Prostate/Genitourinary Cancer

The Prostate and Genitourinary Cancer Center at Loma Linda University Cancer Center treats cancer in the prostate and the genitourinary system. Our center has developed a cancer care system that understands the unique nature of each patient and treats each person who walks through our doors accordingly. With the use of leading diagnostic tools, a multidisciplinary team of oncologists and the latest treatment technology, we are able to offer more options for prostate cancer treatment than any other facility in the West.

Loma Linda University Medical Center has a vast array of resources available for cancer treatment. We work very closely with the James M. Slater, MD Proton Treatment Center and the LLU Robotic Surgery Department to provide our patients with technologically advanced treatment options and a seamless treatment experience.


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Prostate Cancer

What is prostate cancer?

Prostate cancer is the second leading cause of death in men in the United States. Nearly two-thirds of these men will be age 65 or older. Prostate cancer is a condition in which abnormal cells grow from a malignancy on the prostate. If untreated, it can metastasize to the bones, lymph nodes, rectum, bladder, and other parts of the body. The prostate gland is found only in men near the urethra, below the bladder and in front of the rectum. The prostate depends on adequate levels of testosterone to function properly. It produces seminal fluid, and regulates and controls urine flow by contracting and releasing muscle fibers.

Signs and symptoms

Prostate cancer symptoms may include:

  • Abdominal pain
  • Anemia
  • Bloody semen
  • Bloody urine (hematuriaFatigue)
  • Problems urinating and incontinence
  • Leg inflammation
  • Lower back pain/Spinal compression
  • Weight loss

More severe symptoms can present in late stages of prostate cancer depending on where the cancer has spread to other parts of the body. If the cancer has spread to nearby bones, bone pain, sensitivity and even fractures can occur. Urological problems can occur if the cancer spreads to urological areas.

The exact symptoms can depend on a variety of factors:

  • Patient’s age
  • Current state of health
  • How far along the cancer has progressed
  • Where the cancer may have spread to other parts of the body

Most men with early prostate cancer may not even know they have it since early prostate cancer seldom causes noticeable changes. Regular prostate exams can reduce the risk of prostate cancer.

Diagnosis

The American Urological Association (AUA) recommends that beginning at age 50 (age 40 if there is a family history of prostate cancer), men undergo a yearly PSA check and digital rectal exam (DRE).

It has been shown that PSA testing can lead to detecting prostate cancer at a stage when it is more likely to be cured, and that prostate cancer treatment can lengthen life. PSA level is determined by a blood test that can detect prostate cancer before there are any symptoms. Your urologist may order a free PSA to help improve the accuracy of the PSA test.

The digital rectal exam allows the doctor to examine the prostate through the rectal wall, feeling for areas of hardness.

Treatment

Treatment for prostate cancer depends on many factors:

  • Results of the biopsy
  • Whether the cancer has spread to other areas
  • Patient's general health
  • Patient's preference for treatment

Some treatment options are:

Nutrition, exercise and prostate Cancer

In general, our society combines low levels of exercise along with foods that are high in calories, fat, sugar and salt. Our bodies respond as they were designed- they store excess food as fat to prepare for times of prolonged starvation. Prolonged starvation does not typically happen in modern society and this safety mechanism means that we just continue to gain weight and store more fat.

This excess fat, especially the fat around the middle of your body has been associated with an increased risk of many diseases, including prostate cancer, and particularly aggressive prostate cancer. Body fat is actually an organ with functions. It secretes hormones and specialized proteins that can increase inflammation and oxidation in the cells or your body - two natural processes that are strong contributors to the development and progression of prostate cancer.

Effects of Oxidation and Inflammation

Oxidation is a normal chemical reaction that occurs when free radicals form ithin the cells of the prostate. Each oxygen atom contains two electrons that cling together. When heat or light breaks apart the atom, the electrons are separated, leaving unpaired oxygen radicals. These radicals are free to roam around and initiate a process of breaking down normal cellular structures, causing damage and promoting the development of cancer. The more free radicals present, the more cancer-causing damage occurs.

One of the most common causes of the loss of protective antioxidants is inflammation, a biochemical process that your body initiates when fighting off an infection. If the body senses invaders, such as bacteria, white blood cells are mobilized to go to the site of the invasion and to release oxygen and nitrogen radicals to help kill the invaders. Unfortunately, if they remain unchecked, these same oxygen radicals can also break down normal tissue and promote the development of cancer. Oxygen radicals damage normal DNA, causing errors that allow cancer growth.

In fact, researchers have noted the presence of inflammatory cells in virtually all prostate cancer tissue that is removed surgically and have found that inflammation leads to the atrophy or wasting away of normal prostate tissue adjacent to precancerous and cancerous areas of prostate tissue.

Based on these and other observations, evidence is mounting that inflammation and oxidation play key roles in the development of prostate cancer. Why is this important? Because although other contributory factors such as aging and altered hormone secretions are difficult or impossible to change, nutritional and exercise habits that reduce the development of inflammation and oxidation can be changed.

There are many anti-inflammatory and antioxidant substances found in colorful fruits and vegetables, whole grains and spices, nearly all of which are absent from the processed foods that rely on sugar, salt and fat for flavor. By focusing your diet on fresh fruits and vegetables, ocean-caught fish and whole grains, you can increase the protective anti-inflammatory components of your diet and to benefit from their effects.

The Contribution of Carcinogens

A carcinogen is a chemical that directly or indirectly causes or leads to more aggressive forms of cancer. Hundreds of chemical have been definitively linked to cellular changes that lead to cancer development and hundreds more have been implicated in processes that might be involved.

Overcooking of any type of meat at very high temperatures produces a set of carcinogens that causes prostate cancer in animal studies. In addition, charbroiling red meat or chicken, with its skin intact produces yet another set of carcinogens. Laboratory research findings have suggested that intake of these charred meat carcinogens trigger mutation in prostate cell DNA and leads to a chronic inflammatory response in the prostate. This combination of mutations and inflammation appear to be a key to the development of prostate cancer.

Switching to alternate source of protein that are not prone to forming carcinogens when cooked, such as soy, is an important first step in minimizing the damage caused by overcooking and charbroiling meats. Also, using alternate methods to cook meat can significantly cut down on the amount of carcinogens produced. Choose steaming or baking over char-broiling or pan-frying, marinate the meat and turn the meat frequently to prevent over-cooking. Finally, increase your consumption of cruciferous vegetables, which have unique properties that enable them to help “sponge up” carcinogens and possibly even counteract some of the damage caused by these carcinogens.

Effects of excess sugar

Sugar is a prime energy source for many cancers, including prostate cancer. Most normal cells can adapt to an environment low in sugar and use other energy sources. A process developed through evolution when people would go through periods of starvation. However, cancer, which grows faster than normal cells, does not have the same ability to adapt to low sugar environments. Thus, the more excess sugar is consumed, the more the tumor is stimulated. Indeed, several animal studies suggest that cutting simple sugar intake can slow prostate cancer growth.

Obesity is the result of an imbalance of food intake and exercise. When you eat more and exercise less, fat accumulates in the body. The first place that fat accumulates in men is in the middle of the body around the belly and abdomen.

Belly fat is specially evolved to store fat quickly and release it quickly. Thus, this is the first place the fat settles when you gain weight and the first place it leaves when you lose weight. Since this fat grows so quickly, it can sometimes outgrow its blood supply, causing the fat cells to dies. When this happens, the body’s immune systems sends out scavenger white blood cells to clean up the debris which, as we described earlier, set off a cascade of inflammatory and oxidative events that can ultimately promote heart disease, diabetes, and certain types of cancer including prostate cancer.

Beyond the effects of the excess body fat, the consequences of caloric imbalance that lead to fat accumulation can be significant. Cancer cells grow faster than do normal cells and require excess energy for their growth. Thus, excess calories, above your body’s need, will help feed tumor growth. Also, rapidly growing tumors live on the edge of survival due to a lack of an adequate blood supply and low levels of oxygen. Without oxygen, the cells can’t break down fat so instead rely on sugars and carbohydrates for energy. Thus, the higher your sugar intake, the more nutrients you are providing to the tumor.

Effects of Muscle Loss

Muscle plays a number of roles in maintaining health. Not only are muscles critical to posture, balance and movement, they also maintain healthy bones by putting a physical stress across the bones. Hormonal therapies often used in men with advancing prostate cancer can have a detrimental effect on muscle, leading to muscle atrophy or wasting. Thus, with muscle loss, from aging, inactivity and hormonal therapies, the bones become more brittle and the loss of balance can also lead to bone fractures.

Incorporating Good Nutrition and Exercise Into Your Everyday Routine

In the majority of cases, when prostate cancer is detected early, primary surgical or radiation treatment is curative and taking additional steps to prevent the growth of the cancer might seem unnecessary. Nevertheless, men at this stage would do well to take an opportunity to inventory and tune up their nutritional habits. Remember, maintaining a healthy diet and regularly exercising can be important steps toward preventing other diseases that commonly occur with aging, including heart disease and diabetes.

Men with advanced prostate cancer or with disease that has recurred can begin by incorporating a healthy diet and regular exercise into their regular routines to help slow the progression of disease while recognizing that there is limited direct proof of the effectiveness of such changes. The key in this phase of the disease is to rationally make dietary and exercise changes in a way that complement any ongoing treatments.

Men who have received hormonal treatments are at particularly increased risk of developing weaker bones and muscles. For these men, endurance training to keep the cardiovascular system strong and resistance or weight training to keep the muscles strong coupled with healthy dietary choices focusing on achieving a goal weight, can be integrated into the treatment plan on an ongoing basis.

Finally, in men with metastatic or advanced disease, supportive nutrition is most important. Because weight loss and loss of appetite is common in men at this stage of disease, healthy nutrition and ensuring adequate calories is critical to the success of therapy and to the support of a healthy immune system.

 

Kidney Cancer

What is cancer?

Cancer is when cells in the body change and grow out of control. To help you understand what happens when you have cancer, let’s look at how your body works normally. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them, and die when your body does not need them any longer.

Cancer is made up of abnormal cells that grow even though your body doesn’t need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasis).

What is kidney cancer?

Cancer that starts in kidney cells is called kidney or renal cancer.

Understanding the kidneys

The kidneys are 2 bean-shaped organs. Each is about the size of a bar of soap. They sit in the body towards the middle to lower part of the back. There is 1 kidney on each side of the spine. The kidneys help filter waste and excess fluid from the blood. The liquid and waste is then sent as urine to the bladder through thin tubes called ureters. Urine then leaves the body through a tube called the urethra. The kidneys also help control blood pressure. And they help make sure there are enough red blood cells in the body.

Outline of human torso showing front view of urinary tract. Two kidneys are in upper abdomen. Each kidney is connected by ureter to bladder which is in pelvis. One kidney in cross section to show inside. Urethra goes from bladder to outside body. Closeup of blood vessels in filtering unit of kidney. Tube leading from filtering unit monitors balance of fluid and chemicals.

When kidney cancer forms

A kidney is made up of many layers of cells. Kidney cancer can affect any one or all of these layers. The cancer can stop the kidneys from working normally. Kidney cancer may spread to other parts of the body. When cancer spreads, it’s called metastasis. The more cancer spreads (metastasizes), the harder it is to treat.

What are the different types of kidney cancer?

The main type of kidney cancer is called renal cell carcinoma (RCC). About 9 out of 10 kidney cancer tumors are this type. If you have this type of kidney cancer, you may have more than one tumor in one or both kidneys. These may be large by the time they are diagnosed. But most cases of kidney cancer are found before the cancer has spread to other organs.

There are different types of RCC. A healthcare provider called a pathologist identifies these types by looking at the cancer cells under a microscope. The types of RCC include:

  • Clear cell. This is the most common type of RCC. The cancer cells look pale or clear.
  • Papillary. This is the second most common type of RCC. This type of tumor has tiny fingerlike growths.
  • Chromophobe. This is a rare form of RCC. The cells are larger than other types of RCC.
  • Collecting duct. This is also a rare form of RCC. The cancer cells look like irregular tubes.
  • Unclassified. This includes tumors that have cells from more than 1 type of cancer. It also includes tumors with cells that don’t fit into the other categories.

Other types of kidney cancer

Other less-common types of kidney cancers include:

  • Transitional cell carcinoma. This is also known as urothelial carcinoma. It starts where the ureter and kidney meet. This area is called the renal pelvis. This type of kidney cancer can act and look like bladder cancer.
  • Wilms’ tumor. This cancer most always occurs in children. It's very rare in adults.
  • Renal sarcoma. This is a very rare type of kidney cancer. It begins in the blood vessels and connective tissue around the kidneys.

Kidney tumors that aren’t cancer

There are several types of kidney tumors that are not cancer (benign). These include renal cell adenoma, renal oncocytoma, and angiomyolipoma. These types of tumors may still affect kidney function and can cause pain and other symptoms. But the cells usually do not spread to other organs.

Talk with your healthcare provider

If you have questions about kidney cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer.

What are the symptoms of kidney cancer?

Kidney cancer often causes no symptoms in its early stages. As the cancer grows, it can cause symptoms such as:

  • Blood in the urine. Blood in the urine (hematuria) is one of the most common signs of kidney cancer. Hematuria can be caused by other tumors, such as bladder cancer or prostate cancer tumors. It can also be caused by benign (noncancer) conditions, such as kidney stones and infections. You may be able to see the blood easily in your urine. Or the blood cells may show up only when a urine test is done.
  • Pain in the side or lower back. Side and back pains that are not from an injury can also be symptoms of kidney cancer. Pain is caused by the tumor growing and pushing against nearby organs. It is usually felt on one side only.
  • A lump in the kidney area. If you feel a lump in the kidney area (the lower back or side) and have not had an injury, a tumor may be there. The lump may also be painful.
  • Tiredness. Chronic tiredness is a common problem for people with cancer. This is usually caused by a low number of red blood cells (anemia). Anemia can be found by blood tests. It can be caused by almost all cancers, as well as by many other diseases.
  • Fast weight loss. Weight loss that happens quickly without any effort to lose weight can be a sign of kidney cancer.
  • Other symptoms. Kidney cancer can also cause loss of appetite, swelling of the legs and ankles, and a fever.

When to see your healthcare provider

Many of these symptoms may be caused by other health problems. But it is important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is kidney cancer diagnosed?

Diagnosing kidney cancer starts with your healthcare provider asking you questions. He or she will ask about your medical history, your symptoms, risk factors, and family history of disease.

Your healthcare provider will also give you a physical exam. You may be checked for a fever and high blood pressure. The healthcare provider may feel your belly (abdomen), sides, and back for lumps.

What tests might I need?

Symptoms of kidney cancer can be caused by other less serious problems. Because of this, you will likely have some tests. Unlike most types of cancer, kidney cancer can often be diagnosed without a biopsy. A biopsy is when small pieces of tissue are taken and looked at with a microscope. Instead, you may have 1 or more of the following:

  • Urine test
  • Blood tests
  • CT scan
  • MRI
  • Ultrasound
  • Intravenous pyelogram (IVP)
  • Angiography
  • Fine needle aspiration or biopsy 

Urine test

About 50% of all people with kidney cancer have blood in their urine. This can be found by doing a test called a urinalysis. For this test, a small sample of your urine is tested in a lab to see if it has blood. Your healthcare provider may do a special kind of urine test. This test is called urine cytology. It checks for cancer cells in the urine.

Blood tests

There is no blood test that can diagnose kidney cancer. But a complete blood count (CBC) and blood chemistry test can show signs in the blood that are linked with kidney cancer. For example:            

  • Too few red blood cells. This condition is called anemia. It is common in many kinds of cancer. 
  • Too many red blood cells. This condition is called erythrocytosis or polycythemia. Some types of kidney cancer cells make a hormone called erythropoietin. This causes bone marrow to make too many blood cells.
  • A high blood calcium level. This may show that the cancer has begun to affect the bones.  
  • A high level of liver enzymes. This may be a sign that the cancer has spread to the liver.

Imaging Tests

CT scan

A CT scan uses a series of X-rays and a computer to create detailed images of the inside of the body. This test can confirm a diagnosis of kidney cancer. During the test, you lie still on a table as it slides into a CT scanner. A CT scan is painless. You may be asked to hold your breath 1 or more times during the scan.

In some cases, you will be asked to drink a contrast dye 4 to 6 hours before the scan. Then you may be asked not to eat anything until a second set of pictures is taken. The dye allows your healthcare provider to see certain parts of the body more clearly. The dye will pass through your body and exit through your bowel movements. Dye may be given by injection into a vein as well. When the dye is injected, you may have a warm feeling from your chest to your groin. Tell your healthcare provider if you have ever had a reaction to contrast dye. This includes hives, trouble breathing, or becoming suddenly hot. Special medicines can be given before the test to help prevent these kinds of reactions.

MRI

An MRI uses radio waves, large magnets, and a computer to create detailed images of the body. An MRI can show if cancer has spread to your spine or brain.

During the test, you lie still on a table as it passes into a scanner tube. If you can’t handle small enclosed spaces (claustrophobic), you may be given a sedative before having this test. The scanner takes 2 to 15 minutes to create an image. You may need more than 1 set of images. The test may last an hour or more. An MRI test is painless, but it is noisy. You can bring earphones and an MP3 device, or ask for earplugs.

Ultrasound

An ultrasound test uses sound waves to create images on a computer screen. A gel is put on the skin of your lower back. A technician then uses a wand called a transducer to press on the skin above your kidneys. This test can help show if a kidney tumor is a fluid-filled sac (cyst) or a solid tumor. A solid tumor is more likely to be cancer.

Intravenous pyelogram (IVP)

This test uses a special dye and X-rays to look at the kidneys, ureters, and bladder. During this test, your healthcare provider injects dye into 1 of your veins. X-rays are taken as the dye passes through your urinary tract. With the help of the dye, your healthcare provider can see abnormal things, tumors, kidney stones, or any blocked areas that may be caused by kidney cancer. The test can also check the blood flow through the kidneys. 

Angiography

This test is very much like an IVP. It uses dye and X-rays to look at the kidneys. With angiography, the dye is injected directly into an artery that goes to your kidney. The test helps show the blood vessels and lets your healthcare provider see which blood vessels are sending blood to tumors. This test can also help your healthcare provider see if the tumor can be taken out by surgery.

Biopsy

Fine needle aspiration (FNA) or biopsy

A biopsy is a test to take small pieces of tissue from the body. The tissue is then looked at with a microscope. A biopsy is not often done for kidney cancer. In most cases, imaging tests and surgery give all the information needed to diagnose and treat the cancer. But in some cases, a biopsy may be done to confirm a diagnosis of kidney cancer. It can also and give more information to help your healthcare provider decide which treatment is best.

During a biopsy, your skin is numbed. A thin needle is then inserted through your skin to remove fluid or small pieces of tissue from your kidney. Your healthcare provider then sends the sample to a specialist, called a pathologist. The pathologist then looks for abnormal cells under a microscope. It usually takes several days for the results of a biopsy to come back.

The difference between an FNA and a biopsy can be subtle. An FNA involves sucking (aspirating) a small amount of tissue or fluid through a needle using a syringe. The needle used for FNA biopsy is thinner than the ones used for routine blood tests. The needle used in core biopsies is larger than that used in an FNA. It removes a small cylinder of tissue.  

Kidney Cancer: Grade and Stage

Once your healthcare provider knows you have cancer, the next step is to find out the grade and stage of the cancer. Stage is a way to note the size of the tumor, and if it has spread. Grade is a way to note how abnormal the cancer cells look under a microscope. Staging and grading of cancer is important for deciding how to treat it, and how curable it is.

Grades of kidney cancer

The grade refers to how the cancer cells look when compared to normal kidney cells. The grade of your cancer will help your healthcare provider predict how fast the cancer may grow and spread. The Furhman scale of 1 to 4 is used to grade kidney cancer. The lower the number, the more the cancer cells look like normal cells. This means the cancer can be easier to treat and cure. This is because cancer cells that look more like normal cells tend to grow and spread slowly. Grade 4 cancer look very different from normal kidney cells. This grade of cancer is harder to treat.

Stages of kidney cancer

The stage of your cancer describes the size of a tumor, and how much it has spread. Healthcare providers use different rating systems to stage cancer. The American Joint Committee on Cancer (AJCC) staging system is used most often for kidney cancer. It’s called the TNM system.

  • T stands for tumor. This category notes the size of the tumor and if it has spread into nearby areas.
  • N stands for nodes. Lymph nodes are small organs around the body. They help the body fight infections. This category notes if cancer cells have spread to the nearby lymph nodes.
  • M stands for metastasis. This category notes if the cancer has spread to other organs in the body. This may include a lung, your bones, liver, or brain. It also includes lymph nodes that are not near your kidneys.

Numbers from 0 to 4 are assigned to the T, N, and M categories. Once your health care provider has determined your T, N, and M values, he or she then determines your stage grouping. The lower numbers mean smaller cancers and that are easier to treat and cure. Here are the 4 stages of kidney cancer:

Stage I. The cancer is found only in the kidney. It is 7 centimeters (cm) (about 2.75 inches) or less in diameter.

Stage II. The cancer is found only in the kidney. The tumor is larger than 7 cm in diameter.

Stage III. In this stage, one of the following is true:

  • The cancer may have spread outside the kidney. It has spread to 1 or more nearby lymph nodes. The cancer has not spread to distant lymph nodes or distant organs. 
  • Cancer has grown into the main blood vessels of the kidney. Or it has grown into the large vein (the vena cava) where blood travels from the kidneys. Cancer may be growing into nearby tissue, but has not spread to any lymph nodes or into the adrenal gland. It has not spread to distant organs.

Stage IV. In this stage, one of the following is true:

  • The cancer has spread outside the tissue covering of the kidney (Gerota's Fascia). Cancer may have also spread to the adrenal gland on top of the kidney. The cancer may be in nearby lymph nodes. It has not spread to distant lymph nodes or organs. 
  • The cancer has grown outside the kidney. It has spread to distant lymph nodes or other organs. These may include bones, liver, brain, or lungs. It may also be found in nearby lymph nodes. 

Recurrent. Recurrent cancer has come back after it has been treated. It may come back in the original area. Or it may come back in another part of the body.

Talking with your healthcare provider

When your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.

What is a risk factor?

A risk factor is anything that may increase your chance of having a disease. Risk factors for a certain type of cancer might include smoking, diet, family history, or many other things. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer.

Things you should know about risk factors for cancer:

  • Risk factors can increase a person's risk, but they do not necessarily cause the disease. 
  • Some people with one or more risk factors never develop cancer. Other people can develop cancer and have no risk factors.
  • Some risk factors are very well known. But there is ongoing research about risk factors for many types of cancer.

Some risk factors, such as family history, may not be in your control. But others may be things you can change. Knowing the risk factors can help you make choices that might lower your risk. For example, if an unhealthy diet is a risk factor, you may choose to eat healthy foods. If excess weight is a risk factor, your healthcare provider may check your weight or help you lose weight.

Who is at risk for kidney cancer?

Risk factors for kidney cancer include:

  • Age. Most kidney cancers occur in people who are 55 and older. The risk increases with age, but this cancer can happen at any age. It can also affect children and young adults.
  • Sex. Men are more likely than women to develop kidney cancer. This may be because men are more likely to smoke and be exposed to cancer-causing chemicals while at work.
  • Race. African Americans are at a slightly higher risk for kidney cancer.
  • Smoking. The longer you have smoked, the greater your chance for kidney cancer.
  • Obesity. People who are very overweight are more likely to get kidney cancer than those at a healthy weight.
  • Misusing medicines. Kidney cancer has been linked to using certain medicines for a long time. These medicines include water pills (diuretics) and over-the-counter pain medicines.
  • Contact with chemicals. Contact with certain substances puts you at higher risk for kidney cancer. This includes chemicals and substances such as the metal cadmium, herbicides, and organic solvents, especially trichloroethylene.
  • High blood pressure. People with high blood pressure have a higher risk for kidney cancer. It is not known if the risk is because of the condition, the medicines used to treat it, or both.
  • Advanced or chronic kidney disease. This puts you at a higher risk for kidney cancer. People getting dialysis are at an even higher risk.
  • Certain inherited conditions. People who have von Hippel-Lindau (VHL) disease are at higher risk for kidney cancer. Other conditions linked to kidney cancer include Birt-Hogg-Dube syndrome, hereditary papillary renal cell carcinoma, and hereditary leiomyomatosis.
  • Family history of kidney cancer. People with a family history of kidney cancer have a higher chance of having the disease. This risk is highest in brothers or sisters of those with the cancer.

What are your risk factors?

Talk with your healthcare provider about your risk factors for kidney cancer. If you have a family history of kidney cancer or other disorders linked with the disease, you may want to consider genetic testing and kidney cancer screening.

If genetic tests show a risk for kidney cancer, your healthcare provider may advise you get screened often for kidney cancer. There are no standard guidelines for how often you should be screened if you are at increased risk. Your healthcare provider will advise a screening schedule based on your overall health and risk factors.

Kidney Cancer: Treatment Questions

Talking with healthcare providers about cancer can be overwhelming. It can be hard to take in all of the information. It helps to be prepared. Make a list of questions and bring them to your appointments. Write the answers down in a notebook. Make sure you ask how the treatment will change your daily life, including your diet, and how you will look and feel after treatment. Ask how successful the treatment is expected to be, and what the risks and possible side effects are.

You may also want to ask a friend or family member to come with you. He or she can take notes and write down the answers, and also ask questions you may not think of. You can also ask your healthcare provider if you can record the conversation.

Below are some questions to ask during your appointments.

Deciding on a treatment

  • What kind of kidney cancer do I have?
  • What is the grade and stage of my cancer?
  • Has the cancer spread anywhere else in my body?
  • What are the treatment choices?
  • What treatment do you think is best for me?
  • What are the goals of the treatment you are recommending?
  • What is the success rate of this treatment for my type and stage of kidney cancer?
  • What is the life expectancy for someone with my stage of cancer receiving this treatment?
  • Are there any clinical trials that I can apply for?

Getting ready for treatment

  • What is the length of the treatment period?
  • How long will each treatment take?
  • Where do I have to go for the treatment?
  • Who will give me the treatment?
  • Does someone need to go with me during treatments?
  • Can I take my other medicines during treatment?

Coping during treatment

  • What side effects should I expect?
  • How long will side effects last?
  • Are there side effects that I need to call you about?
  • How do I reach you after hours and on weekends?
  • What can I do to ease the side effects?
  • Should I change my diet? What foods can't I eat?
  • Will I be able to go to work and be around my family?
  • Are there support groups nearby that I can join?

After treatment

  • How will I feel after the treatment?
  • What type of follow-up will I need after treatment? 
  • How will we know if treatment worked?