Saturday, January 14, 2006

cancer, kidney (malignant hypernephroma, renal adenocarcinoma)

Cancer of the kidney is seen in adults over the age of 40; however, the risk increases in adults over 60 years of age. Both sexes can be affected, but cancer of the kidney is twice as common in men as women. Cancer of the kidney is known as malignant hypernephroma or renal adenocarcinoma. Since these tumors are deeply seated in the body, they can become quite large before they cause symptoms. They are dangerous because they usually metastasize early but do not present distressing symptoms until late in the disease.
Symptoms of a malignant tumor may include weight loss, unexplained fever, malaise, and blood in the urine. Sometimes symptoms do not appear until the disease has metastasized.
Removal of the primary cancer is the preferred treatment if the tumor is localized or if there is severe pain, bleeding, or infection. Nephrectomy (removal of the kidney) has been done for metastatic disease but is discouraged because the mortality of the operation is greater than the likelihood of improvement. Radical nephrectomy is a hazardous procedure in the geriatric patient. When these tumors invade blood vessels and then metastasize to lung and bone, systemic therapy is of little benefit. Regression from radiation or chemotherapy only lasts several months.
An important part of treating patients with these tumors is managing a variety of syndromes. In addition, the patient should be kept as comfortable as possible with the use of analgesics and pain medication.
Scherer, J. C. Introductory Medical-Surgical Nursing, 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.

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