Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Kidney cancer refers to a cancer that arises from the kidneys, the organs that filter out toxins from the blood to create urine that is then excreted from the body. Most of us have 2 kidneys. They are bean-shaped organs located in the lower back, one on either side of the backbone.
There are 2 main types of cancer that arise from the kidney. The most common is renal cell carcinoma, which arises from the cells that are located in the solid, outer portion of the kidney. The second type of cancer we see in the kidney is called transitional cell carcinoma. These cancers arise from the transitional cells that are found in the lining of the collecting system, or the hollow part of the kidney. The management of transitional cell carcinoma of the kidney is different from renal cell carcinoma. Since transitional cells are the same as those that line the ureter and bladder, the treatment for this type of kidney cancer is similar to that of bladder and ureteral cancers.
Over 50,000 new cases of kidney cancer are diagnosed in the United States every year. Kidney cancer is currently among the 10th most common cancers in the US.
Because a person may undergo an ultrasound and computed tomography (CT) exams for a wide variety of problems, it is not uncommon to find an abnormality of the kidney during these studies. The most common type of kidney abnormality found is a renal cyst. Kidney cysts are almost always benign and generally pose no threat to our health. Cysts are watery fluid-filled structures and can be easily identified on CT scan or ultrasound.
Kidney cancer, on the other hand, is a solid mass. Many kidney cancers are discovered early enough to be treated successfully with surgical removal. Generally, healthy people have substantial reserves of kidney function that allow for removal of part or all of one kidney without substantially limiting quality of life or health.
Early kidney cancer often produces no symptoms. We most commonly find this type of cancer while performing a CT or an ultrasound to evaluate other unrelated conditions. These imaging studies allow us to diagnose kidney cancer early and help improve treatment outcomes. However, some signs of kidney cancer can include the following:
Most kidney cancers are not hereditary and are not clearly due to any specific cause. However, there are some known risk factors, including:
We diagnose kidney cancer with a combination of medical imaging procedures that may include CT, ultrasound, or MRI. This usually gives us enough information to develop a treatment plan. Kidney cancer usually has a characteristic appearance on CT scan. We therefore generally do not always need a kidney biopsy prior to treatment. Biopsies are only recommended if there is a reason to suspect another type of cancer, or if the cancer has spread beyond the kidneys.
Staging is a process that helps determine the spread and the severity of the cancer:
When we evaluate the test results in order to develop your treatment plan, we consider several factors, including other medical conditions, the location and size of the tumor, the status of the unaffected kidney, the stage of the cancer, and your preferences for treatment.
Surgical removal of the cancer is the mainstay of treatment if we think the disease is confined to your kidney. Specific operations used to treat kidney cancer include:
Each can be done with conventional "open" surgery or less invasive "laparoscopic" techniques. We will work with you to determine which choice is best.
Surgical treatment provides an accurate, specific diagnosis and can also provide some information regarding your prognosis or long-term outlook. Kidney cancers that are completely removed often have a long-term remission rate approaching 90 percent.
In some cases, surgery may be too risky. We may recommend other minimally invasive treatments, including the following:
These types of treatments may have an increasing role in the management of certain tumors.
We may also discuss the possibility of enrolling in a clinical trial if you decide it might benefit your treatment. Clinical trials are research studies designed to improve treatment for cancer patients. Some trials investigate new cancer drugs and treatments, while others compare standard treatments to new treatments.
Treatment for metastatic kidney cancer, when the tumor has spread beyond the kidney to other organs, has evolved dramatically over the last decade. Approximately 10 years ago, the treatment options for metastatic kidney cancer only included removal of the affected kidney (nephrectomy), and treatment with interferon, interleukin-2, and chemotherapy. These treatments were helpful to some patients, but often did not work very well.
Fortunately, we now have many different drugs available for effectively treating metastatic kidney cancer. These drugs are called molecular targeted therapeutics because they target a few proteins that often stimulate kidney cancer to grow. By blocking these proteins, these drugs can shrink the tumors or slow their growth rate.
While not all patients with kidney cancer will benefit from these drugs, they have dramatically changed the life expectancy of some patients with advanced kidney cancer.
There is a wide range of side effects associated with these drugs, including fatigue, tiredness, weakness, fever, body aches, malaise, headache, high blood pressure, loss of small patches of skin color, skin rash, diarrhea, and others. We can discuss specific side effects with you.
While most patients who have surgery for early stage kidney cancer will remain cancer free, about 10 to 20 percent may have a recurrence of their cancer. There is currently no treatment that has been shown to reduce the risk of relapse.
We will work with you to develop recommendations for your follow-up care depending on your condition, your health, and factors that become evident during treatment. For example, we will evaluate whether to administer chemotherapy.
One of the most important aspects of cancer therapy is good self-care throughout the treatment period and beyond. There are several things that you can do:
All cases will include a treatment plan and information on when to contact us.
We may also discuss the possibility of enrolling you in a clinical trial if you decide it might benefit your treatment. Clinical trials are research studies designed to improve treatment for cancer patients. Some trials investigate new cancer drugs and treatments, while others compare standard treatments to new treatments.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
For general medical advice, our Appointment and Advice line is available 24 hours per day, 7 days per week.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.