Treatment of renal cancer
Renal cancer is the commonest kidney tumour. This is usually an adenocarcinoma (80% of cases). It is also known as “clear cell carcinoma”. Other malignant kidney tumours are much less common: tubulopapillary or papillary renal cell carcinomas, chromophobe renal cell carcinoma, collecting duct carcinoma, etc.
Each type of tumour has its own very specific treatment.
Renal cancer tends to be asymptomatic for a long period (absence of clinical features). It may then be found fortuitously during an imaging investigation. Blood in the urine (haematuria) is the main warning sign.
It is rarely hereditary (2% of cases). Von Hippel-Lindau disease is one of the reported genetic abnormalities. Patients display the VHL gene, which is indirectly involved in the control of tumour vascularity.
Treatments
The mainstay of kidney cancer treatment is surgery. In situations where there is a high risk of relapse, additional immunotherapy may sometimes be offered. In the case of metastases, treatment is based on specific targeted therapies. These include anti-angiogenic treatments, which work against the development of tumour vasculature, and immunotherapies, which aim to induce an immune response in the body directed against the cancer.
Multidisciplinary consultation
The care (diagnosis and treatment) of renal cancer necessitates collaboration of doctors from various disciplines: chemotherapy, surgery, radiotherapy, imaging and histology. This is coordinated with the work of private doctors outside the Institute. Any major decision is taken in the multidisciplinary consultative committee meetings (RCP). In some instances, the patient is asked to attend the meeting.
Research on renal cancer
A number of Gustave Roussy research teams are engaged in collaborative research with the oncologists who manage renal cancer. The intention is to understand better the mechanisms of cancer development, how drugs work and the phenomenon of escape from cancer treatment. Thus, we may continue to improve the treatment we offer.
Clinical trials on renal cancer also facilitate access to novel agents such as the anti-angiogenics.