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Kidney Cancer

Laproscopic Surgery

kidney cancer patientForty-one year old Debbie Askew of Blackstone, has her grandson to thank for discovering her kidney cancer. “I was picking up my grandson, and he put his heel under my rib cage,” Debbie says. “His foot hit my side and I felt a lump. I went to my doctor to have it checked out.” The lump was originally thought to be a fatty tumor, but an ultrasound showed a large mass on Debbie’s right kidney. Fortunately, Debbie was a candidate for minimally invasive, laparoscopic surgery. She was also fortunate to have Tri-County urologist Sanjaya Kumar, MD, as her surgeon.

Each year over 30,000 people are diagnosed with kidney cancer in the United States, and the rate has been increasing by 1.5% each year. There is an increased rate in kidney cancer because of better diagnostic methods. Kidney cancer often has no symptoms, but many tumors are picked up incidentally. A patient may go in for a CT scan for one condition, and the scan picks up a kidney tumor. The benefits of early detection are substantial. According to Dr. Kumar, smaller kidney tumors are being caught at earlier stages. “Since surgery is the only treatment,” he says, “the cure rate is much better today than it was ten years ago.”

There are many risk factors associated with kidney cancer. Cigarette smoking, obesity, and a family history of kidney cancer are all well-known causes. Exposure to heavy metals like cadmium, asbestos and other chemicals can also increase an individual’s risk of acquiring the disease. Other cancer causes include infection, chronic kidney failure and certain kidney diseases. Statistically, men are twice as likely as women to develop renal cell carcinoma, perhaps because of greater exposure to heavy metals or a higher rate of smoking.

Kidney cancer is treated primarily through surgery. The type of surgery depends upon the cancer, specifically the size of the tumor and how far the cancer has spread. The goal of surgery, which is to remove all the cancer, can be accomplished by several methods. Removing the kidney and the attached adrenal gland is called a radical or total nephrectomy, while removing just the part of the kidney with cancer is called a partial nephrectomy. Like other surgical procedures, these surgeries can be performed by open surgery – requiring an abdominal incision- or by laparoscopic surgery, also called minimally invasive surgery. The benefits to laparoscopic surgery are a faster return to work, less pain, and less blood loss. Dr. Kumar states, “Over the last ten years, laparoscopic surgery for kidney cancer has been perfected. I use a special minimally invasive laparoscopic technique that enables us to take the kidney out intact, and gives us a better specimen for tumor classification. Patients have less pain with a faster recovery.” Dr. Kumar also emphasizes the importance of Milford Regional’s new, state-of-the-art operating rooms, noting that they are “one of its kind in Massachusetts.” In addition, he points to the significance of the Medical Center’s sophisticated surgical instruments and the “highly skilled operating room nurses and staff, which allows us to effectively utilize this minimally invasive technique.”

Debbie, for one, is happy to have had her surgery done laparoscopically. “It was unbelievable,” she exclaims, “I woke up with a three-inch incision on my lower right abdomen, and a couple of small incisions on my stomach. I was back to cooking for my family in just a couple weeks after surgery.”

There are other surgical methods that may be considered in treating kidney cancer. Laparoscopic cryotherapy, a procedure that kills the cancer through freezing, is performed by inserting a tiny needle into the core of the tumor and freezing the tumor to a subzero temperature. Another method destroys the tumor by liquefying its tissue through heat generated through radiofrequency waves. And while chemotherapy is not an effective option for localized kidney cancer, surgery often eliminates the disease. Chemotherapy may be needed in advanced patients. “My tumor was cancerous, but it was confined,” Debbie says gratefully. “I’ve been having CT scans every three months after surgery, and they have all been clear.”

Generally, recovery from laparoscopic kidney surgery is fast. “Everyone has their own threshold to pain,” Dr. Kumar explains, “but generally by two weeks, patients no longer need any pain medication and are able to return to work by four weeks.” Debbie attributes her fast recovery to the care she received at Milford Regional. “I was really overwhelmed by the care I received at the hospital,” she states emphatically. “The nurses were so attentive; I never had to ring the buzzer. I felt so fortunate and comforted by the medical support system behind me. I almost didn’t want to leave the hospital because of the rest I was getting.”

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