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CLIENT WITH
KIDNEY CANCER

NUR LISA BINTI HAMZAH

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ANATOMY OF KIDNEY

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KIDNEY
• 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

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Cont….

• 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

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LEARNING OUTCOMES
At the end of the class on Kidney
Cancer, the student must be able to:

i. Define kidney cancer

ii. State the etiology of kidney cancer
iii. List the clinical manifestation of
kidney cancer

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Cont…
iv. Identify diagnostic tests to diagnose
kidney cancer.
v. State the staging in the kidney cancer
vi. Explain the treatment for client with
kidney cancer.
vii. Explain nursing management for kidney
cancer.
viii.Explain home care for client with renal
kidney cancer
ix. Awareness of nursing care plan for client
with kidney cancer
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DEFINITION
• Cancer that forms in tissues of the kidneys.

• includes renal cell carcinoma and renal

pelvis carcinoma

• It also includes Wilms tumor, which is a type

of kidney cancer that usually develops in
children under the age of 5.

(National Cancer Institute, 2010) 8

Cont…

• The most common type of

renal tumor is renal cell or
renal adenocarcinoma,
accounting for more than 85%
of all kidney tumors

(Hock et al., 2002)

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RENAL CELL CARCINOMA

FIGURE: 1 10
ETIOLOGY

primary secondary

ethiopathic From other

condition

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 Risk Smoking
factor

Obesity

High
blood
pressure 12
Renal calculi Long – term
dialysis

Risk
factor Genetic factor – von
Hipple – Lindau
syndrome

Occupation – expose in the

working environment in the
asbestos or cadmium
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MANIFESTATION

• Onset

• Palpable abdominal mass (flank

mass)

• Haematuria

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Cont….

• Pain in the side that does not goes

away

• Weight loss

• Fever

• Fatigue

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DIAGNOSTIC TEST
• Physical examination – check for
general sign of health, feel the
abdomen and side for tumors.

• Urine tests – check for

hematuria

• Blood tests – check the kidney

function
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Cont…

• Intravenous pyelogram (IVP) –

determine space occupying lesion
• Ct Scan - determine tumor size,
extension, regional lymph node
• Ultrasound – detect renal masses

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Cont…
• Biopsy – percutaneousely renal
biopsy
• Renal angiography to evaluate
extent of vascular involvement
• Chest x-ray, bone scan, liver
function test to identify
metastases
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 STAGING
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
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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

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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
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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

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TREATMENT

1- Surgery
• Surgery is the most common
treatment for kidney cancer.
• There are several type of
nephrectomies depends on the
stage of tumors

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Cont…

a- Radical nephrectomy

• Total removal of kidney including

adrenal gland and lymph nodes in
the kidney area also been removed.

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Cont….

b- Simple nephrectomy
• Only kidney been removed
• Usually stage 1 kidney cancer may
have a simple nephrectomy

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Cont…

c- Partial nephrectomy
• Only the part of the kidney will be
removed.
• This type usually may be used when the
person only have one kidney or when the
cancer affects both kidneys
• Also to a person with small kidney tumor

• ( less than 4cm) 26

TREATMENT

• Arterial embolization
i. Local therapy that shrinks the
tumor

ii. Usually done before operation to

make surgery easier

iii. Or when operation is not possible

to the patient
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TREATMENT

• Radiation therapy

 To treat recurrent tumor cell

 Treat lymphatic involment
 Treat metastatic sites

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TREATMENT

• Biological therapy

a. Interferon alpha
b. Interleukin 2

• Chemotherapy

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NURSING CARE

• Focus on needs related to

diagnosis and surgical
intervention

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Cont….

• Provide care for a client with

nephrectomy
• Provide care for a client receiving
chemotherapy and radiation
therapy
• Nutrition

• Follow up care
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 Nursing Diagnosis
( surgery and cancer diagnosis)

• Pain

• Ineffective breathing pattern

• Risk for impaired urinary
elimination
• Anticipatory grieving

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HOME CARE

• Focus on protecting remaining

kidney
• monitor for recurrence

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Any question??

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THANK YOU

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