Drugs for kidney cancer in the elderly

Kidney cancer, also known as renal cell carcinoma, renal adenocarcinoma, clear cell carcinoma, etc., is the most common malignant tumor of the kidney parenchyma. The incidence of kidney cancer in men is several times higher than that in women. Due to the increase in average life expectancy and the progress of medical imaging, the incidence of kidney cancer has increased compared to before. The number of kidney cancers that are accidentally discovered during physical examinations without obvious clinical symptoms is increasing, and can reach a minority.

The treatment of renal cancer is mainly surgical resection. Radical nephrectomy should include the perirenal fascia as well as fat, kidneys, adrenal glands, lymphatic tissue and ureters.

Kidney cancer is a multi-vascular tumor with large collateral veins. It is easy to bleed during surgery and difficult to control. Therefore, renal artery embolization is selected before surgery for larger tumors to reduce bleeding and facilitate surgery. However, embolization should not be used routinely because of severe pain, intestinal paralysis, fever, etc. after surgery. If a solitary kidney cancer does not spread, partial nephrectomy or tumor resection can be performed under local hypothermia, and the prognosis is good. Radiotherapy before kidney cancer surgery has no significant effect on the 5-year survival rate.

Chemotherapy: Current chemotherapy regimens can only control symptoms and disease progression to a limited extent in the treatment of advanced or recurrent renal cancer, with a reported efficacy rate of one in four. Single drugs are often ineffective, and multi-drug treatment is superior to single-drug treatment.

Radiotherapy is meaningful as an adjuvant therapy. Preoperative radiotherapy can shrink the tumor by more than half, thus significantly reducing the number of inoperable tumors.

The mass in the waist or abdomen gradually increases in size, the back pain becomes more severe, the hematuria worsens, the appetite is poor, the complexion is pale and dull, the urine is red and the stool is hard, there are ecchymoses on the edges and tip of the tongue, the tongue coating is thin, and the pulse is thin and wiry.

Treatment method: Promote blood circulation, resolve stagnation, remove blood stasis and relieve pain.

Prescription: Dahuangchanchong Pills (from Synopsis of the Golden Chamber) with modifications.

Rhubarb, leeches, itch worms, Curcuma zedoaria, Rehmannia glutinosa, red ginseng, astragalus, bead, red peony root.

For patients with severe pain, add purslane, curcuma, frankincense, and myrrh. For patients with heavy bleeding, add fried pollen, donkey-hide gelatin, and Panax notoginseng powder.

Kidney Yang deficiency syndrome. Obvious lumps in the waist, little blood in urine, back pain, cold limbs, clear urine and loose stools, pale tongue with thin coating, deep and fine pulse. Warming Yang and tonifying the kidney, removing blood stasis and detoxifying.

The prognosis of kidney cancer is sometimes difficult to estimate. Generally, the 5-year survival rate of kidney cancer treated with nephrectomy is very low. Tumor size has no effect on prognosis. Patients with local lymph node metastasis have a poor prognosis. From a histological point of view, the degree of cell differentiation can affect the survival rate. Pure clear cell carcinoma has a better prognosis, granular cell carcinoma or mixed type is slightly worse, and spindle cell carcinoma has the worst prognosis.