Kidney Cancer and Kidney-Sparing Surgery
In a recent study, The American Cancer Society estimated that there were about 57,760 new cases of kidney cancer (35,430 in men and 22,330 in women) in the United States annually, and about 12,980 people (8,160 men and 4,820 women) will die from this disease. These statistics include both renal cell carcinomas and transitional cell carcinomas of the renal pelvis. There is a trend toward finding kidney tumors at earlier, more treatable stages; this may be due to the more widespread use of medical imaging such as ultrasound, CT scans, and MRIs being conducted to evaluate other medical conditions. Therefore these "incidentally detected" cancerous growths, often not yet having presented symptoms, are more likely to be benign, smaller, and offer better rates of survival.
Kidney cancer occurs most often in people between the ages of 50 and 70, affecting men almost twice as often as women. Smokers develop renal cell carcinoma about twice as often as nonsmokers and develop cancer of the renal pelvis about 3 times as often. Elimination of smoking would reduce the rate of renal pelvis cancer by one-half and the rate of renal cell carcinoma by one-third.
The vast majority of kidney cancers arise in the renal cortex and are adenocarcinomas (renal cell carcinoma, hypernephroma). Approximately 80 to 85% of kidney adenocarcinomas are clear cell type, 10% are papillary, and the remainder comprise chromophobe and oncocytoma. Kidney tumors arising in the renal pelvis or collecting system are most often of the transitional cell carcinoma cell type.
Capital Region Urology physicians utilize the clinical cancer stage as a guide for the most appropriate recommendation for therapy. In cases of cancer localized to the kidney, the recommended treatment is surgical. Options may include removal of the entire kidney, or an approach where the cancer and surrounding rim of kidney is removed and the remaining kidney left intact. This is referred to as partial nephrectomy, segmental nephrectomy or nephron-sparing surgery. There is increasing evidence that small kidney cancers can be managed safely with partial nephrectomy and renal preservation, and our physicians now frequently perform this procedure.
Capital Region Urology surgeons are experienced in all aspects of kidney surgery including complete nephrectomy, partial nephrectomy, laparoscopic renal surgery, cryosurgical ablation of renal tumors, and radio-frequency ablation of renal tumors. Numerous scientific studies support the use of partial nephrectomy whenever possible for the management of kidney cancer. Capital Region Urology has performed over 100 partial nephrectomy surgeries for kidney cancer in which the cancerous growth was removed while preserving the rest of the kidney.
Advanced Kidney Cancer Surgery
An advanced surgical procedure for kidney cancer practiced by Capital Region Urology surgeons is robot-assisted radical or partial nephrectomy using the da Vinci® surgical system. This precision robotic surgery allows instruments to recheck their positions by computer 1,500 times per second. The surgeon, controlling a console near the patient uses a high-powered camera with a headrest to view a high-resolution 3D color image of the surgical field, magnified 10 times. From this console, the surgeon manipulates the instruments by flexing his/her thumb, forefinger or wrist in a joystick-like control. Because there is little bleeding, the surgeon has a clear view inside the patient.
Typical benefits of robotic surgery:
- Faster healing
- Smaller incisions with less scarring
- Much less pain after the procedure
- Faster recovery
- Less blood loss and need for transfusions
- A shorter hospital stay
Another type of minimally-invasive surgery is laparoscopic radical or partial nephrectomy, which allows our surgeons to operate on the kidney using handheld instruments inserted through several small abdominal incisions. Capital Region Urology surgeons have performed hundreds of laparoscopic procedures.