100 Questions & Answers About Kidney Cancer

by Steven C. Campbell, Brian I. Rini, Robert G. Uzzo, Brian Lane

Overview

According to the American Cancer Society, kidney cancer is one of the ten most common cancers in both men and women. No one with kidney cancer needs to be alone in their fight against this disease. That's where this book and the information within can help. 100 Questions & Answers About Kidney Cancer, Fourth Edition offers authoritative and practical answers to the most common questions asked by patients and their loved ones. What is kidney cancer? What causes kidney cancer? How is kidney cancer treated? The authors bring their vast experience, expertise, and cutting-edge research in the field to answer these and other questions. They provide information on different types of kidney cancer, signs and symptoms, treatment options, and more. 100 Questions & Answers About Kidney Cancer, Fourth Edition is an invaluable resource for anyone coping with the physical and emotional uncertainty of this disease. NEW to THIS EDITION: -New section (Part 10) brings together and summarizes all of the treatments that are now being utilized for patients with metastatic kidney cancer. -New summary of the most recent recommendations from the National Comprehensive Cancer Network (NCCN), a leading source of up-to-date cancer treatment recommendations, regarding systemic treatments for metastatic kidney cancer (Appendix).

Product Details

ISBN-13:	9781284234404
Publisher:	Jones & Bartlett Learning
Publication date:	10/25/2021
Edition description:	4th ed.
Pages:	250
Product dimensions:	5.90(w) x 8.90(h) x 0.60(d)

About the Author

Steven C. Campbell, MD, PhD, is a Professor of Surgery and a member of the Section of Urologic Oncology in the Glickman Urological Institute at The Cleveland Clinic. He obtained his MD and PhD degrees at The University of Chicago and then completed a Urology Residency at The Cleveland Clinic (1989–1995), followed by a fellowship in Urologic Oncology at Memorial Sloan-Kettering Cancer Center (1995–1996). Dr. Campbell’s primary interests include renal cell carcinoma, bladder cancer, prostate cancer, and tumor angiogenesis. His background also includes American Foundation for Urological Diseases (now known as the American Urological Association Foundation) and Kimmel Research Scholarship Awards. He is chair of the Society of Urologic Oncology Exam Committee and a member of the American Board of Urology Examination Committee. Dr. Campbell has edited or co-edited three textbooks about kidney cancer and authored or co-authored the chapter on kidney cancer in Campbell/Walsh Urology, the premier textbook in Urology, for the past four editions.

Brian I. Rini, MD, FACP is a Professor of Medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in Cleveland, Ohio. A staff member of the Department of Solid Tumor Oncology and co-leader of the Genitourinary Program of the CASE Comprehensive Cancer Center, Dr. Rini’s work focuses on genitourinary malignancies. Dr. Rini earned his medical degree at the Ohio State University College of Medicine. Dr. Rini completed a Residency program in Internal Medicine and a Fellowship in Hematology/Oncology at University of Chicago Hospitals. Dr. Rini was an Assistant Professor at the University of California San Francisco before moving to The Cleveland Clinic. Dr. Rini’s primary research has been in renal cell carcinoma (RCC) and prostate cancer, with special focus on antiangiogenic therapy and immunotherapy. Dr. Rini has been involved in the initial and ongoing development of targeted agents for metastatic RCC, and was an integral investigator in the clinical development of several agents which are now FDA approved. Dr. Rini was the Principal Investigator of an international phase III cooperative group trial of bevacizumab plus interferon and the PI of the phase III axitinib trial in metastatic RCC that lead to FDA approval, and is currently the PI of several global phase III trials in RCC. Dr. Rini’s research has been published in peer-reviewed journals including, Journal of the National Cancer Institute, Journal of Clinical Oncology, Cancer, Lancet and JAMA. He is a member of the editorial boards of Journal of Clinical Oncology and co-chair of the NCI RCC Task Force.

Robert G. Uzzo, MD, FACS, is currently the G. Willing "Wing" Pepper Chair in Cancer Research. He is a professor and chairman at the Department of Surgery at Fox Chase Cancer Center and Temple University School of Medicine. Dr. Uzzo graduated Summa Cum Laude from Union College prior to attending Cornell University Medical College. He completed two years of general surgical training at The New York Hospital-Cornell Medical Center and Memorial Sloan-Kettering Cancer Center under the tutelage of G. Thomas Shires, MD. Dr. Uzzo went on to complete four years of urologic surgical training at The New York Hospital-Cornell Medical Center and Memorial Sloan-Kettering Cancer Center under the guidance of E. Darracott Vaughan, MD. He then became an American Foundation for Urological Diseases (now the American Urological Association Foundation) Scholar in Urological Oncology at the Cleveland Clinic under the direction of Andrew C. Novick, MD. Dr. Uzzo completed a second fellowship in Renal Vascular Surgery and Transplantation at the Cleveland Clinic Foundation. He has an active and funded lab researching the basic mechanisms of kidney and prostate cancer. His clinical interests are in minimally invasive urological oncology. He is the national urology principal investigator for the E.C.O.G. 2805 (A.S.S.U.R.E.) trial and is the co-chair of the genitourinary early management committee at E.C.O.G. Dr. Uzzo is a member of the American Urologic Association, a fellow in the American College of Surgeons, a member of the American Association of Cancer Research, the Society for Basic Urological Research, the Society of Urological Oncology, and also on the medical advisory board for the Kidney Cancer Association. He has authored more than 300 peer reviewed articles and chapters in urology and urologic oncology and has been the recipient of numerous awards.

Brian R. Lane, MD, PhD, FACS, is currently Chief of Urology at Spectrum Health Medical Group. He obtained his MD and PhD degrees in Cellular and Molecular Biology at the University of Michigan Medical School and then completed a Urology Residency and Fellowship in Urologic Oncology at The Cleveland Clinic. Dr. Lane was named an American Urologic Association Foundation Scholar and is a former member of the American Council for Graduate Medical Education Review Committee for Urology. He is currently the Director of Robotic Surgery in the Department of Surgical Subspecialties as well as the Physician Lead in the Robotic and Advanced Minimally Invasive Surgery Program at Spectrum Health. Dr. Lane is also an Associate Professor in the Department of Surgery at Michigan State University. His primary clinical interests include kidney cancer, prostate cancer, bladder cancer, testicular cancer, and adrenal cancer. Dr. Lane’s research has focused on characterizing molecular factors involved in angiogenesis and kidney cancer and predicting outcomes in kidney cancer patients. He has authored more than 100 peer-reviewed publications in urology and oncology.

Table of Contents

Introduction vii

Part 1 The Basics 1

Questions 1-4 answer basic questions about the urinary system, such as:

1 What is kidney cancer?

2 Where are the kidneys located in the body?

3 What do the kidneys normally do?

4 How is kidney function measured?

Part 2 Causes and Risk Factors for Kidney Cancer 11

Questions 5-20 discuss various types of kidney cancer and their causes:

5 How common is kidney cancer?

6 Are there different types of kidney cancer?

7 What causes kidney cancer?

8 Is kidney cancer inherited?

9 What is the VHL syndrome?

10 What is a tumor suppressor gene?

11 What is an oncogene?

12 What is angiogenesis and what is VEGF?

13 Can kidney cancer be prevented?

14 Are all kidney cancers aggressive?

15 Should we be screening the general population for kidney cancer?

16 Who is at highest risk for developing kidney cancer?

17 Should my family members be evaluated for kidney cancer?

18 Is kidney cancer seen in children?

19 Are men or women more likely to have kidney cancer?

20 Are other types of cancer seen in the kidney?

Part 3 Presentation and Evaluation 39

Questions 21-32 discuss important issues in the doctor's office, such as:

21 What are the typical signs and symptoms of kidney cancer?

22 What is hematuria?

23 What kind of doctor should I be seeing?

24 Does the type of hospital matter?

25 What tests are usually performed?

26 What is an ultrasound?

27 What is a CT scan?

28 What is an MRI scan?

29 What is a bone scan?

30 Is there a blood test that can detect kidney cancer?

31 Are there benign kidney tumors?

32 Will a biopsy help sort this out?

Part 4 Staging of Renal Cell Carcinoma 65

Questions 33-41 deal with the staging of kidney cancer and how it spreads:

33 How is kidney cancer staged?

34 What does tumor grade mean?

35 What is a tumor thrombus?

36 What is a lymph node? How are the lymph nodes involved in kidney cancer?

37 Where does kidney cancer metastasize to?

38 What symptoms do metastases cause?

39 What is a paraneoplastic syndrome?

40 What causes weight loss or fatigue?

41 Do patients die from kidney cancer?

Part 5 Treatment of Localized Disease 89

Questions 42-56 answer questions regarding treatment of cancer confined to the kidney:

42 How is kidney cancer treated?

43 What are the treatment options for localized (stage I-II) kidney cancer?

44 What is the prognosis for patients with localized kidney cancer?

45 What is a radical nephrectomy?

46 What is a partial nephrectomy?

47 What is an "elective" partial nephrectomy?

48 What happens to the tumor after it is removed?

49 What is minimally invasive surgery, and how are laparoscopy and robotics different?

50 What is cryoablation?

51 What is radiofrequency ablation (RFA)?

52 What are the pros and cons of each of these ablation options?

53 Can I just be observed? What are the risks of not actively pursuing treatment for kidney cancer?

54 How will I be followed after a radical nephrectomy?

55 How will I be followed after a partial nephrectomy?

56 How will I be followed after cryoablation or RFA?

Part 6 Treatment of Locally advanced Disease 127

Questions 57-62 discuss treatment of locally advanced kidney cancer:

57 What is the treatment for locally advanced (stage III) kidney cancer?

58 How is a tumor thrombus removed?

59 What if the tumor thrombus goes into the heart?

60 What is the treatment of enlarged lymph nodes?

61 Why are adjacent organs sometimes removed?

62 What is an adjuvant treatment, and should I consider this?

Part 7 Treatment of Metastatic Disease: Overview 141

Questions 63-70 deal with cancer that has spread beyond the kidney:

63 What are the treatment options for metastatic kidney cancer (stage IV)?

64 What is the prognosis for patients with metastatic kidney cancer?

65 Should I have my kidney removed even if I have stage IV disease (cytoreductive or debulking nephrectomy)?

66 Can other sites of disease be removed surgically?

67 Is chemotherapy an option?

68 Is hormonal therapy on option?

69 Is there a role for radiation therapy?

70 Is there a role for vitamins and alternative treatments?

Part 8 Immunotherapy 155

Questions 71-77 deal with immunotherapy and its role in the treatment of kidney cancer:

71 What is immunotherapy?

72 What is imrnunogenicity? How do we know that kidney cancer is immunogenic?

73 What is interleukin-2 (IL-2) and what is interferon?

74 What is inhibition of checkpoint control and how do checkpoint inhibitors work?

75 What is the likelihood of a cure with checkpoint inhibitors?

76 What are the side effects of checkpoint inhibitors?

77 Can checkpoint inhibitors be combined with other treatments for metastatic kidney cancer?

Part 9 Targeted Molecular Therapy 165

Questions 78-87 discuss various molecular treatments of kidney cancer:

78 What is targeted molecular therapy?

79 How does bevacizumab work?

80 How do tyrosine kinase inhibitors work?

81 How do mTOR inhibitors work?

82 How were the VEGF-targeted molecular agents developed?

83 Do these targeted molecular agents work and which is best for me?

84 What is the likelihood of a cure with targeted molecular agents?

85 What are the side effects of targeted molecular agents?

86 How is hypertension caused by targeted agents treated, and what does it signify?

87 What is hand-foot syndrome?

Part 10 Summary of Systemic Therapy: What Treatment Should I Receive First or Subsequently? 181

Questions 88-95 discuss various systemic treatments of kidney cancer:

88 Do I need to start systemic treatment right away?

89 What systemic treatment should I get first for my metastatic kidney cancer? Checkpoint inhibitors or targeted agents or a combination of these?

90 How long should I be treated with therapy and how will I be followed?

91 Can one agent or protocol work when another has failed?

92 Is there still a role for nephrectomy in patients receiving targeted molecular therapy or immunotherapy?

93 Can I have surgery later to "clean things up?"

94 What new agents are on the horizon?

95 What is palliative care, and when should hospice be considered?

Part 11 Clinical Trials 191

Questions 96-100 aim to help kidney cancer patients navigate their way through various clinical trials and explain how to choose the right one:

96 What is a clinical trial?

97 What is informed consent? How do I know that someone Is making sure that the clinical trials are conducted in a safe and ethical manner?

98 How do I decide whether I should participate in a clinical trial?

99 How can I learn more about clinical trials?

100 How can I learn more about kidney cancer?

Appendix 203

Glossary 213

Index 225