of about 1 million renal units, and each renal unit is a tiny and sophisticated filtration system. These millions of renal units do not work at the same time, but implement a regular "shift system". Such a physiological mechanism can effectively protect the function of the renal units and prevent them from "death from overwork". However, this will also bring unexpected negative effects, that is, it will make it difficult for people to perceive the early symptoms of kidney disease. If you really wait until the typical symptoms such as hematuria, low back pain and waist and abdominal lumps appear before you go to the doctor, the disease has often progressed to the late stage and you have missed the best time for diagnosis and treatment.

Smoking, obesity...

Nine groups of people are high-risk factors

The onset of renal cancer is caused by a combination of factors, and its pathogenesis is still unclear, but studies have confirmed that its onset is related to factors such as genetics, smoking, obesity, hypertension and anti-hypertensive treatment.

First of all, a large number of scientific studies have shown that smoking is one of the important risk factors for kidney cancer. The risk of kidney cancer in smokers is twice that of non-smokers, and the risk is even higher in long-term smokers.

Other studies have shown that obese people are twice as likely to develop kidney cancer as people of normal weight, and high blood pressure is also a factor that increases the risk of kidney cancer.

There are also reports showing that people with diabetes are more likely to develop kidney cancer. 14% of kidney cancer patients have diabetes, which is five times the rate of diabetes in the general population. In addition, a high-protein, high-fat diet can also increase the risk of kidney cancer. Workers who are exposed to heavy metals for a long time, petrochemical workers, radiation workers, and other practitioners are also considered to be at risk of kidney cancer.

Drugs also have a certain toxic effect on the kidneys. People who take certain drugs for a long time have a higher risk of developing kidney cancer than the general population.

Generally, kidney cancer is not inherited, but some cases are hereditary, accounting for about 4% of all kidney cancer cases. These cases have a very obvious genetic tendency, including VHL syndrome, hereditary papillary renal cancer, hereditary leiomyoma renal cancer, and BHD syndrome. People with a family history of kidney cancer should be alert.

What factors can reduce the occurrence of kidney cancer? The first is to quit smoking. The risk of kidney cancer will decrease year by year after quitting smoking. Secondly, a diet rich in fruits and vegetables can reduce the risk of disease. The most important thing is to start by changing bad living habits. In life, you should quit smoking, not drink too much, not drink too much coffee, avoid staying up late; reduce the intake of high-sugar and high-fat foods, control your weight, and exercise appropriately; avoid radiation damage, prevent the abuse of hormones, and reduce contact with chemical carcinogens; do not eat moldy, rotten, and pickled foods; do not abuse painkillers and other drugs.

Surgery is curative

Color Doppler ultrasound is the most effective screening method

From a pathological perspective, there are several types of renal cancer.

The most common type is clear cell carcinoma, which accounts for about 60% to 85% of renal cancer. Most renal clear cell carcinomas are unilateral single lesions, while hereditary renal cancers are mostly bilateral multifocal lesions. A small number of clear cell carcinoma tissues contain sarcomatous components, indicating a poor prognosis.

Papillary renal cell carcinoma accounts for approximately 7% to 14% of renal cancer, and its lesions are more common in patients with bilateral kidney involvement and multifocal lesions.

Chromophobe cell carcinoma accounts for about 4% to 10% of renal cancers. Most tumors are solitary tumors with a generally good prognosis. In addition, there are some rare renal cancers such as collecting duct carcinoma, renal medullary carcinoma, and genetic ectopic renal carcinoma.

Although the early symptoms of kidney cancer are not obvious, the five-year survival rate after surgical treatment of early kidney cancer can reach more than 90%. In addition, from a clinical point of view, kidney cancer occasionally occurs in young people aged 30-40, and often occurs in middle-aged and elderly people aged 50 to 70, so regular physical examinations are very important.

In routine physical examinations, color Doppler ultrasound is the most economical and effective way to detect kidney cancer. Almost all kidney cancers can be detected by color Doppler ultrasound. Ultrasound can detect kidney tumors with a diameter of 1 cm. If color Doppler ultrasound finds abnormalities, a CT scan should be performed, which can detect tumors larger than 0.5 cm.

Men over 40 should insist on having annual renal ultrasound examinations, especially those with a family history of renal cancer, or those suffering from diabetes, hypertension, chronic kidney disease, and especially those in high-risk groups who are receiving long-term dialysis treatment.

Surgery is the only way to cure kidney cancer. Nowadays, with the improvement of minimally invasive technology, patients recover faster after minimally invasive surgery and can be discharged from the hospital for recuperation in about a week. After the recovery of kidney cancer patients without distant metastasis, their daily life is not affected, and some patients can even do physical labor. Whether it is a complete kidney removal surgery or a kidney-preserving surgery, the patient's daily life and work are not greatly affected after the recovery of the surgery.

Text/Fat Bear Picture/Internet (Please contact to delete) Review/Urological Oncology Department

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