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Cancer Education Slides

Cancer Education Slides. Kidney Cancer. 2009. What is Cancer?. A group of 100 different diseases The uncontrolled, abnormal growth of cells Cancer may spread to other parts of the body. What is Kidney Cancer?. An estimated 57,760 people diagnosed in the United States in 2009

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Cancer Education Slides

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  1. Cancer Education Slides Kidney Cancer 2009

  2. What is Cancer? • A group of 100 different diseases • The uncontrolled, abnormal growth of cells • Cancer may spread to other parts of the body

  3. What is Kidney Cancer? • An estimated 57,760 people diagnosed in the United States in 2009 • Seventh most common cancer and tenth most common cause of cancer death in men • A disease of the kidneys in which cells grow uncontrollably and form a tumor • Several types of kidney cancers: renal cell carcinoma (85% of cases), transitional cell carcinoma (10% to 15% of cases), sarcoma, and Wilms tumor • Two most common cell types in kidney cancer: clear cell, caused by a VHL gene mutation, and papillary, caused by several genetic mutations

  4. What is the Function of the Kidneys? • Two fist-sized organs located above the waist on either side of the spine • Filter blood and remove impurities, excess minerals and salts, and surplus water • Process 200 quarts of blood every day to generate two quarts of urine • Produce hormones to help control blood pressure, red blood cell production, and other functions • The human body can function with less than one complete kidney, or, through dialysis (a mechanized filtering process), can live without kidneys

  5. What are the Risk Factors for Kidney Cancer? • Smoking • Gender, race, and age • Nutrition and weight • Hypertension (high blood pressure) • Overuse of certain medications • Exposure to cadmium (a metallic element) • Long-term dialysis • Genetic and hereditary risks

  6. Hereditary Kidney Cancer Syndromes—VHL • People with von Hippel-Lindau syndrome (VHL) have about a 40% risk of developing clear cell kidney cancer • Mutations in the VHL gene cause VHL; genetic testing is available • Screening for VHL symptoms should begin at age 2 in affected families • A small number of families appear to have a hereditary risk of clear cell kidney cancer without VHL symptoms (familial non-VHL clear cell renal cell carcinoma); genetic testing is available

  7. Hereditary Kidney Cancer Syndromes—BHD • People with Birt-Hogg-Dubé (BHD) syndrome have about a 15% risk of developing kidney cancer • Mutations in the FLCN gene cause BHD; genetic testing is available • Yearly screening with ultrasound, beginning at age 25 and magnetic resonance imaging (MRI) or computed tomography (CT) scan every two years should be considered

  8. Hereditary Kidney Cancer Syndromes—HLRCC • People with hereditary leiomyomatosis (HLRCC) have about a 15% risk of developing type 2 papillary renal cell carcinoma • People with HLRCC develop skin nodules (leiomyomata) on the arms, legs, back and chest • Mutations in the fumarate hydratase (FH) gene cause HLRCC; genetic testing is available

  9. Other Hereditary Kidney Cancer Syndromes • Several other genes and genetic conditions can increase a person’s risk of kidney cancer • Talk with your doctor about finding a genetic counselor if you have a history of kidney cancer in your family • For more information, visit www.cancer.net/genetics

  10. Kidney Cancer and Early Detection • No tests are recommended for screening the general population • People at high risk for the disease may undergo regular computed tomography (CT or CAT) scans

  11. What are the Symptoms of Kidney Cancer? • Hematuria (blood in the urine) • Pain, pressure, or a mass or lump in a person’s side, back, or testicle • Ankle and leg swelling • High blood pressure, anemia (low red blood cell count) • Fatigue • Loss of appetite or unexplained weight loss • Recurrent fevers (not from cold, flu, or other infections)

  12. How is Kidney Cancer Diagnosed? • Diagnosis, including cell type, is confirmed with a biopsy • Physical examination • Blood and urine tests • Imaging tests, such as intravenous pyelogram (IVP) and CT scan

  13. Kidney Cancer Staging • Staging is a way of describing a cancer, such as the size of a tumor and if or where it has spread • Staging is the most important tool doctors have to determine a patient’s prognosis • Staging is described by the TNM system: the size and location of the Tumor, whether cancer has spread to nearby lymph Nodes, and whether the cancer has Metastasized (spread to other areas of the body) • Some stages are divided into smaller groups that help describe the tumor in even more detail • Treatment depends on the stage of the cancer • Recurrent cancer is cancer that comes back after treatment

  14. Stage I Kidney Cancer • The tumor is 7 cm or smaller and is in the kidney only • Divided into Stage Ia (tumor is smaller than 4 cm) and Stage Ib (tumor is between 4 cm and 7 cm) • The tumor has not invaded the lymph nodes or distant organs

  15. Stage II Kidney Cancer • The tumor is larger than 7 cm and is in the kidney only • The tumor has not invaded the lymph nodes or distant organs

  16. Stage III Kidney Cancer • The tumor of any size is located only in the kidney and has spread to regional lymph nodes, but not to other parts of the body, or • The tumor has spread into major veins or tissue around the kidney, and possibly to regional lymph nodes but not to other parts of the body

  17. Stage IV Kidney Cancer • The tumor has spread beyond the envelope of tissue surrounding the kidney and extends into the adrenal gland on the same side of the body, possibly to lymph nodes, but not to other parts of the body, or • The tumor has spread to any other organ

  18. How is Kidney Cancer Treated? • Treatment depends on stage of cancer • More than one treatment may be used • Surgery • Targeted therapy • Immunotherapy • Radiation therapy • Chemotherapy

  19. Cancer Treatment: Surgery • If the cancer has not metastasized (spread) beyond the kidneys, surgery may be the only treatment necessary • Radical nephrectomy: Surgery to remove the tumor, kidney, and surrounding tissues; affected lymph nodes may be removed • Partial nephrectomy: Surgery to a remove a small tumor while saving as much of the kidney as possible. This is recommended for a stage I tumor • Laparoscopic surgery: Surgeon makes several small incisions in the abdomen instead of one large incision • Radiofrequency ablation: use of needle inserted into tumor to destroy the cancer with an electrical current • Cryoablation: Freezing cancer cells

  20. Cancer Treatment: Targeted Therapy • Three approved drugs: sunitinib (Sutent), pazopanib (Votrient), and sorafenib (Nexavar); these are anti-angiogenic drugs (starve the tumor by disrupting its blood supply) • Another anti-angiogenic drug, bevacizumab (Avastin), slows growth of metastatic renal carcinoma • Other approved drug, temsirolimus (Torisol) and everolimus (Afinitor) targets a different protein that controls tumor growth and blood vessel formation • Clinical trials are testing combinations of these and other new drugs

  21. Cancer Treatment: Immunotherapy • Uses materials made by the body or in a laboratory to boost patients’ natural defenses against cancer (also called biologic therapy) • Kidney cancer, one of the few cancers that the human body can fight, responds well to immunotherapy • Interleukin-2 (IL-2) is the most effective drug used against advanced kidney cancer • Alpha-interferon is also used in the treatment of advanced kidney cancer

  22. Cancer Treatment: Radiation Therapy • The use of high-energy x-rays to destroy cancer cells • Different types of delivery: external beam (outside the body) and internal beam (inside the body using implants) • Rarely use alone to treat kidney cancer and used only if the patient cannot have surgery • Most often used on metastases to help ease symptoms • A recent advance is stereotactic radiosurgery, designed to optimize the dose of radiation therapy given to a specific area without damaging nearby tissue

  23. Cancer Treatment: Chemotherapy • Use of drugs to kill cancer cells • Typical chemotherapy (use of drugs to kill cancer cells) not effective for treating most types of kidney cancer • Transitional cell kidney cancer and Wilms tumor are more sensitive to chemotherapy • New drugs and combinations of drugs are being researched

  24. Current Research • New targeted therapies, including axitunib (AG 013736) • Cancer vaccines that are made either from a person’s tumor or from kidney cancer proteins and given after surgery

  25. The Role of Clinical Trials for the Treatment of Kidney Cancer • Clinical trials are research studies involving people • They test new treatment and prevention methods to determine whether they are safe, effective, and better than the standard treatment • The purpose of a clinical trial is to answer a specific medical question in a highly structured, controlled process • Clinical trials can evaluate methods of cancer prevention, screening, diagnosis, treatment, and/or quality of life

  26. Clinical Trials: Patient Safety • Informed consent: participants should understand why they are being offered entry into a clinical trial and the potential benefits and risks; informed consent is an ongoing process • Participation is always voluntary, and patients can leave the trial at any time • Other safeguards exist to ensure ongoing patient safety

  27. Clinical Trials: Phases • Phase I trials determine the appropriate dose of a new treatment in a small group of people and provide preliminary information about the drug’s safety • Phase II trials provide information about the safety of the new treatment and provide the first evidence as to whether or not the new treatment is effective in treating the cancer that is being studied • Phase III trials compare two or more different treatments. Most commonly, they test whether a new treatment is better than the standard treatment. Patients are typically divided randomly into two or more different groups. Each group gets a different treatment, and the researchers evaluate which group has had the best results. This is the best way to measure whether a new treatment results in longer life or better quality of life for patients

  28. Clinical Trials Resources • Coalition of Cancer Cooperative Groups (www.CancerTrialsHelp.org) • CenterWatch (www.centerwatch.com) • National Cancer Institute (www.cancer.gov/clinical_trials) • EmergingMed (www.emergingmed.com)

  29. Coping with Side Effects • Side effects are treatable; talk with the doctor or nurse • Fatigue is a common, treatable side effect • Pain is treatable; non-narcotic pain-relievers are available • Antiemetic drugs can reduce or prevent nausea and vomiting • For more information, visit www.cancer.net/sideeffects

  30. After Treatment • Talk with the doctor about developing a follow-up care plan • Periodic blood tests to check kidney function • Chest x-rays, CT scans of the abdomen and chest, and other imaging tests to watch for new tumors, metastasis, or signs that the cancer came back • Checkups should occur every three months for the first year, every four months for the second to fifth year, and yearly thereafter • Kidney function should be monitored in people with one kidney • Fear of recurrence is common; talk with your doctor about ways to cope

  31. Where to Find More InformationCancer.Net Guide to Kidney Cancer(www.cancer.net/kidney) • Overview • Medical Illustrations • Risk Factors • Symptoms • Diagnosis • Staging With Illustrations • Treatment • Clinical Trials • Side Effects • After Treatment • Current Research • Questions to Ask the Doctor • Patient Information Resources

  32. Cancer.Net (www.cancer.net) • Comprehensive, oncologist-approved cancer information • Guides to more than 120 types of cancer and cancer-related syndromes • Coping resources • Survivorship information • Cancer information in Spanish • Weekly feature articles • The latest cancer news • For patient information resources, please call 888-651-3038

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