Elderly renal cell carcinoma

　　The etiology of renal cell carcinoma is not yet clear. The relative risk of renal cell carcinoma increases in smokers, and those exposed to cadmium industrial environments are more likely to develop renal cell carcinoma than the general population. Renal cell carcinoma has a familial predisposition, and the incidence of renal cell carcinoma varies by region, which may be related to urbanization, diet, and lifestyle.

　　If elderly renal cell carcinoma is not treated in a timely manner, complications such as the following may occur:

　　1. Anemia and fever

　　Anemia is one of the complications of renal cell carcinoma and is also a common one, generally believed to be caused by chronic bleeding. However, some patients have anemia without a history of hematuria, which may be related to tumor toxins or the destruction of renal tissue inhibiting the hematopoietic mechanism.

　　2. Hypertension

　　A small number of renal cell carcinoma patients may have hypertension symptoms, which can be treated with traditional Chinese medicine.

　　In the early stage of renal cell carcinoma, there may be no symptoms at all, and the patient's complaints and clinical manifestations are variable, making it easy to misdiagnose as other diseases. Often, it is accidentally discovered during physical examination or other examinations such as B-ultrasound or CT, and some people call it an incidental cancer. The common manifestations of renal cell carcinoma are as follows:

　　1. Hematuria

　　Hematuria is the most common symptom of renal cell carcinoma, and the occurrence of hematuria is only possible when the tumor invades the renal pelvis, so it is no longer an early symptom. Hematuria is often painless, intermittent, and gross hematuria, and when there is a lot of bleeding in renal cell carcinoma, it may be accompanied by renal colic, which is caused by blood clots passing through the ureter, and the degree of hematuria is not related to the size of the renal cell carcinoma.

　　2. Back pain

　　Back pain is mostly dull, caused by the growth and expansion of the renal capsule, and the pain is more severe and persistent when the tumor invades surrounding organs and lumbar muscles.

　　3. Mass

　　Before renal cell carcinoma reaches a relatively large size, the mass is difficult to detect, usually smooth in surface, hard in texture, non-tender, and can move with respiration.

　　4. Systemic symptoms

　　More than 1/3 of patients have systemic symptoms, fever is extremely common, mostly low fever, persistent or intermittent, usually caused by internal bleeding, necrosis, and pyrogens within the tumor mass. Blood pressure elevation is due to tumor compression of blood vessels, arteriovenous短路 within the tumor, and the production of renin by the tumor tissue.

　　The prevention of renal cell carcinoma should start early by changing one's own habits. The following are some common measures for the prevention of this disease:

　　1. The primary prevention of renal cell carcinoma should be not smoking or quitting smoking as soon as possible. Secondly, water is the best preventive 'medicine', and drinking more water can reduce the effective concentration of toxins, thereby reducing the chance of developing renal cell carcinoma.

　　2. Dietary and environmental factors are also related to the occurrence of renal cell carcinoma. Eat less high-fat and high-calorie foods, and maintain physical activity. Eating more fruits and vegetables such as bananas, carrots, and beets can significantly reduce the risk of cancer.

　　3. Patients with kidney cysts and other kidney diseases should be treated actively to prevent the further development of the disease and recover health as soon as possible.

　　4. Avoid radiation exposure and be cautious with hormones.

　　5. Develop good hygiene habits, do not eat moldy, rotten, or preserved food. It is advisable to have light food, and eat fish, eggs, and a small amount of lean meat in moderation.

　　6. Regularly participate in physical exercise, enhance physical fitness, and increase the body's immunity.

　　The clinical manifestations of renal cell carcinoma are numerous, and it is generally diagnosed by the following examinations:

　　First, laboratory examination

　　1. Accelerated erythrocyte sedimentation rate.

　　2. Caused by iron entering cancer cells, or an increase in red blood cells, hematocrit > 50%, Hb > 155g/L.

　　3. Abnormal liver function, such as elevated alkaline phosphatase levels.

　　4. Increased blood calcium levels, the cause is unknown.

　　5. Elevated renin levels.

　　6. Elevated blood cancer胚抗原(CEA).

　　Second, other auxiliary examinations

　　1. B-ultrasound examination: Low echo of renal cancer. If there is hemorrhage, necrosis, or cystic change in the tumor, the echo is uneven.

　　2. X-ray Film: The kidney shape is enlarged, the contour changes, and occasionally calcification.

　　3. IVP: Understand the function of the kidneys and the condition of the renal pelvis, ureter, and bladder for reference in treatment.

　　4. CT: The manifestation is a renal parenchymal mass. CT value > 20Hu, often 30-50Hu, slightly higher than normal renal parenchyma. Enhanced scanning, the tumor is significantly lower than the renal parenchyma. CT can also check the extent of tumor invasion, whether the veins are invaded, whether the lymph nodes are enlarged, whether the adjacent organs are invaded, and the condition of the renal pelvis, etc.

　　5. Other: MRI, renal arteriography, radioactive isotope examination, etc., can be used for the diagnosis of renal cancer.

　　Elderly patients with renal cancer should eat light and easy-to-digest foods, fresh vegetables, and moderate amounts of fruit, drink water appropriately, and pay attention to a balanced diet and nutrition. At the same time, pay attention to not overeating or eating unclean food. Avoid seafood, beef, mutton, spicy and irritating foods, alcohol, and all kinds of irritants should not be eaten.

　　There are many treatment methods for elderly renal cancer, and the following is a specific introduction:

　　1. Surgical Treatment

　　The treatment of renal cancer is mainly surgical resection, and radical nephrectomy should include the perirenal fascia and fat, kidney, adrenal gland, lymphatic tissue, and ureter.

　　2. Chemotherapy

　　The current chemotherapy regimen can only control symptoms and disease progression to a limited extent in the treatment of advanced renal cancer or recurrent renal cancer, and the reported efficacy rate is 4% to 28%. Monotherapy is often ineffective, and combination therapy is better than monotherapy.

　　3. Radiation Therapy

　　Radiation therapy as an adjuvant therapy is meaningful. Preoperative radiation therapy can reduce the tumor volume by more than 50%, thereby significantly reducing the number of inoperable tumors.

　　4. Immunotherapy

　　Adopt adoptive immunotherapy, that is, using immunological active preparations such as immune cells, antibodies, and other immunological response modulators for the treatment of malignant tumors. The combined treatment of LAK cells produced and amplified in vitro and interleukin-2 (IL-2) for malignant tumors is a form of adoptive immunotherapy. Interferon also has certain efficacy for renal cancer.