Kidney Cancer Kidney cancer is the third most common of the genitourinary system and represents approximately 3% of malignant diseases in adults. Kidney cancer is also known as hypernephroma or renal adenocarcinoma. The most frequent is clear cell kidney cancer, accounting for 85% of diagnosed tumours. Kidney cancer usually affects individuals between 50 and 70 years of age, being twice as frequent in men than in women. According to urologist in Noida, approximately 54% of the kidney tumours diagnosed today are confined to the kidney, 20% are locally advanced (affecting regional ganglia close to the kidney) and 25% already have metastases of the disease, mainly to the lungs, liver and bones. Some risk factors for kidney cancer are known, including:
6% to 10% of patients have flank pain, blood in the urine and a palpable abdominal mass. However, the most frequent form of diagnosis is incidental findings in routine examinations such as ultrasound of the abdomen. The definitive diagnosis of the disease is made by ultrasound and computed tomography of the abdomen. Tomography, in addition to making the diagnosis of the disease, is very useful in its staging (checking the extension to other organs) and in planning the most appropriate therapy, says the best urologist in Noida. Chest radiography is used to assess the involvement of the lungs, and in some cases, it can be used for a more detailed assessment. Nuclear magnetic resonance is rarely used in the evaluation of these tumours and is only performed in very specific situations. Preoperative renal biopsy is usually not performed, and is only necessary in exceptional situations, in order to differentiate between malignant and benign lesions, which would not require treatment, explains urologist in Ghaziabad. The most important prognostic factors in kidney cancer, which assist in therapeutic planning and disease follow-up, are:
Treatment Surgery is the only definitive curative kidney cancer treatment in Noida. Radical nephrectomy, ie the removal of the kidney en bloc with its linings, adrenal gland (only in large tumours or in the upper pole of the kidney) and regional lymph nodes in the traditional treatment for kidney tumours. However, with the evolution of diagnostic methods and the increasingly early findings of small renal masses, radical nephrectomy, in most cases, is no longer indicated, and partial nephrectomy should be chosen. This type of treatment consists of removing the tumour with a small safety margin, thus preserving the rest of the renal parenchyma, explains urologist in Greater Noida. The oncological results of partial surgery are similar to that of radical nephrectomy for selected cases of tumours smaller than 4 centimetres, less aggressive, and can even be applied to larger tumours as long as they are in a favourable anatomical situation. Laparoscopic radical nephrectomy is a new method that can be applied in kidney cancer treatment in Ghaziabad, offering the same cure rates as open surgery. Among the advantages is the fact that it is a less invasive method, with less morbidity and shorter hospital stay, in addition to the aesthetic advantage (small holes instead of the large scar from open surgery). It is possible to use laparoscopic surgery to perform partial nephrectomy, however in very selected cases, and with complication rates even higher than those of open surgery. It is also worth mentioning the treatment methods for kidney cancer that lead to tumour destruction through freezing (cryotherapy) or heat (radiofrequency) and the minimally invasive methods using needles, indicated in special situations, says the best urologist in Greater Noida. In patients with advanced disease, with distant metastases, there are forms of systemic treatment with immunotherapy (interferon or interleukin) or with the use of drugs that inhibit angiogenesis. These drugs, associated or not with surgical treatment, can lead to disease control and regression. According to a urologist in Delhi, the kidney tumour responds very poorly to chemotherapy treatments and radiation therapy. The only modalities that have proven objective responses are immunotherapy with interferon or interleukin with modest responses and high toxicity. More recently, angiogenesis inhibiting drugs have appeared, which have shown very promising response rates, being the main therapeutic option in patients with metastatic disease.
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WHAT IS PROSTATE CANCER? Prostate cancer is the most common non-skin cancer in India. It is estimated that approximately 1 in 6 men suffers from it, and it is more frequent at older ages. Even though prostate cancer can be slow-growing cancer, thousands of men die from prostate cancer each year. Internationally, prostate cancer is the second most common cause of cancer death in men. The marked variation in the rates of presentation of prostate cancer in different parts of the world suggests that certain genetic factors are present. Family predisposition also occurs. Environmental factors, especially diet, are also of importance, explains urologist in Noida. Currently, due to technological advances in medical practice, most prostate cancers are identified in patients who are asymptomatic. Diagnosis in such situations is based on the detection of abnormal levels of prostate-specific antigen (PSA) or on the findings at the time of digital rectal examination on physical examination. Causes There are many known causes of prostate cancer today. The marked variation in the rates of presentation of prostate cancer throughout the world suggests the participation of genetic factors within the probable causes of prostate cancer.
There are many symptoms of prostate cancer that a patient can present, however, in most cases, patients with prostate cancer remain asymptomatic. The diagnosis of prostate cancer in patients who are asymptomatic is carried out by research when carrying out control studies and observing that there are abnormalities in the results, specifically in the levels of the specific prostate antigen and on other occasions when performing Physical examination of the prostate by digital rectal examination may reveal abnormalities, explains the best urologist in Delhi. When the symptoms of prostate cancer appear and the appropriate studies are not available to make the diagnosis, they can be confused with some other disease, for example, increased urinary frequency, urinary urgency and decreased urine flow, can be symptoms of benign prostatic hypertrophy or hyperplasia. The symptoms of prostate cancer in advanced stages are manifested in the bones frequently, because prostate cancer has a great predilection for metastasizing to the bone. Some of the symptoms of advanced prostate cancer are as follows:
The best urologist in Ghaziabad recommends that the selection of prostate cancer treatment in Delhi should consider the following points:
Unfortunately, despite any prostate cancer treatment in Noida that may be used, it can rarely be cured in cases where there is already metastasis. The management of these cases usually includes therapy directly related to the relief of symptoms (palliative treatment for pain) and attempts to slow the progression of the disease. When we choose the best option as a prostate cancer treatment in Delhi, it is done to create long-term survival in less than 10% of patients. Most patients undergoing treatment for prostate cancer are cured either because the treatment was effective or because they had a non-fatal tumour and treatment was not entirely necessary. The rest of the patients are not cured, either because there were unsuspected micrometastases in them or because local therapy did not eradicate all the malignant cells. Watchful waiting as a treatment for prostate cancer is normally recommended by a urologist in Greater Noida for patients who are elderly and for those who have significant comorbidities that limit their life expectancy or a life expectancy of less than 10 years. It is possible and very likely that these patients will have a poorer quality of life if their cancer is treated than if it allows the disease to run its course. They have a high chance of dying from any of the added comorbidities, and treatment for prostate cancer could worsen your condition and thus hasten death, warns the best urologist in Greater Noida. As for radiation therapy, we have two possibilities:
The first-line treatment for prostate cancer in patients in whom metastasis has been identified is the suppression of male hormones, however, this may cause some side effects such as anaemia, erectile dysfunction, decreased libido. , fatigue, decreased muscle strength, decreased bone density, among others, says sexologist in Noida. What Are Kidney Stones? When we speak of the presence of kidney stones, we are referring to the disease known as kidney stones or nephrolithiasis, which is characterized by the presence of stones in the kidneys, however, in most cases, the stones in the kidney are related to the presence of stones in the ureters. Most of the kidney stones contain calcium. The pain that is caused by the presence of kidney stones is colic (renal colic) and is caused by dilation, stretching and spasm, due to acute ureteral obstruction, which explains urologist in Noida. What are the signs and symptoms of a kidney stone patient? The classic presentation for a patient with kidney stones is the sudden and intense appearance of acute renal colic, which originates in the flank (abdominal region) and moves down and forward, it is known that in 50% Nausea and vomiting are present in the cases of patients with kidney stones, says the best urologist in Noida. Patients with urinary stones may report pain, urinary infection or hematuria (presence of blood in the urine). Patients with small, non-obstructive stones may experience moderate and easily controlled symptoms and may even have no symptoms at all, says urologist in Greater Noida. The location and characteristics of pain that occurs in patients with kidney stones are given as follows:
The presence of kidney or ureter stones is not a guarantee that the patient does not have some other unrelated underlying medical problem causing gastrointestinal symptoms. How are kidney stones diagnosed? The diagnosis of nephrolithiasis is usually made based solely on the clinical symptoms that the patient presents; however, studies can be performed to corroborate the diagnosis, says urologist in Ghaziabad. The laboratory tests that are recommended by the best urologist in Ghaziabad are the following:
The kidney stone treatment in Noida used in patients is of several types, in the first instance, it is necessary to treat the patient's symptoms and eliminate them, so various medications are used, such as pain relievers, antiemetics, among others. In cases where the patient deserves surgery for kidney stone treatment in Ghaziabad, the options available will be explained to the patient. There are multiple surgeries to remove kidney stones, however, the application of each one depends on the characteristics of the stones and the patient. If you or any of your family members present or have presented symptoms related to kidney stones, do not hesitate to consult a urologist in Delhi to have a certain diagnosis and initiate appropriate kidney stone treatment in Greater Noida. Causes The most common causes of pyelonephritis are gram-negative aerobic bacteria, most commonly Escherichia coli. All organisms that cause acute cystitis can also cause acute pyelonephritis. Proteus species are particularly important because they produce an enzyme called urease, which causes urine to alkalinize and favours the formation of kidney stones (stones). Staphylococci can infect the kidney via the hematogenous route (by spreading from another outbreak to the bloodstream) and can cause renal abscesses, explains the best urologist in Noida. Symptoms The onset is sudden with chills and fever above 38.5 degrees C, pain in the kidney, general malaise, frequent urination (urination) and dysuria (urination on the urine). Often, nausea, vomiting and diarrhoea are associated. Untreated causes septic shock, most often fatal. Children may experience abdominal pain, states the urologist in Noida. Investigations Among the modifications of the laboratory tests are:
With the exception of leukocyte cylinders, bacteremia and flank pain, none of the clinical or laboratory features are specific for pyelonephritis, so it is important to exclude other causes of fever, back (etc.) pain. Urea and creatinine are usually within normal limits in uncomplicated pyelonephritis. Treatment Hospitalization is required if the patient is:
Recent data indicate that pregnant patients with a good general condition (who “look healthy”) can be treated in the outpatient setting, but this is not the standard approach, says the urologist in Greater Noida. This condition is treated empirically with:
According to the urologist in Ghaziabad empirical treatment is required until the results of culture and sensitivity to antibiotics are obtained. Gentamicin and fluoroquinolones are avoided in pregnant patients. Treatment is given intravenously for about 48 – 72 hours or more depending on the clinical response. Continue with oral antibiotics for another 2 – 6 weeks. Symptomatic medication (which relieves pain, fever and nausea) is also indicated. It ensures adequate hydration and maintenance of urinary flow with fluids administered orally or intravenously. If the patient does not have an acute disease, treated as outpatients for 10 days to 6 weeks with antibiotics. An effective therapeutic option is giving antibiotics intravenously or intramuscularly at the time of diagnosis and follow-up of the patient the next day. If necessary, an additional dose of antibiotics may be given for further examination if the patient’s condition warrants administration of doses higher than oral doses but does not require hospitalization. Good communication with the patient should be ensured in case of worsening of the condition. Continuous monitoring must be attempted. If the patient’s condition does not improve after 72 hours of adequate antimicrobial therapy, an infection superimposed on renal lithiasis is suspected(stones) or an obstruction in the urinary tract and is treated as quickly as possible to avoid complications. If the patient does not respond to antibiotics and the pathogen is known to be sensitive to current antibiotics, emphysematous pyelonephritis or abscess is suspected. Computed tomography will identify patients with these complications. In the few patients who have relapse after 2 weeks of therapy, a 6-week treatment is usually curative, suggests the urologist in Vaishali. To Remember! Empty cystourethrogram (VCUG) is considered after the resolution of the urinary tract infection in all patients with frequent relapses or unusual symptoms, says the urologist in Delhi. Urocultures should be restored 1 to 2 weeks after treatment in the following groups of patients:
Urocultures for subsequent monitoring are optional in the cases of the patients other than those listed above. |
AuthorDr Shailendra Goel is consultant urologist at Max Hospital, Noida. He is one of the leading urologist in Noida. He performs all type of uro-onco surgery including kidney cancer, kidney transplant in Delhi, Noida. Archives
November 2020
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