Department of Medical Oncology
Atrayee Basu Mallick, MD
Avnish Bhatia, MD
Christina Brus, MD
Andrew E. Chapman, DO, FACP
Jean Hoffman-Censits, MD *
W. Kevin Kelly, DO *
Jianqing Lin, MD *
Michael J. Ramirez
Lewis J. Rose, MD, FACP
Allison Zibelli, MD, FACP
*Practice Focus: Genitourinary Oncology
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Thomas Jefferson University Hospital
About 54,000 Americans are diagnosed with kidney cancer each year. Most are over 55 years old.
Risk factors include smoking, obesity, high blood pressure, a family history of kidney cancer, or a family history of Von Hippel-Lindau (VHL) syndrome. Other names for kidney cancer include “renal cancer” and “renal cell carcinoma.”
Kidney cancer forms in tissues of the kidneys. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). It also includes Wilms tumor, which is a type of kidney cancer that usually develops in children under the age of 5.
Stage I: The tumor is no bigger than a tennis ball (almost 3 inches or about 7 centimeters). Cancer cells are found only in the kidney.
Stage II: The tumor is bigger than a tennis ball. But cancer cells are found only in the kidney.
Stage III: The tumor can be any size. It has spread to at least one nearby lymph node. Or it has grown through the kidney to reach nearby blood vessels.
Stage IV: The tumor has grown through the layer of fatty tissue and the outer layer of fibrous tissue that surrounds the kidney. Or cancer cells have spread to nearby lymph nodes or to the lungs, liver, bones, or other tissues.
Renal cell carcinoma (RCC) is the most common form of kidney cancer. Most RCCs are found incidentally, by imaging studies such as ultrasound, CAT scan or MRI, performed for unrelated medical problems. A nephrectomy, whether partial, simple or radical, is usually performed when the diagnosis of RCC is made; the surgery may be open or laparoscopic. Patients with metastatic kidney cancer often receive sunitinib malate (Sutent).
Small renal masses (SRMs) present a particular challenge because they have a malignancy rate of from 70 to 80 percent but distinguishing them from renal cysts is difficult because of their small size (less than 4 centimeters in maximum dimension). While not long ago radical nephrectomy was the gold standard, the current approach to treating an SRM is to preserve as much as possible of the healthy part of the kidney not involved with the mass. To individualize the treatment based on factors such as the particular SRM, age and comorbidities, Jefferson’s Small Renal Mass Clinic offers a multidisciplinary approach, involving urologic oncologists and interventional radiologists, all of whom have specialized training in the latest minimally invasive techniques for the treatment of SRMs, including laparoscopic and robotic partial and radical nephrectomy and laparoscopic and percutaneous cryotherapy, as well as the more traditional open partial nephrectomy.
Reference: National Cancer Institute. http://www.cancer.gov/cancertopics/types/kidney