Elderly kidney cancer

Introduction to kidney cancer in the elderly Renal cancer, also known as renal cell carcinoma, renal adenocarcinoma, clear cell carcinoma, etc., is the most common malignant tumor of the renal parenchyma. The incidence of renal cancer in men is 2.5 to 3 times higher than that of women. Due to the prolonged life expectancy and advances in medical imaging, the incidence of renal cancer has increased more than before, and there are no clinically obvious symptoms. The number of kidney cancers that are accidentally discovered during physical examinations is increasing, reaching 1/2 to 1/5. basic knowledge The proportion of illness: 0.005% Susceptible people: the elderly Mode of infection: non-infectious Complications: hematuria anemia

The cause of kidney cancer in the elderly

Causes:

The etiology of kidney cancer is still unclear. The relative risk of kidney cancer in smokers is increased. Kidney cancer is higher than normal in people exposed to cadmium and industrial environment. Kidney cancer has a family-like tendency, and the incidence of kidney cancer varies from region to region. May be related to urbanization, diet, and lifestyle.

Pathogenesis

Renal cancer is often a single-sided single lesion. The incidence of left and right side is similar. There are 2% to 2% of kidneys with kidney cancer at the same time or in succession. Most of the kidney cancers are round, different in size, and can occur in all parts of the kidney. Histological envelope, but there is a pseudo-envelope formed by the compressed renal parenchyma and fibrous tissue, a few are uniform yellow or brown, most with hemorrhage, necrosis, fibrotic plaque, hemorrhagic necrosis can form cystic, there are It is a papillary cystadenocarcinoma. The tumor can have calcification. The tumor can destroy the whole kidney and can invade adjacent fat, muscle tissue, blood vessels, lymphatic vessels, etc. The fascia around the kidney is a barrier to prevent local spread. Kidney cancer It is easy to spread into the vein to form a tumor thrombus, which can be extended to the renal vein, the inferior vena cava and even the right atrium. The renal cancer spreads to the surrounding tissues of the kidney, adjacent to the organs, the lymph nodes are more serious than the intravenous tumor thrombus, and the adrenal gland is affected by the same side. About %, distant metastasis is usually lung, brain, bone, liver and so on.

Renal cancer cells are pluripotent, and their tissues and cells are diverse. They are usually transparent cells, so they are also called clear cell carcinoma. They are also granulosa cell carcinoma, or mixed type, and spindle cell carcinoma, with poor prognosis.

Elderly kidney cancer prevention

1. Prevention of kidney cancer should first stop smoking or quit smoking as soon as possible. Secondly, water is the best preventive "drug". Drinking more water can reduce the effective concentration of toxins and reduce the risk of kidney cancer.

2. Diet and environmental factors are also related to kidney cancer. Eat less high-fat, high-calorie foods, exercise, control weight, and avoid obesity and high blood pressure. Eating more fruits such as bananas, carrots, and beets can significantly reduce the risk of cancer.

3. Kidney diseases such as kidney cysts should be actively treated to prevent further development of the disease and restore health as soon as possible.

4. Avoid radiation damage and use hormones with caution.

5. Develop good hygiene habits and do not eat moldy rotten pickled foods. It is advisable to use a light diet and eat fish, eggs and a small amount of lean meat.

Elderly kidney cancer complications Complications, hematuria anemia

Hematuria, anemia, secondary infection, intracranial transfer, etc.

Renal cancer symptoms in the elderly common symptoms dull pain low fever hematuria

Kidney cancer can be completely free of symptoms in the early stage. The patient's complaints and clinical manifestations are variable, and it is easy to be misdiagnosed as other diseases. It is often referred to as incidental cancer because of physical examination or accidental findings such as B-ultrasound and CT examination.

1. Hematuria: Hematuria is the most common symptom of kidney cancer. The appearance of hematuria must be invaded by the tumor in the renal pelvis. Therefore, it is not an early condition. Hematuria is often a painless intermittent episode of gross hematuria. Kidney cancer may be bleeding for a long time. Accompanied by renal colic, caused by blood clots through the ureter, the degree of hematuria has nothing to do with the size of kidney cancer.

2. Low back pain: mostly dull pain, caused by swelling of the kidney and swelling of the kidney capsule. The pain of the tumor invading the surrounding organs and the lumbar muscles is heavy and persistent.

3. Lump: Kidney cancer is difficult to find before reaching a considerable volume. Generally, the surface of the tumor is smooth, hard, and has no tenderness.

4. Systemic symptoms: About 1/3 of the patients have systemic symptoms, fever is very common, mostly low fever, persistent or intermittent appearance, mostly caused by internal bleeding of the mass, necrosis and pyrogen caused by tumor tissue, blood pressure is increased due to tumor Compression of blood vessels, short-circuiting of arteries and veins in tumors, renin in tumor tissue, etc., can also be accompanied by changes in the immune system, such as accompanied by vasculitis.

5. Clinical staging: Commonly used are Robson staging and TNM staging.

(1) Robson staging:

Stage 1: The tumor is limited to the kidney.

Stage 2: The tumor invades the peri-renal fat, but is confined to the fascia around the kidney, and the renal vein and local lymph nodes are not infiltrated.

Stage 3: The tumor invades the renal vein or local lymph nodes, with or without the inferior vena cava, and the fat around the kidney is involved.

Phase 4: Transfer or invade adjacent organs in the distance.

The disadvantage of Robson staging is that the prognosis of stage 2 and stage 3 is the same.

(2) TNM staging (separating vein and lymph node metastasis):

T0 has no primary tumor.

The maximum diameter of T1 tumor is 2.5cm, which is confined to the kidney.

The maximum diameter of T2 tumors is >2.5 cm, which is confined to the kidney.

T3 tumors invade large blood vessels, adrenal glands and perirenal tissues, and are confined to the fascia around the kidney.

T4 invades the fascia around the kidney.

N0 has no lymph node metastasis.

N1 single, unilateral lymph node metastasis, maximum diameter <2cm.

N2 multiple local lymph node metastases, or a single 2 to 5 cm.

The maximum diameter of N3 local metastatic lymph nodes was >5 cm.

M1 is transferred from afar.

In addition to clinical manifestations, the diagnosis of kidney cancer is mainly based on imaging studies.

Elderly kidney cancer examination

1. ESR increases.

2. Anemia, caused by iron entering cancer cells, or increased red blood cells, hematocrit>50%, Hb>155g/L.

3. Abnormal liver function, such as elevated alkaline phosphatase.

4. The blood calcium is elevated for unknown reasons.

5. Increased renin levels.

6. Elevated blood carcinoembryonic antigen (CEA).

7. B-mode ultrasonography: hypoechoic of renal cancer, such as hemorrhage, necrosis, cystic changes in the tumor, uneven echo.

8. X-ray film: kidney shape increases, contour changes, occasional calcification.

9. IVP: Understand the renal function and renal pelvis, ureter and bladder, for treatment.

10.CT: manifested as renal parenchyma mass, CT value>20Hu, often 30~50Hu, slightly higher than normal renal parenchyma, enhanced scan, tumor is significantly lower than renal parenchyma, CT can also check the scope of tumor invasion, whether the vein is invaded Whether the lymph nodes are swollen, whether the adjacent organs are invaded, and the condition of the renal pelvis.

11. Others: MRI, renal angiography, radionuclide examination, etc. can be used to diagnose kidney cancer.

Diagnosis and diagnosis of renal cancer in the elderly

Clinically, it must be differentiated from renal angiomyolipoma and renal cyst.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.