Download RENAL CELL CARCINOMA UNDERSTANDINGRCC

UNDERSTANDING
RCC
RENAL CELL CARCINOMA
the most common form of kidney cancer
RENAL CELL CARCINOMA
ABOUT THIS GUIDE
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Help you understand renal cell carcinoma (RCC)
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This guide will:
Provide information on its causes and treatment
CONTENTS
What is RCC? .....................................................................................................4
Who is at increased risk for RCC? .......................................................................4
How does RCC start? .........................................................................................4
How does RCC spread? ......................................................................................4
What tests are used to detect RCC? .....................................................................6
What are the stages of RCC? ...............................................................................8
What are the treatments for RCC? ....................................................................10
What should I ask my doctors or nurses about my condition?.............................13
What’s next? ......................................................................................................14
Cancer resources ................................................................................................18
Patient support resources....................................................................................19
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RCC
RENAL CELL CARCINOMA
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RCC is a cancer that begins in the kidneys
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WHAT IS RCC?
It is the most common kind of kidney cancer
– About 46,000 people in the United States were diagnosed
with RCC in 2007
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People who smoke
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People who are obese
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People who overuse certain pain medicines, including over-thecounter medicines, for a long time
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WHO IS AT INCREASED RISK FOR RCC?
People who have certain genetic conditions, such as von HippelLindau (VHL) disease
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RCC starts as a single cancer cell in the kidney. The cell then grows, divides,
and multiplies when it shouldn’t
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HOW DOES RCC START?
A tumor forms once enough cancer cells are made
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As the tumor gets larger, some of the cancer cells may get into the blood
and spread to other parts of the body
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RCC often grows as a single tumor in one kidney
– Sometimes more than one tumor grows in one kidney
– Less often, tumors grow in both kidneys at the same time
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HOW DOES RCC SPREAD?
New tumors may then develop in other organs
– These new tumors are called metastases
– This condition is called metastatic RCC (mRCC)
– For example, cancer from the kidney can spread to the lungs. If this happens,
it is still called RCC. It is not called lung cancer. This is because the cancer
started in the kidney, not in the lungs
RCC
KIDNEY
CROSS-SECTION
Example of renal cell carcinoma
Terms to Know
kidney—One of a pair of organs that remove
waste products from the blood. In the process,
they make urine to help carry waste out of the
body. One is on the left side of the abdomen.
The other is on the right side.
metastases—Tumors that result from the spread
of the primary tumor.
von Hippel-Lindau (VHL) disease—The
VHL gene helps to prevent tumor growth.
If the gene is not working the way it should,
RCC can develop.
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RENAL CELL CARCINOMA
WHAT TESTS ARE USED TO DETECT RCC?
Your doctor may use any or all of the following tests and procedures:
Biopsy
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MRI or NMRI
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CT scan (or
CAT scan)
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Ultrasound
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Urine test (or
urinalysis)
This measures the amount of enzymes the liver
releases into the blood to make sure that cancer has
not spread to the liver
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Liver function
test
These measure the amounts of certain substances
released into the blood by organs and tissues
This test checks the color and contents of the urine
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Blood tests
Patients are asked if they have any unusual
symptoms or about their health history to find out
if they are at risk for cancer
Produces a picture, called a sonogram, of internal
tissues or organs
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Health history
This helps to check a person’s body for signs of
cancer, like lumps or anything else unusual
This is a series of detailed pictures of areas inside
the body taken from different angles
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Physical exam
DEFINITION
Uses a magnet, radio waves, and a computer to make
a series of detailed pictures of areas inside the body
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TEST
A tissue sample is taken and studied by a pathologist
to check for signs of cancer
RCC
Terms to Know
enzymes—Proteins that direct the flow and
speed of a specific chemical reaction.
pathologist—A doctor who identifies diseases
by studying cells and tissues under a microscope.
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RENAL CELL CARCINOMA
WHAT ARE THE STAGES OF RCC?
There are 4 stages of RCC:
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Tumor is 7 centimeters or smaller
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Tumor is found only in the kidney
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Tumor is larger than 7 centimeters
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Stage II
Tumor is found only in the kidney
Cancer may be found in:
– The kidney
– 1 nearby lymph node
– An adrenal gland
– The tissue around the kidney
– The main blood vessels of the kidney
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Stage I
DEFINITION
Cancer has spread beyond the layer of
fatty tissue around the kidney and may
be found in:
– Nearby lymph nodes
– Other organs, such as the intestines,
pancreas, or lungs
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STAGE
Recurrent RCC is cancer that has
returned after it has been treated
– The cancer may come back in the
kidney. Or it may come back in other
parts of the body many years after the
first treatment
Stage III
Stage IV and
recurrent RCC
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RCC
Tumor size is an important factor for determining the stage of RCC
Doctors determine tumor size by measuring its largest area. The images below help
to give you an idea of tumor size.
The size of a
golf ball (5 cm)
The size of a
tennis ball (7 cm)
The size of a
baseball (8 cm)
Scale
Images are not actual size.
0
1
2
3
4
5
Centimeters (cm)
Terms to Know
lymph node—Located throughout the body,
lymph nodes filter lymph fluid. They store
special cells that can trap cancer cells or
bacteria that are traveling through the body
in the lymph.
adrenal gland—One of a pair of small glands;
one sits on top of each kidney. The adrenal
glands produce hormones that help control
heart rate, blood pressure, the way the body
uses food, and other vital functions.
pancreas—A 6-inch-long organ that
stretches across the back of the abdomen.
It makes pancreatic juices, which help digest
food in the small intestine. The pancreas also
makes insulin, which controls the amount of
sugar in the blood.
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RENAL CELL CARCINOMA
WHAT ARE THE TREATMENTS FOR RCC?
Any of the following treatments may be used:
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Surgery
This is used to remove the tumor and/or kidney. It is referred to
as a nephrectomy
– It can be simple, partial, or radical
– Blood vessels of the kidney and some lymph nodes may also
be removed
– It is sometimes used as palliative therapy to relieve symptoms
Note: palliative therapy may make a patient feel better, but it cannot
cure the cancer
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Intravenous (IV) or oral drug therapies
These are used to shrink or stabilize the cancer
When making treatment decisions, it may help to discuss what kind of treatment
may be best for you. You should talk with your cancer care team, including your
doctor and nurse. Also, make sure your primary care physician is aware of your
cancer treatment. You can talk with family and friends as well. Do what helps.
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Side effects that your treatment may cause
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Ways to avoid or treat side effects
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You should also talk with your cancer care team at every step of your
therapy about:
How they think you are responding to your treatment
RCC
Terms to Know
simple nephrectomy—Surgery to remove
the kidney.
palliative therapy—Treatment to help control
or reduce symptoms caused by the cancer.
partial nephrectomy—Surgery to remove a
tumor from the kidney while sparing the rest
of the organ.
intravenous therapy (IV)—Treatment given
directly into a vein.
radical nephrectomy—Surgery to remove
the kidney, adrenal gland, lymph nodes, and
surrounding tissue.
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RENAL CELL CARCINOMA
RCC
WHAT SHOULD I ASK MY DOCTORS OR
NURSES ABOUT MY CONDITION?
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During your treatment:
Have honest conversations with your doctors and nurses
– They are eager to answer all your questions, no matter how unimportant they
may seem
– Getting answers will help you feel less anxious
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What type of kidney cancer do I have?
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Do you think my cancer has spread beyond the kidney?
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What is the stage of my cancer? And what does that mean in my case?
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What treatment choices do I have?
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What do you recommend and why?
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What risks or side effects are there to the treatments you suggest?
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Some sample questions:
What are the chances of recurrence of my cancer with these treatment plans?
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Also, be sure to write down questions of your own.
For example, you may want to find out more about things you can do to better
manage your treatment
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RENAL CELL CARCINOMA
WHAT’S NEXT?
Follow-up tests
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X-rays, CT scans of the abdomen and chest, and other imaging studies may be
taken to see if the cancer has returned
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Your doctor will decide which tests you should have and how often they should be
done based on the original stage of your cancer and your response to treatment.
Your doctor will also check for metastases, or for a new tumor. Blood tests to
check kidney and liver function may also be requested
Keep track of your treatment
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At each visit, talk to your doctor about how you are responding to treatment
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Note any side effects you may have
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Your body is unique. Doctors can determine certain facts about tumors and drugs.
They can use many types of treatments to help fight the cancer. But no one can say
for sure how your body will respond to cancer or its treatment.
Tell your doctor about any drugs, treatments, or herbal supplements you
are taking
RCC
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RENAL CELL CARCINOMA
WHAT’S NEXT? (CONT’D)
Lifestyle
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Stop smoking
– If you smoke, quitting now will improve your overall health
– The return of your sense of smell from quitting may also help you
enjoy a healthy diet during recovery
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Drink less alcohol
– Have no more than 1 to 2 drinks per day
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Eat a well-balanced diet and maintain a healthy weight
– Eat more fruits, vegetables, whole grains, and high-fiber foods
– Eat less fatty meats
– Discuss your diet with your health care provider
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Exercise when you are ready
– Consult with your doctor or nurse regarding any exercise limitations
you may have
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Give your body the rest it needs to recover from treatment
– Cancer treatment can add to the fatigue caused by the disease itself
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Making changes in your lifestyle can help your recovery. These may help:
Make an extra effort to talk with loved ones
– Talk about how you are doing. Talk about your feelings
This will help people understand what you are going through.
It will give them a chance to help you
– Talk about treatment choices. If you can, work together to make
treatment decisions
When you can, attend doctors’ appointments together so you
have the same information
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RCC
If you have children, talk with them about your condition
– Take their feelings seriously
Children have many different reactions when they learn a parent is ill
– Tell them that it’s okay to have lots of different feelings and that
you have them as well
– Try to offer a balanced outlook
It’s usually best to give a realistic but hopeful summary of the situation.
Try to focus on the efforts directed toward your recovery
– Prepare your children for the effects of treatment
Cancer and cancer treatment can often change the way a person looks
It’s best to prepare children in advance so they know what is happening
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Consider going to a meeting of a local support group
– Cancer diagnosis and treatment represent major challenges that affect
patients and their loved ones
– Support groups can reduce anxiety associated with isolation
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RENAL CELL CARCINOMA
CANCER RESOURCES
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Treatment guidelines for patients
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Cancer treatment information
for patients
Open clinical trials for new treatments
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National Comprehensive Cancer
Network (NCCN)
(888) 909-6226
www.nccn.org/patients/
Physician directory
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Links to support groups
Information on choosing hospice
and home care
Finding support groups
People Living With Cancer
(703) 519-2927
www.plwc.org
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Helpful advice about RCC
How to pay for cancer treatment
Information about cancer studies
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Stories about cancer survivors
Facts about cancer, treatments,
and clinical trials
Helpful cancer advice
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Facts about treatments
National Cancer Institute (NCI)
(800) 422-6237
www.cancer.gov
Treatment facts
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News about cancer studies
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The American Cancer Society (ACS)
(800) 227-2345
www.cancer.org
Useful cancer glossary
RCC
PATIENT SUPPORT RESOURCES
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Simple ways to make living with
kidney cancer easier
The toll-free help line provides
information and short-term
counseling to patients and
their families
How to find and meet other kidney
cancer patients and survivors
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Information and advice also
provided by e-mail
Free financial services
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Support services for people
living with cancer
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Cancer Hope Network
(877) HOPENET (467-3638)
www.cancerhopenetwork.org
Matches patients one on one
with cancer survivors
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Facts about cancer
The Wellness Community (TWC)
(888) 793-WELL (9355)
www.thewellnesscommunity.org
Community-based support groups
for people living with cancer,
guided by trained professionals
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Helpful cancer advice and counseling
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CancerCare®
(800) 813-HOPE (4673)
www.cancercare.org
24 Wellness Community centers
in the United States
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A service of the AMC Cancer
Research Center
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A group of patients, families, doctors,
and health care providers
who are all involved with kidney
cancer and treatments
Cancer Information and
Counseling Line (CICL)
(800) 525-3777
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Kidney Cancer Association (KCA)
(800) 850-9132
www.curekidneycancer.org
Web-based support groups
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© 2008 Pfizer Inc.
All rights reserved.
Printed in USA/January 2008