[100세건강] Kidney cancer, a ‘silent disease’, has already spread to other organs by the time symptoms appear

In this way, kidney cancer is a ‘silent cancer’ that spreads quietly but fatally. On the 29th, the urology medical staff said, “When the typical symptoms such as flank pain and hematuria appear, we must keep in mind the possibility that the disease may have already spread to other organs.”

According to the 2020 national cancer registration statistics, kidney cancer ranks 10th in overall cancer incidence in Korea (2.4%). The incidence rate is particularly high in men. By age, the majority are in their 70s or older (28.5%), followed by those in their 60s (26.6%), and those in their 50s (16.3%). It is a disease with a high incidence in middle-aged and older men, but in recent years, the age of onset is gradually getting younger.

In most cases, there are no significant symptoms in the beginning and symptoms appear late. Although it is mainly discovered early due to the spread of health checkups that include ultrasound, 30% of patients are found to have ‘distant metastases’ that have spread to other organs.

Kidney cancer has a relatively good prognosis, with a 5-year survival rate of over 90% when the cancer is at a local stage that exists only within the kidney. However, patients with distant metastases are characterized by a sharp decline in the 5-year survival rate to 18.6%.

Most tumors that occur in the kidney are primary tumors that occur in the kidney itself, and 85-90% of them are renal cell carcinoma, a malignant tumor. Most diseases commonly referred to as kidney cancer refer to ‘renal cell cancer.’

The cause of renal cell carcinoma has not been clearly identified, but it is known to be affected by lifestyle habits such as smoking, obesity, high blood pressure, or existing renal diseases such as chronic renal failure. Genetic factors also play a big role. If you have a family history of renal cell cancer, the risk increases 4 to 5 times.

It has been found that 60-70% of patients suffering from hereditary diseases such as Von Hippel-Lindau syndrome (VHL), which causes benign and malignant tumors in multiple organs, develop renal cell carcinoma. .

To lower this recurrence rate, chemotherapy (adjuvant) therapy is necessary after surgery. Professor Song said, “We expect that immunotherapies will effectively reduce the recurrence rate of patients so that they can be used as adjuvant therapy after surgery for renal cell carcinoma starting in 2022.”

Until the first half of 2022, renal cell cancer patients had to be frustrated by the fact that, unlike other cancers, the effectiveness of chemotherapy was significantly low. However, in July 2022, a drug called pembrolizumab was approved in Korea as an adjuvant treatment after surgery for renal cell cancer patients, making it possible for patients to receive immunotherapy.

According to the clinical study that served as the basis for approval, patients treated with this drug over a follow-up period of 2 years and 6 months had a 37% reduced risk of kidney cancer recurrence and death compared to the placebo group. Professor Song explains that patients can look forward to the treatment as a way to escape the fear of recurrence and metastasis.

Although it has been proven effective in patients who do not respond to existing treatments, it is not yet covered by health insurance. Professor Song said, “I hope benefits are applied,” and added, “There is a support system for treatment costs such as catastrophic medical expenses, so I hope patients will not be discouraged and continue treatment positively.”

ksj@news1.kr