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KIDNEY CANCER
PART A
Kidney cancer, also called renal cancer, is one of the most common types of cancer in
the UK. It usually affects adults in their 60s or 70s. It is rare in people under 50. It can
often be cured if it's found early. But a cure will probably not be possible if it's
diagnosed after it has spread beyond the kidney. There are several types of kidney
cancer. These pages focus on the most common type renal cell carcinoma. In many
cases, there are no obvious symptoms at first and kidney cancer may only be found
during tests for another condition or reason. If there are symptoms, they can include:

• blood in your pee – you may notice your pee is darker than usual or reddish in
colour
• a persistent pain in your lower back or side, just below your ribs
• a lump or swelling in your side (although kidney cancer is often too small to feel)
Although it's unlikely you have cancer, it's important to get your symptoms checked
out. The GP will ask about your symptoms and may test a sample of your urine to see
if it contains blood or an infection. The exact cause of kidney cancer is unknown, but
some things can increase your chances of getting it, including:

• obesity – a body mass index (BMI) of 30 or more (use the healthy

weight calculator to find your BMI)
• smoking – the more you smoke, the greater the risk
• high blood pressure (hypertension)
• family history – you're more likely to get kidney cancer if you have a close
relative with it
• some inherited genetic conditions
• long-term dialysis – a treatment for chronic kidney disease where a machine
does some of the jobs of the kidneys
Keeping to a healthy weight, a healthy blood pressure and not smoking is the best way
to reduce your chances of getting kidney cancer.

PART B

See a GP if you have symptoms of kidney cancer. They will do some simple checks
and can refer you for further tests if necessary. These tests can confirm or rule out
kidney cancer. If you have cancer, they can help show whether it has spread to other
parts of your body. The tests you might have include:
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• an MRI scan – a scan that uses strong magnetic fields and radio waves to produce
a detailed image of your kidneys
• a cystoscopy – where a thin tube is passed up your urethra (the tube that
carries urine out of your body) so your doctor can see any problems in your
bladder
• a biopsy – where a needle is inserted into your kidney to remove a small tissue
sample for analysis in a laboratory; local anaesthetic is used to numb the area so
the procedure should not hurt
• a PET scan – a detailed body scan that can be helpful for investigating confirmed
cases of kidney cancer to see if the cancer has spread and how well it's
responding to treatment
If you're diagnosed with kidney cancer, it will usually be given a "stage". This is a
number that describes how far the cancer has spread. Doctors use the TNM system to
stage kidney cancer. This consists of 3 numbers:

• T (tumour) – from 1 to 4, depending on the size of the tumour

• N (node) – from 0 to 2, depending on whether the cancer has spread to nearby
lymph glands
• M (metastases) – either 0 or 1, depending on whether the cancer has spread to
another part of the body

PART C

The treatment for kidney cancer depends on the size of the cancer and whether it
has spread to other parts of the body. The main treatments are:

• surgery to remove part or all of the affected kidney – this is the main treatment
for most people
• ablation therapies – where the cancer cells are destroyed by freezing or heating
them
• embolisation – a procedure to cut off the blood supply to the cancer
Cancer that has not spread out of the kidney can usually be cured by having an operation
to remove some or all of the kidney. Sometimes cryotherapy or radiofrequency ablation
may be used instead. There are 2 main types of surgery for kidney cancer:

• an operation to remove the part of the kidney containing the cancer – called a
partial nephrectomy
• an operation to remove the entire kidney – called a radical nephrectomy
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A partial nephrectomy is usually done if the cancer is small and easy for the surgeon to
get to. A radical nephrectomy may be necessary for larger cancers or if the cancer has
spread beyond the kidney.

Radiofrequency ablation is done by inserting a needle-like probe through your skin, so

no large cuts are needed. Cryotherapy is done using needles inserted into the tumour.
This can be done through your skin (percutaneous cryotherapy) or through a small cut
(laparoscopic cryotherapy). Side effects of ablation therapies can include bleeding
around the kidney and damage ureter.

If your cancer is advanced, you may be offered targeted therapies. These are medicines,
usually taken once or twice a day, that help stop the cancer growing and spreading.

Some people with advanced kidney cancer may be offered a medicine called lenvatinib,
to take along with everolimus. Embolisation is a procedure to block the blood supply to
the tumour, causing it to shrink. It's sometimes recommended if you have advanced
kidney cancer and you're not in good enough health to have surgery to remove the
affected kidney. During embolisation, the surgeon will insert a small tube called a
catheter into a blood vessel in your groin and then guide it to the blood vessel supplying
the tumour. A substance will be injected through the catheter to block the blood vessel.
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PART D
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Questions 1-7 For each question, 1-7, decide which text (A,B,C or D) the
Information comes from. You may use any letter more than once. In which text
can you can find information about.

1. Stages of kidney cancer?

2. Which factors are depends for the treatment of kidney cancer?
3. How can reduce the chances of kidney cancer?
4. Which drug will cause pulmonary fibrosis and interstitial pneumonitis as the after
effects of chemotherapy?
5. What is embolisation?
6. What is the range of body mass has the increased chance of getting kidney cancer?
7. Which is the main treatment recommended for most people with kidney cancer?

Answer the questions,8-14,with a word or short phrase from the texts. Each
answer may include words, numbers or both.

8. What will probably impossible, if the cancer diagnosed after spread beyond the
kidney?
9. In which test a thin tube is passed up your urethra to see any problems in the
bladder?
10. In which treatment the cancer cells are destroyed by freezing or heating them?
11. Which medicines are recommended for advanced kidney cancer?
12. What are the ophthalmological after effects of steroids in radiotherapy?
13. Which treatment may be necessary for large cancers or if the cancer has spread
beyond the kidney?
14. Which dug is caused bladder fibrosis with the late effects of chemotherapy?

Questions 15-20 .Complete each of the sentences, 15-20, with a word or short
phrase from one of the texts . Each answer may include words, numbers or both.

15. ..................is done by using needles inserted in to the tumour?

16. You are more likely to get kidney cancer, if you have...............with it?
17. The kidney cancer generally effects in their.....................?
18. An operation to remove the part of the kidney containing the cancer
called......................?
19. ..........therapies are recommended if the cancer is advanced?
20. Side effects of ablation therapies can include bleeding around the kidney
and...............?
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ANSWER KEY
1. B
2. C
3. A
4. D
5. C
6. A
7. C
8. cure
9. a cystoscopy
10. ablation therapies
11. lenvatinib along with everolimus
12. Cataracts; retinopathy
13. a radical nephrectomy
14. Cyclophosphamide
15. Cryotherapy
16. close relative
17. 60s or 70s
18. partial nephropathy
19. Targeted
20. Damage ureter