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Doctors Caution Against Surgery In Certain Cases Of Kidney Tumors

Doctors Caution Against Surgery In Certain Cases Of Kidney Tumors

An analysis of medical records of those with small kidney tumors suggests older patients may be better off leaving the growths alone than undergo surgical intervention. Surgery is the standard methodology of treatment, but several experts question the necessity of immediately operating.

Dr. William Huang of New York University Langone Medical Center and his team performed an observational review of over 7,000 medical files on those 66 and older with kidney tumors, as half of all kidney cancers occur in this age group.

Researchers used federal cancer registries and Medicare records from 2000 to 2007 and found nearly 8,300 people with kidney tumors less than 1.5 inches wide. Cancer was confirmed in just over 7,100 of the pooled cases. About three-quarters of the patients underwent surgery and the rest opted to be monitored with periodic imaging tests.

After studying the conditions of treatment and outcome, doctors found older people fared better over a five year period having their doctor monitor their condition than to operate right away. Although the tumors were found to be cancerous, it did not mean they were necessarily fatal as surgery to remove them often doubled the patient’s risk of developing other health problems such as heart attack and stroke, which lowered post-surgery life expectancy. In contrast, many who left their slow-growing tumors undisturbed had a lower mortality rate.

After five years, 24 percent of those who had surgery died compared to only 13 percent of those who chose monitoring. Nearly 27 percent of the surgery group and 13 percent of the monitoring group developed cardiovascular disease – heart attack and stroke – which occurred more in situations where doctors removed the entire kidney instead of just a part of it.

The kidneys are two bean-shaped organs, each about the size of an adult human fist. Kidneys, located in the retroperitoneum of the abdominal cavity (lower abdomen on each side of your spine), are regulatory organs essential in the urinary system. They serve a homeostatic function balancing electrolytes, sustaining an acid–base equilibrium, and maintaining proper ratios of salt and water therefore regulating blood pressure.

Kidneys are the body’s natural filter, screening the blood, which is fed through renal arteries and veins. Each kidney removes waste which is then diverted to a ureter and travels to the urinary bladder.

Cellular metabolism generates numerous by-products that require elimination from the bloodstream. These by-products are eventually expelled from the body during urination, the primary method for excreting water-soluble chemicals from the body. Urine is produced from kidney excreted wastes such as urea and ammonium. These bean shaped filters are also responsible for the reabsorption of water, glucose, and amino acids.

Kidney cancer, also known as renal cancer, is the malignant (cancerous), uncontrolled growth of cells forming a tumor in the kidneys. Generally kidney cancer first appears in the lining of tiny tubes (tubules) in the kidney, called renal cell carcinoma.

The majority of kidney cancers are found before they metastasize (spread) to distant organs, typically in people over the age of 40. Cancers caught early are easier to treat, but in the case of slow-maturing kidney tumors, they can grow to a significant size before they are detected – which is usually found by accident when having imagining tests performed for other conditions like back pain.

Men are twice as likely as women to develop kidney tumors. Contributing risk factors can include smoking, obesity, prolonged use of certain pain medications, having pre-existing kidney disease, high blood pressure, chemical exposure to asbestos, organic solvents, and herbicides, and family history.

This particular type of cancer can be asymptomatic, but as the tumor grows larger, symptoms may appear: blood in urine, lump or distention in the side or abdomen, loss of appetite, persistent side pain, sudden weight loss, anemia, lower extremity swelling, and extreme fatigue.

About 65,000 new cases of kidney cancer are diagnosed annually in the US. On average, 13,700 deaths result. Two-thirds of cases are diagnosed at the local stage, isolated to the effected organ, when five-year survival is more than 90 percent.

[Image via Shutterstock]

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