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Kidney (renal cell) cancer

CISS relies strongly in its evaluations below on impartial analyses by the International Cochrane Collaboration and the British Medical Journal’s Clinical Evidence Group – two groups of researchers who specialise in Evidence Based Medicine.

Conventional medicine supports the paradigm that the tumour is the first stage of cancer, therefore, treating and removing the tumour should cure the cancer. Unfortunately statistics will show this is rarely the case. Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy. In fact evidence based medicine suggests that the only reliable evidence needs to come from properly run randomised controlled trials (RCTs). Again, with conventional cancer treatment, this is generally not the case.

The following is based on the conventional cancer paradigm.

There are two kidneys, one on each side of the spine, above the waist. The kidneys clean the blood to take out waste and make urine. Urine collects in the renal pelvis, the area at the centre of the kidney, and then passes through the ureter, into the bladder, and out of the body. The kidneys also make hormones that help control blood pressure and signal the bone marrow to make red blood cells when needed.

There are three main types of kidney cancer. Renal cell cancer is the most common type in adults and Wilms tumour are the most common in children. These types form in the tissues of the kidney that make urine. Transitional cell cancer forms in the renal pelvis and ureter in adults.

Kidney tumours can be benign or malignant. (National Cancer Institute)

Risks: Smoking and certain pain medications taken for a long time can increase the risk of adult kidney cancer. Certain inherited disorders can increase the risk of kidney cancer in children and adults. These include von Hippel-Lindau syndrome, hereditary leiomyomatosis and renal cell cancer, Birt-Dube syndrome, and hereditary papillary renal cancer (National Cancer Institute).

Signs and Symptoms: Most people with kidney cancer have no symptoms and are often diagnosed when they go to the doctor for another reason. Symptoms may include:

  • Blood in the urine (haematuria)
  • A change in urine colour to dark, rusty or brown.
  • Pain in the lower back on one side that is not due to an injury.
  • Pain or lump in the abdomen or side (flank)
  • Constant tiredness.
  • Unexplained weight loss.
  • Fever (not caused by a cold or flu)
  • Swelling of the abdomen or extremities, e.g.: ankles, feet. (Australian Council Cancer).

Treatment:

  1. Kidney Cancer active surveillance – when small tumours (less than 4cm) are found in the kidney, they are less likely to be aggressive. Sometimes a smaller tumour is benign. But even if it’s cancerous, it might not grow big enough in a person’s lifetime to pose a risk to a person’s health. With this in mind, your Doctor might suggest keeping a watch on it, by doing regular ultrasounds or CT scans.
  2. Surgery – is the main treatment for kidney cancer when the cancer has not moved out of the kidney. It is not usually recommended when it has travelled to other parts of the body.

The most common surgery is a radical nephrectomy, which removes the whole kidney, a small part of the ureter and some surrounding tissue.

If the tumour is less that 4cm then you may undergo a partial nephrectomy, where the cancer and just a small part of the kidney is removed.

Please note: there is little evidence that surgery for cancer has any benefit on increased percentage 5 year survival except in cases where the tumour is in a life threatening position (The efficacy of surgical treatment of cancer, DJ Benjamin).

  1. Radiofrequency ablation – is a minimally evasive treatment that is still being assessed in clinical trials. A probe is used that generates heat to kill cancer cells and form internal scar tissue. It is not as effective as surgery. A specialist inserts a needle into the tumour under guided CT scan. An electrical current is passed into the tumour via the needle. The procedure usually takes about 15 minutes and then you can go home after a few hours.

This method is sometimes used for people who have renal cell carcinoma smaller than 4cm in diameter. Most people only need this treatment once.

  1. Cryotherapy – is a type of treatment that freezes and kills cancer cells. Not as effective as surgery and not suitable for people with tumours larger than 4cm in diameter. Cryotherapy is done via a probe inserted into the tumour either during surgery or under CT scan guidance.
  2. Arterial embolisation – is a procedure that blocks supply of blood to the tumour. Without the blood flow the tumour cannot get the food and oxygen it needs to survive. Treatment is done using a catheter inserted into the artery using x-ray as a guide. A substance is then injected through the catheter to block the artery’s flow. Side effects include a pain in the back and a high temperature. Additionally, a risk of this treatment is that cancer cells may break off and spread to other parts of the body.
  3. Targeted therapies – these are newer treatments that attack specific cancer cells or blood vessels to stop or slow down growth or reduce the size of the tumour. They are different from standard chemotherapy which attack all cells, not just the cancer cells. These drugs have side effects so please discuss thoroughly with your doctor.
  4. Immunotherapy – is sometimes used to treat advanced kidney cancer. The aim of immunotherapy is to boost the body’s immune system to help fight off disease and shrink the tumour. This treatment is still a topic of research and clinical trials. It often works best after surgery has removed the tumour. (Australian Cancer Council).
  5. Chemotherapy – the use of toxic drugs to kill the cancer cell or stop them from growing. Research by Morgan et al conclude that chemotherapy in kidney cancer may give a 0% 5 year survival benefit.

The above therapies all come with risks and side effects which should be discussed in detail by your treating physician.

Before deciding on one of these treatments you would benefit from asking your physician three questions:

Question 1: What are my treatment options? – these should include doing nothing.

Question 2: What are the possible outcomes of those options? – including benefits and side effects.

Question 3: How likely is each of the outcomes to occur?

If your doctor or other health practitioner cannot answer these questions, or shows that he or she is not comfortable with you asking these questions, it raises the question as to whether they are practising evidence based medicine and you should consider getting another opinion.

These three questions can be expanded.

Alternative Cancer Therapies

As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the tumout should cure the cancer.

Another paradigm believes that cancer is a systemic disease and the tumour is in fact a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:

  1. Treatment should cause no harm
  2. Treatment should be Wholistic (ie consider the whole person – body, mind, emotions and spirit)
  3. The person with cancer needs to take control of their own health.

This latter paradigm is supported by CISS (See Introduction to CISS).

Alternative cancer therapies are generally consistent with the above principles. In fact those believed to be most effective in controlling cancer – psychotherapy and immunotherapy – also have strong evidence from randomised controlled trials.

There are approximately 200 other alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. What is important in any cancer treatment is to both understand and believe in your chosen therapy.

There are a few alternative cancer therapies claimed to produce benefits with cancer. Those claimed to have the most benefits include:

  • Psychotherapy

Although there were no patients with kidney cancers enrolled in the psychotherapy trials, psychotherapy was found to provide survival benefits in all types of cancers with solid tumours tested, so kidney cancer would not be expected to be an exception.

  • Immunotherapy

It was estimated that a representative sample (252) of Issels’ patients with late stage cancers, of whom 3 (1.2%) had late stage urinary or bladder cancer, showed a 16.6% five year survival following his treatment and 15% 15 years survival. Two (5.1%) of those with urinary, bladder, kidney and adrenal cancers were among those who survived 15 years.

References: Issels, J. Immunotherapy in Progressive Metastatic Cancer – A Fifteen-Year Follow-up. Clinical Trials Journal, August 1970: 357-365 – editorial by Phillips S. Dr Joseph Issels and the Ringberg Klinik. Clinical Trials Journal. August 1970: 355-56.

The above studies, that include RCTs, show that systemic therapies are much more successful than therapies based on the orthodox paradigm.

In Kidney cancer, Ralph Moss (Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention) reports the following alternative therapies have been shown to benefit.

  1. Suramin – A derivative of urea, suramin sodium was discovered by German scientists in 1917 as a treatment for parasitic infections. Because it blocks the activity of enzymes and growth factors in different cellular systems, it is being considered as an anti cancer agent.

National Cancer Institute scientists gave suramin to 15 patients with metastatic cancer. There were partial responses seen in cancers of the adrenal cortex, kidney and adult leukemia – lymnphoma.

References:

Klijn JG, et al. Growth factor receptor pathway interfering treatment by somastatin analogs and suramin: preclinical and clinical studies. J Steroid Biochem Mol Biol.1990;37:1089-95.

Stein CA, et al. Suramin: an anticancer drug wioth a unique mechanism of action. J Clin Oncol.1989;7:499-508.

  1. Tamoxifen – is a synthetic hormone derived from the carcinogenic hormone DES. It was first marketed as a treatment for advanced breast cancer.

Sixty patients with metastatic kidney cancer were given the anticancer drug lonidamine with high dose tamoxifen for over six months. The results at the Hannover University Medical School in Germany suggest that lonidamine and high dose tamoxifen do not cure this disease but are “moderately effective” in widespread kidney cancer if the “treatment intention is palliation”.

Reference: Stahl M, et al. Lonidamine versus high dose tamoxifen in patients who received adjuvant therapy for breast cancer. J Clin Oncol.1991;9:286-94.

  1. Vitamin C – Vitamin C is a powerful antioxidant found in many foods. It is also one of the most promising items in the anti-cancer arsenal. It is vital in maintaining the health of the liver, for the absorption of iron and or the efficiency of the immune system. A lot of research can be found on the benefits of Vitamin C and cancer.

Dr Joachim Liehr from the University of Texas at Galveston reported that vitamin C inhibits the incidence of kidney tumours induced by female sex hormones. Dr M.E. Poydock of the Mercyhurst College Cancer Centre, Eire, PA, told of a patient who showed a significant reduction in tumour after just three injections of vitamin C and B12.

References:

Polydock ME, et al. Inhibiting effect of dehydroascorbic acid on cell division in ascites tumours in mice. Exp Cell Bio.1982;50:34-8.

Polydock ME, et al. Mitogenic inhibition and effect on survival of mice bearing L1210 leukemia using a combination of dehydroabscorbic evidence. Am J Clin Oncol.1985;8:266-9.

   4. Vitamin K – is a little known but essential nutrient. Necessary for both blood clot formation and liver function. Several experiments suggest that Vitamin K, with or without other drugs, may be an effective anti-cancer agent.

One study showed that there was a more than 70 percent inhibition in colony formation of leukemia and hepatoma (liver cancer) cells. Some other tumour types that responded to this treatment were breast, ovary, colon, stomach, kidney, lung, melanoma and bladder.

Reference: Chlebowski RT, et al. Vitamin K3 inhibition of malignant murine cell growth and human tumour colony formation. Cancer Treat Rep.1985;69:527-32.

If you or someone close to you has just been diagnosed with kidney cancer, it is important you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical, mental, emotional, psychological and spiritual treatment.

If you don’t know where to begin in your journey to wellness then we suggest you read Where To Start. This provides an introduction to the alternative approach to treating cancer and also information about some evidenced based alternative cancer treatments.

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