9 Things to Know If You’re Diagnosed with Kidney Cancerby Lisa Davis Health Writer
Kidney cancer isn’t what you’d call rare—in fact, according to statistics from the American Cancer Society, it’s on pace to be the eighth most commonly diagnosed cancer in the United States this year. But it’s not a familiar disease. While most people could probably rattle off a couple of facts about breast, lung, or prostate cancer (ranked first, second, and third for number of people diagnosed), or about endometrial cancer or leukemia (ninth and tenth), chances are they’d draw a blank if asked about renal-cell cancer or any other variety of kidney cancer. That lack of information can add to the fear experienced by the nearly 74,000 Americans who will receive a kidney-cancer diagnosis this year. And that’s unfortunate—because when it comes to kidney cancer, a little knowledge can actually be a reassuring thing.
If you’ve recently received a diagnosis of kidney cancer, here are some key points that can make you feel more in control and help you get the treatment you need.
Try Not to Despair
Perhaps the most important thing to know about kidney cancer is that patients generally have a good outcome. Most cases are discovered by accident in people who aren’t having symptoms: They go in for an X-ray or other imaging exam for an unrelated reason, and the radiologist notices a kidney mass. In medical jargon, it’s what’s called an incidental finding. The majority of people who are surprised by an incidental finding of kidney cancer will be cured, says urologist Bradley Leibovich, M.D., of the Mayo Clinic in Rochester, Minnesota. What’s more, after treatment, which may include removing either the kidney or just the tumor, patients often return to life as usual, with no long-term side effects. (Some people don’t need any treatment at all for their kidney cancer—more on that later.)
Proceed Promptly—But Thoughtfully
Learning you have cancer of any kind is scary and upsetting. But if you had no symptoms that led to your diagnosis, says Dr. Leibovich, “it’s a psychological emergency but almost never a medical one.” The tumor has almost certainly been there for a long time—a few years or a decade—and nothing is going to change in the next few weeks. You can take a little time to consider who you want to see for treatment and whether you want a second opinion.
Of course, that may seem daunting in itself. How do you tell your doctor you want to get some other physician’s advice? Consider it due diligence. Plus, most doctors are comfortable with that idea, say experts at the American Cancer Society. More important, numerous studies have shown that getting a second opinion after a serious diagnosis is often helpful. For instance, researchers at the University of Michigan found that when breast-cancer patients got a second opinion from a “tumor board” made up of specialists in breast-cancer surgery, radiation oncology, medical oncology, radiology and pathology, more than half ended up with a change in their recommended treatment, according to a study in Cancer. Many times, the initial treatment plan didn’t take recent surgical advances into account. That can happen with kidney cancer too, says Dr. Leibovich.
Get Expert Advice
One reason it’s important to talk with a kidney-cancer expert is that others are sometimes unaware of the surprising range of treatments that can be effective for this disease. Some patients will need major surgery; others can be treated with a minimally invasive approach. And if your cancer is small (two centimeters or less, or about three-quarters of an inch in diameter), research shows you may need nothing more than active surveillance. That’s a fancy way of saying that your doctor may suggest simply monitoring your tumor with periodic imaging tests, because between a quarter and a third of small kidney tumors don’t ever grow or cause any harm. In these cases, the cancer can be safely left alone. If a later test shows a change, the tumor can be removed at that time.
“It’s not uncommon that I see patients in my office who have seen their internist for a two-centimeter renal mass, and they’re convinced that they’re dying of kidney cancer,” Dr. Leibovich says. “And when I tell them, ‘Gee, this is probably not going to shorten your life or change the quality of your life,’ that’s huge news to them. So it’s important not to come to conclusions before meeting with an expert.”
Look for Experience
It was true in your childhood music lessons and it still holds today: Practice makes perfect. There’s a fair amount of evidence that surgeons who do a lot of a given procedure tend to have fewer complications. “I tell people, ‘You don’t want to be flown by a pilot who dabbles in flying, and you shouldn’t be operated on by a surgeon who dabbles in the operation that you are having,’” says Dr. Leibovich.
But what kind of numbers are you looking for? As a rule of thumb, surgeons who do at least one kidney cancer procedure a week or more can be considered high-volume specialists, Dr. Leibovich says; less than one procedure every other week is low-volume. A surgeon should be willing to give you his or her numbers.
Share Info With Your Doctor
Clearly, you have questions for your doctor, like how often he or she does the procedure you’re considering. Well, turnabout is only fair: Your doctor has questions for you, too, like about your medical history. It’s important for your answers to be thorough. Discuss any other health conditions you may have and list your prescription and over-the-counter medications. Supplements count! You may barely remember that you pop a daily garlic supplement, but that little capsule has anti-clotting effects; it can increase bleeding during and after surgery. And according to the Institute for Safe Medication Practices, St. John’s wort can dangerously boost the effect of anesthesia and interfere with warfarin, often prescribed to prevent blood clots. To make sure you give your doctor an accurate picture of what you take, toss all your meds and supplements into a bag and bring them with you to your doctor appointment.
Eat Well—But Don’t Worry About a “Kidney-Friendly” Diet
A healthy diet is a good idea for everyone, and proper nutrition is even more important if you’re headed for surgery. But though the Internet may present you with lists of foods to avoid if you have kidney problems, there’s actually nothing about being treated for kidney cancer that means you have to adopt a special diet. In fact, most of the time, people have adequate kidney function even if they’ve had a kidney removed. Assuming that’s you, that means you can keep enjoying avocados and bananas (both are high in potassium, a no-no for people with poor renal function), and drinking milk (high in potassium, phosphorus and protein, all potentially problematic if your kidney function is low). Want a glass of potassium-rich OJ? No reason not to enjoy.
On the flip side, there’s no evidence that specific foods will help you after a diagnosis, either. Some studies suggest (but don’t prove) that eating plenty of cruciferous vegetables, like broccoli, cauliflower, and Brussels sprouts, can reduce your risk of developing kidney cancer. There are similar hints that red wine (not white) and dark beer (not light) may be protective, too. But no research suggests that eating these foods after a diagnosis of kidney cancer will affect your outcome. So chow down on Brussels sprouts only if you feel like eating them.
If You Smoke, Well, You Know What to Do
All the emphasis placed on smoking as a culprit in lung cancer can distract from the role tobacco plays in other cancers. Like kidney cancer, for instance. According to the American Society of Clinical Oncology, smoking tobacco doubles the risk of developing kidney cancer, causing an estimated 30 percent of kidney cancers in men and 25 percent of kidney cancers in women.
Even if you already have kidney cancer, it’s important to stamp out your habit. Smoking reduces the amount of oxygen in your blood—and if less oxygen reaches your surgical wound, you’re likely to heal more slowly. Quitting smoking (and other nicotine products, including e-cigarettes) before surgery will reduce your risk of complications.
Be Wary of Unproven Immune-Boosters…
There’s no end of so-called immune boosters for sale online, but, unfortunately, there’s no evidence that any of them deliver. “People always think that Western medicine doesn’t embrace alternative medicine,” says Mayo’s Dr. Leibovich. “The fact of the matter is, if we know for sure it works, we’re going to want people to do it. But if it’s sold on the internet, if it’s expensive and if it’s unregulated, then there’s also potential danger—and also, unfortunately, potential ecological concerns. I’ve seen people eat shark cartilage, and, you know, sharks need their cartilage.”
…But Embrace What Will Keep You Healthy
What has been shown to strengthen your immunity: Eating well, getting enough sleep, and being physically active. A 2016 study from researchers at the American Cancer Society and the National Cancer Institute, for instance, linked exercise with a lower risk of 13 cancers, including kidney cancer. Equally important: Getting regular exercise also seems to improve the prognosis for people who have cancer, Dr. Leibovich says. “I don’t know of a single solid malignancy where outcomes for people that exercise are not better than for people that don’t exercise.”