“Due to lifestyle choices and genetic factors, the prevalence of kidney cancer in Pakistan is increasing. The most common type of kidney cancer is renal cell carcinoma, which accounts for 90% of cases. Renal cell carcinoma (RCC) may be beneficial to patients who have withdrawn from society. It has a major impact because renal cell carcinoma reduces their ability to perform daily activities.”

Dr. Abdul Qayyum, consultant clinical oncologist and assistant professor at Ziauddin University Hospital in Karachi, shared these facts at a virtual conference called “Kidney Cancer-Silent Killer” organized by the Karachi Neurospinal and Cancer Care Institute on Saturday.

The etiology of kidney cancer is largely unknown, but appears to be multifactorial in nature. Many different risk factors have been studied, some of which can be modified, thus creating opportunities for primary prevention.

“Notable risk factors are smoking, including cigars and cigars, overweight, alcohol consumption, lack of exercise, high blood pressure, chronic kidney disease, kidney stones and diabetes. Environmental and occupational exposures, including trichloroethylene, aflatoxin, hormones, Lead compounds, radiation, certain viruses, and aristolochic acid (aristolochic acid is a group of acids naturally found in many plants called aristolochia and wild ginger) and genetic risk factors. Cystic disease is a common disease in end-stage renal disease and is also related to the high incidence of RCC,” Dr. Qayyum further explained.

“Middle-aged people who ate the most red meat were 19% more likely to be diagnosed with kidney cancer than those who ate the least. The increased intake of chemicals found in barbecue or grilled meat is also associated with an increased risk of disease; people The intake of red meat and processed meat should be limited, and the meat should be prepared through cooking methods such as roasting and grilling,” he suggested.

“The incidence of kidney cancer in men is approximately twice that of women. The lifetime risk of kidney cancer is one in 46 for men and one in 80 for women. This is more common among African Americans and American Indians. . Approximately 5-8% of kidney cancer cases are related to family inheritance,” said Dr. Qayyum.

“Most kidney cancer patients are older, with an average age of 55 years at diagnosis. Kidney cancer is becoming more and more common and recent statistics rank it as the tenth most common cancer in the world, causing more than 131,000 deaths each year And 413,000 new cases. Approximately 30-40% of patients develop metastatic disease, and another 30-40% of patients with locally or locally advanced disease subsequently develop metastases.”

Experts predict that by 2035, kidney cancer cases will further rise by 26%, which will make it one of the fastest-growing cancer types.

Dr. Iqbal Shehzad, Consultant and Assistant Professor of Urology at Liaquat National Hospital, introduced urologists’ views on kidney cancer and shared his experience in dealing with such patients.

According to health experts, kidney cancer is a type of cancer that is difficult to detect because the organs are located deep in the body. Most kidney cancer cases are accidentally discovered through ordinary imaging techniques such as ultrasound, computed tomography (CT) or magnetic resonance. of. Imaging (MRI) has nothing to do with the cause.

Kidney cancer or kidney cancer can show symptoms similar to urinary tract infection (UTI), so even the smallest symptoms must be tested for early detection. “Blood urine, loss of appetite and unexplained rapid weight loss, non-injury-induced low back pain, swelling of ankles and legs, lumps or lumps on the side or waist, fatigue, repeated fever not caused by colds, or flu,” Dr. Shehzad said These signs and symptoms.

“Usually, people with kidney cancer have only one blood in their urine. This is why your primary care physician needs to investigate any blood in the urine immediately. Early detection of kidney cancer is the key to successful treatment, so pay close attention to symptoms and get medical attention It is important for professionals to evaluate it.”

Usually, kidney cancer does not respond to radiotherapy or chemotherapy,” Dr. Shehzad explained. “The only way to deal with it is complete or radical nephrectomy (removal of the entire kidney). Approximately 35% of kidney tumor cases are still undergoing RN. “

“The most widely popular surgical treatment option is nephron sparing surgery (NSS) by partial nephrectomy (PN). This procedure has been extensively studied and is the standard treatment for smaller kidney tumors,” said Dr. Shehzad.

“PN is reserved for patients with isolated functional kidneys, bilateral renal tumors, hereditary renal tumors (for example, Von Hippel-Lindau disease), renal insufficiency, and those with comorbidities who are prone to renal impairment in the future PN is now routinely and selectively used for patients with small tumors and healthy contralateral kidneys.”

Dr. Shehzad added that kidney tumors that were removed at an early stage rarely recur, and patients have a good prognosis after surgery. “Malignant tumors that are found to grow outside the kidney, and those who undergo surgery in the first stage have a 93% survival rate in the next five years.

Dr. Lubna Saleem, a consultant medical oncology physician at the Karachi Cancer Foundation Hospital, said: “There are several new and exciting therapies that are about to emerge. They have the potential to treat metastatic RCC and may ultimately improve the current dull survival statistics.” .

“Kidney cancer is not a single disease, but a heterogeneous group of at least five different histological types. This malignant tumor occurs in sporadic non-hereditary and genetic forms, the latter being associated with different, known genetic mutation Related, leading to an identifiable disease or syndrome.”

Treatment options and recommendations depend on many factors, including cell type and cancer stage, possible side effects, and patient preferences and overall health.

Kidney cancer is most often treated by surgery, targeted therapy, immunotherapy, or a combination of these therapies. Radiotherapy and chemotherapy are occasionally used. Patients with kidney cancer that has spread, called metastatic cancer, usually receive multiple treatments.

Sometimes, the doctor may recommend close monitoring of the tumor through regular diagnostic tests and outpatient appointments. This is called “active monitoring”. Active monitoring is effective for the elderly and people with small kidney tumors and other serious diseases (such as heart disease, chronic kidney disease, or severe lung disease).

Today, immunotherapy is becoming a new standard method based on clinical trials, and clinical trials have shown that it has greater benefits than targeted therapies. “Immunotherapy fights cancer by stimulating your immune system. This method can cure some people and allow others to control their disease for many years. Dr. Lubna said that clinical trials need more information about the patient’s condition after treatment, but in In the next few years, most patients with advanced kidney cancer will most likely receive immunotherapy as part of their first treatment plan.

Targeted therapy is still important because it is now being combined with immunotherapy, and if immunotherapy does not work, it may be useful. Compared with traditional forms of cancer drugs such as chemotherapy and radiation therapy, immunotherapy produces far fewer side effects. In addition, it can target only cancer cells without damaging other healthy tissues like chemotherapy.

Patients who respond to these drugs enter the remission period, not in the extra weeks or months, but in lifetime units.

“This transformative and long-lasting response is a unique value proposition for cancer immunotherapy,” Dr. Lubna further explained.

NCCI Marketing Manager Adeel Ahmed expressed his gratitude and appreciation to the speakers and the medical community.

He said that at NCCI, “we are committed to helping patients get the information and qualified resources they need about kidney cancer.”

“We are also focusing on local research and publicity programs to not only develop treatments to meet unmet medical needs, but also expand community-level awareness of disease prevention, cancer screening and treatment options,” Ahmed said, and Call on non-governmental organizations and industry sectors to help and coordinate cancer care institutions to provide more and in-depth support for such patients.