Treating metastatic kidney cancer

> I am 70 years old, and I have cancer in the right kidney. After chemotherapy, the cancer has spread to the liver and lungs. The doctors decided on a kind of treatment. They called it “immunotherapy”, and in it they took samples of cancer cells from the kidneys, with the aim of producing a treatment that attacked the cancer cells. And they started treatment, but it has side effects. What do you recommend?
R.H. e-mail

This is a summary of your questions, as you described. and start; Let’s clarify the following points:
Kidney cell carcinoma is cancer that begins in the kidneys. In adults, it is the most common type of kidney cancer, compared to other cell carcinomas of the kidney.
Kidney cancer signs and symptoms do not appear in its early stages. Over time, signs and symptoms of the disease may appear, such as blood in the urine, back or side pain, loss of appetite and weight, feeling tired, and possibly fever.
Advances in age, smoking, high blood pressure, kidney failure, and a family history of kidney cancer are some of the factors that raise the odds of developing kidney cancer.
Diagnosis of kidney cancer includes blood tests, radiological examinations, and taking a small sample of cells (biopsy) from the suspected area of ​​the kidney.
According to several data, the “severity” of cancer is classified into “stages”. In the first stage, the cancer is limited to the kidneys only, while in the fourth stage, the cancer has spread to other areas of the body, such as the liver and lungs.
The treatment plan recommended by the doctor depends on the type of cancer, its stage, and the general health of the patient.
– Treatment of kidney cancer usually begins with surgery to remove only the mass if possible, while preserving as much as possible the normal functions of the kidneys.
– In some cases of kidney cancer, which is small in size, or in patients with other health problems that make surgery risky, therapeutic management may be done using non-surgical, percutaneous and imaging-guided therapies, such as heat (heating and burning of cells) and cold (freezing ).
– If the cancer has spread outside the kidney, additional treatments are recommended, according to the assessment of the patient’s general health level, the type of kidney cancer he has, the extent of the cancer, and the treatment options preferred by the patient himself.
Kidney cancer is likely to come back after initial treatment, and it may spread to other parts of the body.
– The doctor may resort to surgery again to remove the cancerous tumor from the kidney, or other surrounding areas, if it is limited to areas around the kidney. Radiation therapy may also sometimes be used to control or reduce symptoms of kidney cancer that has spread to other areas of the body, such as the bones and brain.
– In addition to this; There are several categories of advanced therapies for cases in which cancer begins in the kidney and then spreads to other areas of the body.
The medical staff treating the patient has a lot of information and has a direct and clear evaluation of his condition, and sets the appropriate and most feasible treatment plan protocol to overcome his pathological condition. At the same time, he follows up on the progression of the disease, and any expected side effects, and puts in place ways to overcome or mitigate them.
With regard to what was mentioned in your questions, you mentioned that you were treated with “chemotherapy”. Kidney cancer cells usually do not respond well to chemotherapy. But chemotherapy may be used after kidney cancer has spread, rather than from the beginning. She stated that it was not helpful.
A silver lining that some medical researchers point out is that the cellular properties of metastatic kidney cancer cells, which make kidney tumors resistant to chemotherapy, also make them more responsive to newer treatment options, including “targeted therapy” and “immunotherapy.”
And “targeted drugs” are so named because they target cancer cells only, and not normal cells. This is why these “targeted drugs” are different from chemotherapy drugs.
Targeted drug therapies focus on specific abnormal changes that are found only within cancer cells, but not in other healthy cells. By blocking these abnormal changes, targeted drug therapies can kill cancer cells. The doctor may recommend that the cancer cells be tested (by taking a biopsy) to see which “target drugs” might be most effective in the patient himself.
And to clarify; Most of the “targeted drugs” used to treat kidney cancer work by different mechanisms. Including: preventing the formation of blood vessels, that is, preventing the growth of new blood vessels that feed cancers, or preventing the formation of important proteins in cancer cells that help them grow and survive, or stopping the chemical signals that encourage the cancer cell to grow and divide, or activate the immune system To kill cancer cells, or to carry toxins to cancer cells to kill them, but not normal cells. And so some of these treatments target the immune side.
The most common side effects are nausea, diarrhea, changes in the skin or hair, mouth sores, general weakness, and low white and red blood cell counts. Other possible effects include high blood pressure, congestive heart failure, hemorrhage, low thyroid hormone levels, and sores on the hands and feet.
Treatment with “targeted drugs” is sometimes called “personalized therapy”; Because they are made to target specific changes or substances in a specific patient’s cancer cells. These goals can be different between patients, even when these people have the same type of cancer. So certain types of tumors may be tested for different targets, after a biopsy or surgery, and this can help find the most effective treatment for the same patient. Finding a specific treatment target can make matching patients to treatment more precise or personalized.
And “immunotherapy” depends on activating the immune system to fight cancer. Because the immune system; Responsible for disease resistance, may be unable to attack cancer cells; This is because cancer cells produce proteins that mask them from cells of the immune system. And “immunotherapy” works in some of its types, by interfering with that process and “unveiling” cancer cells. There are several categories of “immunotherapy”. Each of them acts on specific points of articulation in the proliferation of cancer cells.
There are also attempts to use “stem cells” in treating cases of spread of kidney cancer, but they are under research.