Tuesday, August 9, 2022

Immunotherapy has positively changed the paradigm of kidney cancer treatment, Dr. Acosta

Tumors are usually detected in advanced stages due to the absence of symptoms or warning signs.

Dr. Miraelis Acosta, a hematologist oncologist at the Hospital Auxilio Mutuo. Photo: Medicine and Public Health Magazine.

In general, options treatment for cancer patients The condition of the kidney will depend on what stage the tumor is in, its size, and if it has spread to another. area of ​​human body, according to Dr. Miraelis Acosta, a hematologist oncologist at Hospital Auxilio Mutuoin the early stages, usually remedy It is surgical, but in advanced stages systemic treatments are applied.

In this regard, he highlighted immunotherapy as an option that has provided new options for kidney cancer patients advanced, “immunotherapy has changed the kidney cancer treatment paradigm for the better, bringing options especially to patients in stage 4, where it has been observed that this tumor is not chemo-sensitive, that this response Neither does traditional chemotherapy,” he said.

Experts say that Immunotherapy provides a better response include against tumors and in combination with oral agents that are inhibitors of angiogenesis. AndThese treatments mostly target a specific mechanism of tumor development. And when combined with this type of treatment, experts have shown its effectiveness in patients.

Despite this, he also indicated that kidney cancer is a tumor that is considered “somewhat indolent” because it grows slowly, is usually undetectable in its early stages and depends on the type of tumor, its stage. and depending on the location, it remedy, “With tumors less than 2 centimeters in the early stages, we can include observation with images in some patients and based on that the surgical option is taken,” he said.

In stage tumor patients 1 and 2, the most common option is surgery, and there Dr. Acosta emphasizes that they take into account the characteristics of the tests performed and whether the patient is suitable for the procedure, “if it is going to be such a surgery.” the largest part of the kidney that can be saved, we try to redirect it to the urologists and they determine what type of surgery it is, a complete nephrectomy or some partial and Basically, in the early stages, surgery is going to be the primary treatment.Based on the characteristics of that pathology, a Follow-up images and laboratories To see that the patient does not have a recurrence.

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On the other hand, in advanced stages, ie beyond 3, where specialists observe the presence of tumor-associated lymph nodes, they decide alternative treatment options Through prevention, “we try to avoid recurrence with systemic treatments, but this is for more advanced stages, 3 onwards. Also, in stages 1 and 2. remedy It’s surgical” said the oncologist.

The incidence of this type of cancer is increasing, however, for Dr. Mirlis, the mortality rate has decreased, which indicates that Advances in drug screening tools, surgical procedures and systemic therapiesMainly in advanced stage patients.

Certainly, immunotherapy has become a viable option for patients, however, experts emphasize that the choice of therapy is based on the patient, their characteristics, and specific risks. “Immunotherapy is already listed as a first-line option in our guidelines because kidney cancer is a fairly immunogenic tumor,” he said.

In her experience with this type of treatment, she has highlighted that they have improved patients’ quality of life, “It is good to see how one can give a patient a stage 4 option that will help her to live life.” and at the same time delivering a treatment that is working to control the disease.

Kidney cancer is not a very common type compared to other tumors present. According to the expert Makes up 3.8% of total cancers They diagnose on a daily basis.

Its risk factors are associated with environmental exposure or exposure, being obesity, high blood pressure and smoking, in addition to some genetic factors. For the specialist, it is important to determine whether there are genetic mutations in a patient’s family, “Some familial mutations may predispose to the development of primary kidney cancer and this is something that we can investigate once a diagnosis is made. “

Because of the foregoing, it is emphasized that they have shown that Certain genetic syndromes may predispose to an increased risk of developing this type of cancer.So you have to recognize it in time.

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“There are genetic syndromes such as von Hippel-Lindau syndrome (VHL) that predispose to the development of primary kidney cancer and it is an autosomal dominant genetic syndrome where you will have a first-line relative such as a mother, father or sibling who may have had a kidney disease. Has or had cancer,” he said.

Diagnosis is usually not made early, as patients do not present symptoms of suffering from it and when they show discomfort such as a obvious flank mass, pain, and blood in the urineThe tumor is in an advanced stage in most cases.

Dr. Acosta explained, “We don’t have a screening test to diagnose kidney cancer early, because it’s not possible to display and photograph it to detect it.”

“Incidentally, sometimes early-stage kidney tumors have been found when imaging for another medical condition or another symptom and this is the best-case scenario because the patient has no symptoms, and If you have a fairly small mass, it can be operated on and has a better chance of recovery.“He highlighted.

The diagnosis process and classification of the tumor is done with an image first described by the radiologist and is classified according to staging based on TNM.

“We establish the size and then surgically we identify whether nodules are involved or not, if the vessels surrounding the tumor are involved, if the renal gland above the kidney is involved, all this gives us a stage to establish. If there is a lesion in any other organ outside the kidney, in bone or liver and in that case we know it is stage 4 because it is metastatic,” the expert said.

Finally, the role of primary care physicians in diagnosing these tumors is essential, as patients can describe their symptoms to them or, if they have a family history of these conditions, to proceed with genetic studies and tests that allow for early detection. and allow the possibilities to increase. To be okay

View the full program here.

Nation World News Desk
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