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Kidney Cancer

Kidney cancer is the third most common urological cancer. Each year approximately 3000 news cases are diagnosed and it accounts for 920 deaths per year in Australia.

They are often incidentally diagnosed on ultrasound, CT or MRI scans and usually do not present with symptom.

Symptoms however can include:

blood in the urine, pain in flanks or back, tiredness, weight loss or fever.

Kidney cancers could be solid or cystic in appearance. All solid growths as well as most of the cystic growths in the kidneys, require referral further investigations by the urologists.

The solid growths or renal lesions are more often than not cancers, however approximately 1 out of 5 solid lesions are benign. Renal cysts in the other hand are mostly benign. Cysts which have suspicious characteristics such as thickening, enhancement, septation or calcifications, usually would require treatment.

The gold standard of management of small renal masses is partial nephrectomy, where the abnormal area of the kidney is excised while preserving most of the normal kidney. This option allows patients to retain their kidney and have better kidney function. This procedure could be performed with open or keyhole (robotic or laparoscopic) techniques. Robotic partial nephrectomy results in less pain, smaller incisions, faster recovery earlier return to normal activities. However, this type of procedure require dedicated training, significant expertise and experience. Excellent surgical technique is the primary determinant of superior surgical outcome.

Dr Ahmadi has had significant experience in open, laparoscopic and robotic partial nephrectomy. During his overseas fellowship training years in Los Angeles, he was directly trained and mentored in robotic (and laparoscopic) partial nephrectomy by Professor Inderbir Gill who is the world authority in minimally invasive kidney surgery.

What other treatment options are available?

Small renal lesions (<3cm) could be monitored in some patients as the risk of cancer spread is lower. Renal lesions could be biopsied to determine if they are benign or malignant. Biopsy does have the risk of causing significant bleeding (since the kidneys are very vascular organs) or seeding the cancer along the needle tract and subsequently spreading the cancer.

Patients who are at high risk or unsuitable candidates for surgery, could alternatively undergo radiological procedures where the cancer is treated by different sources of energy such as freezing (cryoablation) or heat (radiofrequency (RFA) or High intensity Focus Ultrasound (HIFU) ablation). Renal cancers are often resistant to chemotherapy or radiotherapy.