Precautions for pregnant women with kidney cancer

What should I do if I get kidney cancer while trying to conceive? What precautions should I take? If you get kidney cancer while trying to conceive, you should seek timely treatment and stop trying to conceive. You must consider whether to continue trying to conceive after you have completely recovered based on your physical condition. Many people think that as long as a disease has the word "cancer" in it, it is impossible to cure it. Therefore, they become discouraged and stop seeking treatment, thinking that they will just live the rest of their lives in a passive manner. This idea is really wrong.

Treatment principles: For patients with localized or locally progressive (early or mid-stage) renal cancer, surgery is the main treatment method, while for metastatic renal cancer (late stage), comprehensive treatment with internal medicine as the main method should be adopted.

Surgery is usually the first choice for kidney cancer treatment and is currently recognized as a means of curing kidney cancer. Nephron-sparing surgery (surgery to preserve the kidney) or radical nephrectomy can be used for patients with early-stage kidney cancer. These operations can be performed laparoscopically or by traditional open surgery. Radical nephrectomy is usually used for patients with intermediate and stage kidney cancer, and this type of surgery is usually performed by open surgery.

Energy ablation (radiofrequency ablation, cryoablation, high-intensity focused ultrasound) can be used for the elderly, frail or patients with small renal cancer (tumor diameter less than or equal to 4 cm) who have contraindications to surgery. The tumor recurrence rate after this type of treatment is slightly higher than that of nephron-sparing surgery, and the overall therapeutic effect is similar to that of nephron-sparing surgery.

For patients with renal cancer who cannot tolerate surgical treatment, renal artery embolization can relieve the symptoms of hematuria through interventional treatment, which is a palliative treatment method.

Currently, there is no recommended adjuvant treatment option for patients with early and intermediate renal cancer after surgery to effectively prevent recurrence or metastasis.

Advanced renal cancer should be treated with a comprehensive approach with medical treatment as the main approach. Surgical resection of the affected kidney can help identify the type of renal cancer and reduce the tumor burden, and can improve the effectiveness of immunotherapy (such as interferon-α) or targeted therapy.

Medium- and high-dose interferon-α (6 MIU to 9 MIU) or high-dose interleukin-2 are effective for patients with low- and intermediate-risk metastatic clear cell renal cell carcinoma, with an effective rate of about 15%. In December 2005, the U.S. FDA approved and recommended eight targeted regimens, including sorafenib, sunitinib, temsirolimus, bevacizumab combined with IFN-α, everolimus, pazopanib, axitinib, and erlotinib, for the first-line or second-line treatment of patients with metastatic renal cancer.

Prognosis and follow-up

The 5-year survival rates of patients with stage I, II, III, and IV renal cancer after treatment can reach 92%, 86%, 64%, and 23%, respectively.

The main purpose of follow-up after treatment is to check for recurrence, metastasis and new tumors. Patients who undergo nephron-sparing surgery should undergo abdominal CT scans 4 to 6 weeks after surgery so that doctors can understand the changes in kidney morphology after surgery and use them for comparison in future reviews. The content of follow-up includes:

1. Medical history inquiry;

2. Physical examination;

3. Routine blood tests and blood biochemical examinations, such as liver and kidney function and abnormal blood biochemical indicators in preoperative examinations;

4. Chest X-ray or chest CT scan;

5. Abdominal ultrasound and/or abdominal CT scan.

Follow-up period for each stage of renal cancer: Patients with stage I and II renal cancer should be followed up every 3 to 6 months after surgery for 3 consecutive years, and then once a year. Patients with stage III and IV renal cancer should be followed up every 3 months after treatment for 2 consecutive years, every 6 months in the third year, and then once a year.

Kidney cancer is indeed a serious disease. Not only is the condition serious, but the cost of treatment is also huge. However, it does not mean that kidney cancer patients will die. I hope that kidney cancer patients will not be too pessimistic and should face treatment positively. The above are some effective methods introduced by experts. I believe that as long as you don’t give up, there will be a chance of cure.