Week 24: Renal Cancer
1. What is the commonest pathology of renal cell cancers?
Clear cell. Different pathologies do exist but clear cell is by far the commonest.
2. Do you have to do a total nephrectomy, if the disease is localised?
No, surgeons can do partial nephrectomies, even laparoscopically to minimise complications, with successful outcomes in terms of local disease control. NICE have issued guidance on the appropriate occasions to use this sparing surgery.
3. How does SUNITINIB work – the targeted agent licenced for advanced renal call cancer?
SUNITINIB (trade name Sutent) is a multi tyrosine kinase inhibitor, which blocks the production of a protein called vascular endothelial growth factor, by inhibiting the phosphorylation of important proteins. By doing so it inhibits the formation of new blood vessels, which would normally support the tumour ( known as angiogenesis). This article published in the NEJM demonstrated the superiority of this targeted agent, when compared with the then standard of care for metastatic renal cell cancer, alpha interferon.
It became a drug of controversy, as it was initially turned down by NICE and SMC, as not cost effective, but it is now approved and available to patients
Renal cell cancer is one of the few tumors in which well-documented cases of spontaneous tumor regression in the absence of therapy exist, but this occurs very rarely and may not lead to long-term survival. The incidence of Renal cell cancer seems to be increasing, though it isn’t clear why. The exact cause of renal cell cancer has not been determined but Smoking and misuse of certain pain medicines probably can affect the risk of developing renal cell cancer.
Renal Cell Carcinoma Metastais
By: coolfx89 on September 8, 2011
at 12:21 pm