Kidney Cancer and Robotic Kidney Cancer Surgery

 


What is Kidney Cancer?

Kidney cancer is the cancer which starts when cells in the kidney body begin to grow uncontrollably. Sometimes the cancer remains limited to the kidney, while in other cases it spreads to nearby tissues and organs.

Types of Kidney Cancer

Renal cell carcinoma (RCC), also called as renal cell adenocarcinoma, is the most common type of kidney cancer. About 90% of kidney cancers are renal cell carcinomas.

Other types of kidney cancers include renal sarcomas, transitional cell carcinomas, and Wilms tumours.

Non-Cancerous (Benign) Kidney Tumours

Not all tumours in the kidney are cancerous. Some are benign (non-cancerous), and do not spread (metastasize) to other parts. However, they should still be removed as they can grow and create problems later.

Most of the benign kidney tumours are removed or destroyed by using the same type of treatments as used for kidney cancers, like robotic kidney surgery, etc.

Kidney Cancer Surgery

Kidney Cancer Statistics

  • Kidney cancer is among the 10 most common cancers for both women and men.
  • Kidney cancer is diagnosed in about 190,000 people worldwide every year.
  • Overall, the lifetime risk for a person developing kidney cancer is 1.6%.
  • Kidney cancer is slightly more common in men than in women.
  • Kidney cancer is mostly observed in older people with an average age of 64 years. It is quite uncommon in people younger below 45 years of age.
  • Kidney cancer can be curable if diagnosed early, in which case the survival rate of a patient can be from 79 to 100 percent.

The exact cause of prostate cancer is not known, but researchers believe there are certain risk factors which cause the prostate cells to turn cancerous.

In very simple terms, cancer of prostate is caused when the DNA of a normal prostate cell changes. Such changes to a person’s DNA can be either inherited at birth or acquired during the lifetime.

Following are the main prostate cancer risk factors:

  1. Advanced Age: Almost 60% of prostate cancer cases are found in men above 65 years of age. It is rare in men below 40, and its probability increases rapidly after 50.
  2. Family History: Although a lot of cases are observed in men without any family history of prostate cancer, it does seem to run in certain families, indicating a genetic factor. The risk doubles for a man with a father or brother having this cancer.
  3. Ethnicity: Prostate cancer is more likely to occur in African-American men than white, Asian, and Hispanic/Latino men. The answer to why certain races are more affected than other is not yet clear.

Apart from the above, there are some more factors listed below whose exact effect on prostate cancer is not known:

  1. Diet high in red meat, calcium and dairy foods, and low in fruits and vegetables.
  2. Obesity and smoking.
  3. Exposure to certain chemicals.
  4. Inflammation of the prostate, vasectomy and sexually transmitted infections.
 

Usually early stage prostate presents no symptoms, and hence, gets diagnosed only in the later stages when these symptoms become more pronounced.

Following are some of the main signs and symptoms of prostate cancer:

  • Frequent urination, especially at night
  • Problems in urination, such as pain, burning or weak urinary stream
  • Blood in the urine
  • Blood in the semen
  • Inability to get an erection (erectile dysfunction)
  • Pain in the back, chest, or back
  • Weakness or swelling in the legs and feet
  • Difficulty in sitting down
  • Loss of bladder or bowel control

However, most of these symptoms can also be caused by other non-cancerous conditions such as enlarged prostate, urinary infections, etc. And hence, the exact cause of the above problems can only be determined by a proper diagnosis by a doctor.

 

The following are the various methods used by a doctor to determine the presence of prostate cancer:

Physical Exam

In this you doctor might ask you about any problematic symptoms you having, family history and other risk factors. He may also conduct a Digital Rectal Exam (DRE) to feel for any bumps on the prostate that may indicate presence of cancer. Based on this initial assessment, he may order further tests.

PSA Blood Test

The Prostate-Specific Antigen (PSA) blood test is one of the first tests done, mostly in men with no symptoms, to screen for cancer.

PSA levels under 4 nanograms per milliliter (ng/mL) of blood are generally considered normal, but this cannot be ascertained without a biopsy. As PSA level increases, the chance of having prostate cancer does too.

Trans-Rectal Ultrasound (TRUS)

In this test, a small probe is placed in your rectum and transmits a black and white image of the prostate onto a computer. TRUS is often used PSA level is high or an abnormal DRE result is seen.

Prostate Biopsy

If any of the above tests indicate to the doctor that cancer may be present, he will do a prostate biopsy.

In this procedure, few small samples of the prostate gland are removed using a thin hollow needle, and observed under a microscope to see if they contain cancer cells. If yes, it is given a grade called Gleason Score.

Grade (Gleason Score) of Prostate Cancer

Prostate cancers are assigned different grades based on the Gleason System, which tells how comparable the cancerous tissue is to the normal prostate tissue.

  • Grade 1: The cancer looks a lot like normal prostate tissue
  • Grade 5: The cancer looks very abnormal

Most cancers are graded 3 or higher, as grades 1 and 2 are not much relevant.

For more details on Gleason score, click here.

 

The ‘stage’ of a prostate cancer indicates the extent to which the cancer has spread, and is one of the most important factors in assessing prognosis and determining treatment options for the patient.

Prostate cancer stages are decided based on the following:

  • The results of prostate biopsy results including the Gleason score
  • The blood PSA level
  • The results of any other tests conducted by the doctor

Majority of doctors use the TNM System for determining the prostate cancer stages and their spread.

In this system, “T” stands for “Tumor” and indicates the size of the cancer; “N” stands for “Nodes” and informs if the cancer has spread to nearby lymph nodes or not; and “M” stands for “Metastasis” which refers to whether the cancer has spread to organs surrounding the prostate or not. By combining these three indicators, the prostate cancer stages are decided.

The following stages are most commonly used to describe the spread of the cancer:

  • Stage 1: The cancer is limited to the prostate and small enough not be seen in routine exams
  • Stage 2: The cancer is limited to the prostate but has grown in size
  • Stage 3: The cancer has spread beyond the prostate but is limited to nearby tissues
  • Stage 4: The cancer has metastasized (advanced) beyond the prostate into other organs and lymph nodes

Stage 4 prostate cancer is currently incurable, but there are certain treatment options that can help reduce the painful symptoms of advanced prostate cancer.

 

Once the stage of prostate cancer has been determined, the doctor will present to you a number of treatment options. It is advised that you take your time to think about each option’s pros and cons before making the final decision.

Following are some of the most common prostate cancer treatment options:

  • Active surveillance (or watchful waiting)
  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Hormone therapy
  • Bone-directed treatment
  • Cryotherapy (Cryosurgery)
  • Vaccine treatment

Although these treatments are mostly used one at a time, in certain cases one or more may be combined if the doctor sees fit.

 

Robotic Kidney Cancer Surgery at CRS

Centre for Robotic Surgery (CRS) is an initiative of Muljibhai Patel Urological Hospital, which is one the best kidney hospital in India famously known as the ‘Nadiad Kidney Hospital’.

What is Nephrectomy?

A nephrectomy is the surgery done to remove of a part of or complete kidney. This procedure is done for:

  • Kidney cancer treatment
  • Treatment of kidney damage, kidney stones treatment, kidney cysts, etc.
  • Kidney transplantation of healthy kidney from the donor to the patient.

Types of Nephrectomy Procedures

There are three types of approaches that can be used to conduct Nephrectomy: open surgery, traditional laparoscopic surgery, and the innovative robotic nephrectomy.

Robotic kidney surgery has been proven beneficial to not just the patients, but the robotic surgeons as well due to its various advantages. At Centre for Robotic Surgery – A best kidney transplant hospital in India, the da Vinci Robotic Surgical System is used by our kidney specialist doctor for kidney cancer treatment, kidney stones treatment and other kidney related surgeries.

Robotic Kidney Surgery Using the da Vinci Surgical System

 


The da Vinci Si® Robotic Surgery used at Centre for Robotic Surgery is a state-of-the-art technology which enables the robotic surgeons to perform complex surgeries with great ease and precision.

kidney cancer surgery

Key elements of a Robotic Kidney Surgery include:

  1. Better Visualization: This is due to the 3-D, high-definition camera of the da Vinci system which provides magnified visuals to the robotic surgeon.
  2. Better Precision: The robotic arms hold specially designed instruments which are used by the robotic surgeon to conduct the robotic kidney surgery. The surgeon controls the robot’s arms with special hand controls. This converts the surgeon’s movements into precise and complex movements, which he/she couldn’t achieve otherwise. The robot’s wrists have a 360 degree rotation, which increases the range of motion for the surgeon and improves accuracy.
  3. Ease of Surgery: The surgeon performs the procedure sitting at his console and controls the robot while looking into its vision system. Due to this, the surgeon’s fatigue is reduced and the robotic kidney cancer surgery is completed with ease.

Kidney Surgeries at CRS

The following procedures are performed at Centre for Robotic Surgery for treating kidney cancer surgery, kidney transplant surgery, kidney stones treatment and different types of kidney diseases and conditions:

  1. Robotic Partial Nephrectomy: In this, a part of the kidney having tumour is removed by robotic surgery, while preserving the remaining kidney.
  2. Robotic Radical Nephrectomy: In this, the entire kidney is removed to counter the effects of a large cancer/tumour/disease.
  3. Robotic Donor Nephrectomy/Kidney Transplantation: In this, a healthy kidney is transplanted from a living or deceased donor to the patient.
  4. Robotic Nephro-Ureterectomy: This involves removing the kidney as well as ureter for transitional cell carcinoma that affects the kidney or ureter.
  5. Robotic Pyeloplasty:In this, the blockage is removed in the area where the kidney meets the ureter.
  6. Robotic Pyelolithotomy: This is the procedure in which large kidney stones are removed when they can’t be removed by other methods.
  7. Robotic Anatropic Nephrolithotomy: This is a procedure used to remove large renal calculi.
  8. Robotic Nephro-Ureterectomy: In this, the renal pelvis, kidney and entire ureter are removed so as to increase survival likelihood for patients having transitional cell cancer.

In addition to the above, other procedures involving kidneys are also performed at the Centre for Robotic Surgery – A leading kidney hospital in India.


Benefits of Robotic Kidney Cancer Surgery

At Centre for Robotic Surgery – best kidney hospital in India, the state-of-the-art da Vinci Surgical System is used for surgical procedures for kidney cancer as well as other kidney issues.

Long-term studies like this one have shown that robotic surgeries such as Robotic Partial Nephrectomy have less blood loss, minimal effects on renal function, and an excellent safety profile when performed at high-volume centers.

Among the various benefits of robotic kidney cancer surgery are:

  • Shorter hospital stay
  • Lower blood loss
  • Lesser scarring
  • Lesser pain
  • More precise tumour removal and kidney reconstruction
  • Excellent chances of preserving the kidney in certain operations
  • Lower rate of operative complications such as post-surgery infections
  • Faster return to normal lifestyle

The above are obtained due to the various advanced technological features of the da vinci robotic surgical system , which provide better vision and precise movements to the robotic surgeons and help them achieve better results during a surgery.


Kidney Cancer & Kidney Cancer Surgery: Frequently Asked Questions

 

1. My CT scan/MRI shows a kidney tumor. Can it be cancer?

Usually, most of the kidney tumors are cancerous, but smaller tumors can often be benign (non-cancerous). However, your doctor may still want to remove it since a benign tumour may get bigger later leading to issues.

 

2. If my cancer has spread will I need to get my kidney removed?

This will need to be evaluated by your doctor who will see how much the cancer has spread and how risky the kidney cancer surgery will be. In some cases, removing the cancerous kidney has helped extend the life of patient having metastatic kidney cancer.

3. What are the chances my cancer will be cured by surgery?

Unless the cancer has spread too much, most cases of kidney cancers can be cured by surgery alone. Only in certain cases where the cancer has spread too far, additional therapies may be required.

4. What is Partial Nephrectomy?

This is a surgery which is done in cases where the kidney cancer is still small and has not spread outside. In a Partial Nephrectomy, only the cancerous part of the kidney is removed, and the remaining healthy kidney is kept intact. Due to this, there is still some kidney functionality preserved after the kidney cancer surgery.

5. What is Radical Nephrectomy?

In this surgery, the entire kidney along with surrounding tissues including adrenal gland are removed to eliminate the cancer. Unless the cancer has spread widely, usually this is the only treatment required.

6. Why should I opt for Robotic Nephrectomy?

This is mainly because a robotic nephrectomy (robotic kidney surgery) has several benefits that aid in faster recovery of the patient.

7. What is the benefit of partial nephrectomy over total kidney removal?

In certain cases like when the tumours or cancers are small, partial nephrectomy is preferred since it saves most of the kidney while also getting rid of the tumour. This helps maintains better kidney function overall.

8. What types of follow-ups will I require post my surgery?

The follow-up tests usually include X-rays, CT/MRI scans and blood tests, which can be taken care of at our kidney hospital itself.

9. Will I require chemotherapy or radiation therapy along with surgery?

This is not generally required unless the cancer has spread so much that additional therapies are needed. Mostly the best way of treating kidney cancer is surgery itself.

10. How can I learn more about my kidney cancer and various treatment options?

Although we have tried to include a lot of relevant information on this website, it is best to consult an expert in person who can explain the various aspects of kidney cancer and most suitable kidney cancer treatments for you.