Kidney Cancer (Part III)

By: Prof. Dr. Seyed Saeid Zamanieh Shahri, MD  and  Prof. Dr. Sonia Sayyedalhosseini, MD

Continued of kidney cancer:

۲) Pleural effusion:

When kidney cancer spreads to the lungs or the edges of the lungs, it may cause fluid to build up between the membranes that cover the lungs. When cancer cells are present, it is referred to as a malignant pleural effusion. Sometimes a large amount of fluid (several liters) collects and causes shortness of breath.

The procedure, called thoracentesis, involves inserting a tiny needle through the skin on the chest wall and into the pleural cavity to remove fluid. Pleural effusions frequently recur and can be induced using an indwelling pleural catheter (a shunt that allows continuous drainage of fluid) or a procedure in which an irritant (talc) is placed between the membranes and caused them to ulcerate so that the fluid could no longer collect.

۳) Pathological fractures:

in case of metastasis, bone pain may be the first sign of kidney cancer. When cancer invades the bone, it weakens the bone and may lead to fractures with minimal or no damage. These are referred to as pathological fractures.

When kidney cancer spreads to the spine, the microstructure of the spine may cause vertebral collapse and pressure on nerve roots, causing spinal cord compression. This may lead to leg weakness along with loss of bladder and bowel control and is a medical emergency.

Bone metastases from kidney cancer are very destructive and require careful attention to pain, possible fractures and nerve compression, hypercalcemia (high blood calcium due to bone destruction), and more. Fortunately, today there are various types of treatment that can reduce these complications.

  Small Intestine Cancer (1)

۴) High blood pressure:

Kidney cancer may lead to persistent high blood pressure.

۵) Hypercalcemia:

High levels of calcium in the blood may occur both due to paraneoplastic syndrome and due to bone fractures with bone metastases. High blood calcium levels with cancer (hypercalcemia) may not only cause symptoms such as nausea, but also severe muscle weakness, confusion, coma, and even death. That being said, it is treatable as long as it is diagnosed.

۶) Elevated red blood cell count (erythrocytosis):

May occur, even though anemia is common in early kidney cancer. This causes the bone marrow to produce red blood cells due to the production of protein by cancer cells. Too many red blood cells, in turn, can increase the risk of blood clots, heart attack, and stroke.

۷) Liver failure:

Kidney cancer may affect the liver through the spread of cancer and also part of the paraneoplastic syndrome. Because the liver filters the blood the same way as the kidneys, the combination of liver and kidney dysfunction can lead to a build-up of toxins in the blood, leading to confusion, personality changes, mood swings, and more.

Diagnosis of kidney cancer: Tests and methods used to diagnose kidney cancer include:

Blood and urine tests may provide the doctor with information about what is causing the signs and symptoms of the disease.

Imaging tests allow your doctor to locate a kidney tumor or any abnormality. Imaging tests may include ultrasound, X-ray, CT scan, or MRI.

Biopsy or removal of a sample of kidney tissue:

In some situations, your doctor may order a procedure to remove a small sample of cells (biopsy) from a suspicious area of the kidney. The sample is tested in a lab to look for signs of cancer. Of course, this method is not always needed.


Once the doctor has diagnosed a kidney lesion that may be kidney cancer, the next step is to determine the grade of the cancer. Staging for kidney cancer may include additional CT scans or other imaging tests that your doctor feels are appropriate.

Stages of kidney cancer are indicated by Roman numerals, which range from I to IV, and the lowest stage (I) indicates cancer limited to the kidney. In stage IV, the cancer is considered advanced and may have spread to lymph nodes or other areas of the body (metastasis). End

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