The kidney is an essential organ for us to function daily. Kidney functions include creating hormones that help control blood pressure and stimulate the bone marrow to make red blood cells. For a healthier kidney, a balanced diet and proper hydration are important. This is to avoid kidney diseases and kidney cancer. However, there are other factors that can trigger kidney cancer cells as well. In conjunction with Kidney Cancer Awareness Month and World Kidney Day, Motherhood Story chats with Dr Koh Eng Thye, a Consultant Urologist at Mahkota Medical Centre, as he shares his knowledge and expertise relating to this pair of organs. Image credit: Dr Koh Eng Thye, Consultant Urologist at Mahkota Medical Centre What Are the Symptoms of Kidney Cancer? \tThe most common symptom \u2013 blood in the urine \tRare \u2013 feeling a mass on the side of the abdomen \tWeight loss if advanced cancer and anaemia symptoms \tNo definite sign your kidney has been attacked with cancer unless there is an apparent mass felt on the side of the abdomen What Type of Procedures Should Newly Diagnosed Kidney Cancer Patients Go Through? If a patient presents with blood in the urine, he must see a doctor immediately. Often, the patient will blame \u201cheaty\u201d foods consumed or the hot weather. Remember, blood in the urine is an important symptom, so you should see a doctor. A doctor must perform (at least) an ultrasound on the kidneys to rule out kidney cancer. Once confirmed, he will proceed with a CT scan to ascertain the stage of cancer. Are There Different Types of Kidney Cancer? \t85% of kidney cancer is Renal Cell carcinoma. \t10% Urothelial cancer \u2013 usually related to smoking. \tRare - Sarcoma \u2013 aggressive cancer.\u00a0 \tChildren kidney cancer \u2013 Wilm\u2019s tumour. This tumour behaves differently from the common adult kidney cancers.\u00a0 If kidney cancer develops during pregnancy, the symptoms can be masked by the pregnancy. For example, you may not feel the mass because of the gravid uterus, which may delay the diagnosis and treatment. How Common Is It in Malaysia? Kidney cancer is one of the 10 most common cancers both in men and women. In Malaysia, it is reported as about 2 in 100,000. But this incidence may be underreported. The male to female ratio is roughly 2.75:1. Pregnancy does not individually pose a special risk for kidney cancer. What Type of Tests Are Required To Determine Treatments? If it is a confirmed case of kidney cancer, the doctor will do an initial ultrasound, followed by a CT scan. A PET scan may be required if the doctor suspects more advanced cancer from the CT scan. What Happens If a Pregnant Women Gets Kidney Cancer? What Type of Treatment Would She Undergo? Pregnancy and kidney can happen as a coincidence situation and the treatment of kidney cancer is by surgery. There are two types of surgery: \t Partial Nephrectomy For this surgery, we will remove cancer in the kidney and preserve that part of the kidney that is not invaded by cancer.\u00a0 \t Radical Nephrectomy As for this type of surgery, we will remove the whole kidney if cancer has invaded more than half of the normal kidney tissues. Of course, due consideration will be given to the stages of the pregnancy. Earlier pregnancy may have adverse effects on the foetus if she needs an earlier surgery to remove the cancer. Our primary goal is always to achieve a potential cure for the mother. Consideration can be given in the late stage of pregnancy, to delay until she delivers her baby before subjecting her to remove her kidney cancer. If a Breastfeeding Mother Is Diagnosed With Kidney Cancer, How Does It Affect Their Milk Production? If you are breastfeeding and diagnosed with kidney cancer, it is advisable to remove that cancer via surgery as soon as possible. After the surgery, if she has recovered from the surgery and the drugs do not affect her milk, then the mother can continue to breastfeed her baby as usual. What Are the Risks of the Treatments for Cancer Patients? Most kidney cancers are sporadic. It means it happens not because you have eaten the wrong foods or some kind of genetic issue inherited by the patient. However, there are some genetic predispositions to kidneys. For example, people born with Von Hippel-Lindau syndrome. Or string familial history of kidney cancers within the immediate family. Risks to develop kidney cancer generally is the same as general population unless there is a suggestion of strong familial history. As for the treatment, it depends on a few factors such as the size of cancer, the function of both kidneys, and of course, the stage of cancer. Generally, in the early stage and if the size of the cancer is less than 7cm, the patient can undergo surgery to remove only the cancer cells and preserve the remaining normal kidney. Adverse effects of the treatment depend upon the residual kidney function. Our aim is to achieve cancer-free status and normal kidney function. For example, if the patient already has some degree of kidney failure but still does not require dialysis. If this patient develops kidney cancer and requires surgery to achieve cancer-free, then after the surgery, he\/she may then need dialysis immediately. Can These Treatments Affect Their Daily Activities? If the cancer is early stage and has normal contralateral kidney function, after the surgery, he\/she can still enjoy a normal life by doing normal activities. What Are the Chances of the Cancer Returning After Treatment? Kidney cancers generally do very well after surgery if it is early stages. If localized cancer, 5-10 years cancer-free survival can be as high as 93-95%. Of course, once it has spread to other organs, then the outcome will be guarded. Do Hospitals Provide Mental Health Support or Emotional Therapy for Cancer Patients? I will divide this question into a few scenarios such as:\u00a0 \tScenario 1 - Early and localised cancer with normal kidney function. For this scenario, mental and emotional support is given with the aim of preparing the patient for major surgery. \tScenario 2 - Locally advanced or advanced cancers. Besides preparing such patients for major surgery, the patient will need some form of chemotherapy or immunotherapy in the post-operative periods. Throughout the process, we will provide the patient with some advice and counselling in terms of emotion and finances.\u00a0 \tScenario 3 - Impaired kidney function with kidney cancer. The patient must be warned about long term dialysis. What Types of Cancer-Causing Food Should Be Avoided? A high protein diet has been linked to kidney cancer. Generally, a balanced diet is important. Keep in mind that vegetables, fruits and not too much protein are the key goals in our diets. For more insightful stories and fun recipes, stay tuned to Motherhood Story!