Cancer is currently the leading cause of many deaths in the world. Currently, several people are being diagnosed with cancer. Reasons as to why there is the rapid increase in cases of cancer are yet to be established, but some researchers speculate that this may be dietary related. Chemicals added to the food we eat may be the reason why people are developing cancer. Two characteristic features define a cancer: tissue invasion or metastasis and uncontrolled or unregulated growth. Uncontrolled growth with no invasion is known as benign neoplasms. In this case, the cancer does not spread out from one part of the body to another, however when there is uncontrolled growth with invasion, the cancer is said to be malignant and in this case, the cancerous cell have the ability to move from one part of the body to another. Metastatic cancer is classified to various groups based on the tissues or organs involved. For instance, cancer of the epithelial tissues is known as carcinomas; cancer of mesenchymal tissues is known as sarcomas and cancer arising from lymphoid cells is known as lymphomas ( Hsieh, Purdue, Signoretti, Swanton, Albiges, Schmidinger & Ficarra, 2017) . Cancer is a genetic condition that is associated with mutations in different genes that regulate the cell cycle like genes for cell proliferation, DNA repair, invasion, motility survival and angiogenesis. Cancer-causing gene mutations repeatedly stimulate signal transduction pathways resulting to abnormal cell multiplication and distresses of tissue specific differentiation programs. In the discussion we shall focus on the causes, how the disease disturbs the organs involved, symptoms and treatments of renal cell carcinoma.
Renal cell carcinoma as the name suggests is a carcinoma, therefore a cancer of the epithelial tissues. The condition is also known as renal or kidney cancer, hypernephroma or renal adenocarcinoma (Hsieh et al., 2017) . Kidneys are essential body organs, which are responsible in eliminating waste products from the body, at the same time maintaining the fluid balance within the body. In the kidneys, there exists tiny tubes (tubules), which are essential in filtering blood, excreting wastes and in making urine. Renal cell carcinoma arises when the cancerous cell begin growing uncontrollably in the linings of these tubules. The disease is highly metastatic and quickly spreads to the lungs and other surrounding organs.
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Causes of Renal Cell Carcinoma
The condition is most commonly found in men of ages between 50 and 70 years. The main risk factors for the condition include:
smoking
Obesity
Long term use of some medicines like pain pills
High blood pressure
Horseshoe kidney
Dialysis treatments
Polycystic kidney disease
Genetic inheritance, mostly the abnormal VHL gene, a tumor suppressor gene is passed from an affected parent to the child ( Fukawa, Shannon, Huang, Tan, Yao, Rozen & Teh, 2017) . These gene together with other factors can cause cell carcinoma. Meaning that persons with that gene are more at risk of developing the condition as opposed to those who have the normal gene.
The genetic disease Von Hippel-Lindau, which is characterized by tumors and cysts in various organs.
How Renal Cell Carcinoma Disturbs the Kidney
Renal cell carcinoma, causes the continued growth of the cells found in the tubules, which can hinder the process of eliminating waste products and formation of urine. In case, the cells spread to the lungs, they can disrupt the oxygen circulation process.
Symptoms of Renal Cell Carcinoma
Back pain
Abdominal pain and swelling
Blood in the urine
Weight loss
Pale skin
Excessive hair growth in females
Swelling of veins around the testicle
Flank pain
Vision problems
The Treatment of Renal Cell Carcinoma
Surgery
Surgery involves the removal of some parts of the kidney of even the entire kidney. The removal of a part of the kidney entails the partial nephrectomy. Here the part of the kidney that is suspected to have cancerous cells is removed to stop the process of metastasis. The process is effective when the disease is detected earlier, normally during the first and second stages of renal cell carcinoma. When the entire kidney is removed, it means that the cancerous cells has spread over the entire kidney and therefore, the only suitable option in that situation is to remove the entire kidney. In some cases if the disease has spread to other neighboring tissues, more extensive surgery may be applied to remove lymph nodes, surrounding tissues and the adrenal gland (radical nephrectomy) ( Motzer, Escudier & Choueiri, 2016) . In case both kidneys are removed, the patient must receive a transplant so as to ensure that they do not lose their lives.
Radiation Therapy
The process involves the use of high energy x-rays to destroy or kill cancerous cells found in the kidney. The process can either be accomplished through the use of X-ray machines, where the radiations are issued externally or through the use of seeds or wires to place radiations internally.
Chemotherapy
This involves the use of drugs to destroy and kill cancerous cells leading to renal cell carcinoma ( Motzer, Escudier & Choueiri, 2016) . The drugs can either be given parenteral or orally depending on the type of medication chosen by the healthcare provider or oncologist. After these drugs have been taken they get absorbed into the blood stream and can reach out to the target cancerous cells, where through various mechanisms they can induce apoptosis, resulting to cell death. For example, Imatinib and Sunitinib drugs used in treating different cancers, targets specific genes such as c-Kit, Bcr-Abl, c- Abl and VEGFR-2. These two drugs (Imatinib and Sunitinib) blocks Adenosine triphosphate (ATP) binding to tyrosine kinase active site and they also inhibit VEGFR (Vesicular endothelial growth factor receptor) in renal cell carcinoma ( Ravaud, Motzer, Pandha, George, Pantuck, Patel & Carteni, 2016) . The VEGFRs are important tyrosine kinase receptors found on cancerous cells that allow the binding of VEGF (Vesicular endothelial growth factor), which is essential in initiating a signal cascade that results to angiogenesis (the formation and development of new blood vessels). The process of angiogenesis allows cancerous cells to maintain constant blood supply and hence promoting continued cell division, which results to unregulated cell growth.
Biologic Therapy
This therapy involves the use of body immune cells to attack cancerous cells. The therapy is also known as immunotherapy. Mostly, the immunoglobulins or antibodies are isolated from the serum and are reintroduced into the body where they bind to cancerous cells bearing abnormal cell surface proteins such the major histocompatibility complex. The process cancerous- antibody complex can activate the phagocytic cells such as the neutrophils, macrophages and natural killer cells, which destroy the cancerous cells in the kidney.
Targeted Therapy
The process allows the targeted delivery of drugs to cancerous cells found in the kidney. The most used antibodies in this particular case are the monoclonal antibodies, which are specific antibodies targeting a single target. These antibodies are usually bound to a specific drug that they help in delivering to the specific target cancerous cells. The therapy is very effective since it minimizes changes of destroying other neighboring cells, which can also make them cancerous ( Motzer, Escudier & Choueiri, 2016) .
Future Possible Treatment Techniques
Gene Therapy
Given the resistance displayed by renal cell carcinoma especially with the use of chemotherapy and radiation therapy, the use of gene therapy is currently considered as the most suitable process after surgery. This technique employs the use of genes to treat cancerous cells. Mutations results due various ways: replacement of a gene, insertion of a new gene, deletion of a gene or even amplification of a gene. Any of these can result to tumor cells. The use of gene therapy, therefore, may allow the application of various approaches, which are currently under study like
Replacement of a mutated gene with a health gene. For instance, in renal carcinoma if gene A responsible for DNA repair is abnormal, it can be replaced by another normal gene A1, which can aid in restoring DNA repair process and therefore helping in treating cancerous cells.
Inactivating abnormal or mutated genes. For instance, if gene B, responsible for cell proliferation remains activated it means that the cell will be in the on state at all times and that results to abnormal growth. Using another gene C to inactivate that gene can help treat renal cell carcinoma and other types of cancer.
Conclusion
As discussed above, cancer is a genetic condition, which can be caused by many factors. Renal cell carcinoma is a kidney cancer that rapidly spreads to other tissues such as the lungs and other tissues, therefore making it a highly dangerous condition. With the various symptoms such as back pain, blood in urine and abdominal pain, which can easily be confused with other conditions such as Leishmaniasis, Amoebiasis and Giardia, persons who experience such symptoms should ignore visiting an oncologist. In fact, men aged between 50 and 70 years should frequently visit the oncologists for regular checkups to avoid developing the condition. That way if one is found to be having the condition earlier enough, they can be able to receive relevant medications that can help eliminate the cancerous cells and therefore, restoring their normal health.
References
Fukawa, T., Shannon, N., Huang, D., Tan, J., Yao, X., Rozen, S. G., ... & Teh, B. T. (2017). Molecular Genetics of Renal Cell Carcinoma. In Renal Cell Carcinoma (pp. 83-103). Springer Japan.
Hsieh, J. J., Purdue, M. P., Signoretti, S., Swanton, C., Albiges, L., Schmidinger, M., ... & Ficarra, V. (2017). Renal cell carcinoma. Nature Reviews Disease Primers , 3 , 17009.
Ravaud, A., Motzer, R. J., Pandha, H. S., George, D. J., Pantuck, A. J., Patel, A., ... & Carteni, G. (2016). Adjuvant sunitinib in high-risk renal-cell carcinoma after nephrectomy. New England Journal of Medicine , 375 (23), 2246-2254.
Motzer, R. J., Escudier, B., & Choueiri, T. K. (2016). Treatment of Advanced Renal-Cell Carcinoma. The New England journal of medicine , 374 (9), 889.
