Kidney cancer treatment in Switzerland: diagnosis, therapy and surgery
- 12 January
- Diagnosis & Treatment
In recent years, kidney cancer treatment in Switzerland has become world-renowned for its high technological level and outstanding clinical results.
Kidney cancer is a rare disease in Switzerland.
It accounts for about 2% of all cancers in adults.
The most common is renal cell carcinoma (hypernephroma).
Rarer forms are nephroblastomas, sarcomas or lymphomas.
In most cases, cancer affects only one kidney.
The incidence in Switzerland is about 800 people per year.
Around two thirds of the patients are men, one third are women. The mean age of onset is 68 years in males and 71 in females.
Due to the abdominal ultrasound examination, which is frequently used today, kidney tumors are discovered much earlier than they were years ago. However, about 30% of patients already have advanced cancer at the time of diagnosis.
Kidney cancer symptoms and diagnosisThe exact causes of kidney cancer are not yet clear.
However, some risk factors are known that contribute significantly to the tumor development. These include smoking and obesity. In most cases, kidney cancer does not become noticeable until late stages. Early signs of the disease are rare. Kidney cancer is therefore often discovered by chance during an ultrasound examination of the abdomen for a completely different reason.
Often, symptoms only appear when the kidney tumor is already very large or has spread to lymph nodes or distant organs (the so-called secondary tumors or metastases). Most patients then demonstrate constitutional symptoms such as fatigue, fever, and loss of appetite.
An important symptom directly suggestive of kidney cancer is blood in urine (hematuria). Also, back pain, anemia and blood pressure fluctuations may occur.
If the tumor has spread to other organs, bone pain due to metastases is also possible.
In the process of diagnostics, Swiss oncologists ask the patient in detail about complaints and risk factors.
Imaging techniques such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are critically important.
Unfortunately, imaging techniques and physical examination, as well as the blood tests, excretory urography and urinalyses, do not always provide clear answers. Kidney biopsy is sometimes performed to get more information for further treatment.
To determine whether the tumor has spread to other organs, further investigations, including a special examination of the bones with radiolabeled substances (bone scintigraphy), chest X-ray and ultrasound examination of the liver are used.
Biopsy helps to choose the best treatment.
Although this trend is developing, in 2017, researchers at the University of Zurich created an animal model for studying genetic mutations in kidney tumors. In the future, it can help in the development and choosing immunotherapy.
Prognosis and possible complicationsThe earlier kidney cancer is detected and treated, the better the chances of recovery. In the course of the disease, it can lead to complications. Malignant kidney tumors tend to spread through the body's lymphatic system and blood vessels, forming metastases, especially in the lymph nodes, lungs and bones, and less commonly in the liver and brain. As a result, life-threatening complications of kidney cancer, such as pneumonia and blockage of blood vessels, can develop. Therefore, early and adequate treatment is very important.
Thanks to innovative Swiss surgical techniques and medications, complete cure in the early stages of kidney cancer is possible in almost 90% of cases. With the wide use of ultrasound in modern clinical practice, many cases of the disease can be caught early.
And that means: You can treat them in time!
Kidney cancer treatment in Switzerland: localized and metastatic stageAfter confirming the diagnosis, the doctors' efforts will be directed either towards the complete cure of the cancer or to slowing the growth of the tumor in order to prolong the patient’s life.
Lenvatinib, savolitinib, sunitinib and their combinations, vaccine immunotherapy – all of these options may someday be available to patients with advanced kidney cancer in Switzerland. If cancer is not treated, it can spread, metastasize, and kill.
Leading university hospitals in Switzerland are conducting promising clinical studies on the combinations of immunotherapy and other therapies. These studies offer hope for a significant increase in survival and even a future victory over metastatic kidney cancer.
We can wait only in very small, asymptomatic tumors and in cases where surgery is too dangerous for the patient. Each treatment has the goal of completely destroying the tumor and its offspring (metastases). When complete elimination is possible, such treatment is called curative therapy.
If this goal cannot be achieved, we can only try to control the tumor as long as possible while maintaining a good quality of life.
Treatments for localized kidney cancerSurgical removal (nephrectomy) is the only way to completely cure kidney cancer. The kidney can be accessed in different ways: via laparotomy or using the keyhole technique (laparoscopy). Whenever possible, Swiss surgeons try to remove the tumor so that the affected kidney is preserved (partial kidney resection). If the tumor is too large or it is located centrally in the kidney, the entire organ must be removed.
The remaining kidney usually takes on all the vital functions.
Nephrectomy in Switzerland is best performed in special centers for visceral surgery, which have extensive experience in such operations. Enhanced recovery programs after nephrectomy are also available in local cancer rehabilitation centers and hospitals.
If there are metastasesIf the tumor already has metastases in other organs at the time of diagnosis, it usually still makes sense to remove the affected kidney, as this can prolong patient life. In addition, this surgery can prevent bleeding, infection and pain, thus improving the quality of life. European scientists have studied whether cytostatics can be useful for kidney tumors. These drugs interfere with cell division, slowing the growth and spread of malignant neoplasms.
Since 2006, new drug therapies, the so-called tyrosine kinase inhibitors, have been successfully used for metastatic kidney cancer treatment in Switzerland. Today, these targeted agents along with immunotherapy offer more hope than traditional cytotoxic drugs.
© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator