Kidney cancer is a disease that has a high cure rate if detected early, but often remains undetected for a long time and is identified by chance. What we know about the symptoms, causes and treatments of the cancer that had struck Michela Murgia.
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The writer, playwright, literary critic and activist Michela Murgia she passed away on August 10, 2023 at the age of only 51because of a metastatic kidney cancer which he had decided to don’t cure but to “buffer” through aimmunotherapy, to gain months of life. She had announced that she was ill in Mayemphasizing that she has advanced stage cancer (Stage IV) and with a poor prognosis. If the kidney tumor is small, confined to the organ, and is detected and treated early, statistics indicate a survival greater than 90 percent five years after diagnosis, as explained by the authoritative MSD Manuals for Healthcare Professionals. Nonetheless, it is one neoplasia which is most often discovered incidentally (60 percent of cases) during tests for other conditions. If the metastasis have already spread in the body the prognosis is much less favorable. Based on the report “The numbers of cancer in Italy 2022” Of Aiom-Airtumin our country every year about 12.600 new cases of kidney cancer, which predominantly affects men. Altogether it represents about 3 percent of all cancers diagnosed: just under 4 percent of those found in men and 2.5 percent of those found in women. In most cases, the diagnosis is made around the age of 70.
What is the kidney tumor that has affected Michela Murgia
Kidney cancer is an oncological disease that affects the organs responsible for blood filtration / purification and the expulsion of metabolic waste products through the urinary tract. They are two, symmetrical and located on the sides of the abdominal cavity. Kidney cancer usually originates from the uncontrolled proliferation from the kidney cells, as specified by the Italian Association for Cancer Research (AIRC). Most often those that develop aberrations in the DNA and trigger the tumor mass are the cells that line the inner wall of the renal tubulesthe longest structures of the nephrony, the functional units of the kidneys responsible for modifying the composition of the fluid filtered by the glomerulus (another component of the kidney) which is transformed into urine. Sometimes, as indicated by the AIRC, it is the cells of the capsule that covers the kidneys that trigger cancer.
The MSD Manuals specialists point out that nearly all kidney cancers are carcinomas and that “most solid tumors of the kidney are malignant,” while “fluid-filled growths (cysts) are generally not.” The AIRC indicates that the most common forms are the clear cell carcinoma – up to 80 percent of cases – , the papillary renal cell carcinoma (15 percent) and the carcinoma cromofobo (5 percent). Kidney cancer is rarely multiple or affects both organs (2 percent of cases). Another type of kidney cancer called Wilms tumor is more common in children nefroblastoma.
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Symptoms of the disease
The AIRC highlights that the kidney tumor is “usually asymptomaticup to the advanced stage. This is one of the reasons why it is often diagnosed by chance during other checkups. THE symptoms there are three main ones: blood in urine (hematuria); pain in the lumbar o al flank, between the hip and ribs; And palpable mass (lump or swelling) in the abdomen, although “kidney cancer is rarely found on palpation,” explains the MSD Manuals. As regards the presence of blood in the urine, the experts point out that sometimes it can be so modest “that it can only be detected under a microscope”, while in other cases “the urine can be visibly red”. Among other possible symptoms indicated by the Humanitas Institute include unexplained weight loss; high pressure; fatigue; fever; night sweats; varicocele; loss of appetite and bone pain in case of spread of bone metastases.
Who suffers from kidney cancer
As indicated, kidney cancer accounts for approximately 3 percent of all diagnosed cancers and predominantly affects men. Of the 12,600 diagnoses made in one year in Italy, 7.800 pertain to men and 4.800 women, according to the report “The numbers of cancer 2022”. Most cases of renal cell carcinoma involve people aged between 65 and 74 years (peak incidence around 70 years). Like most cancers, the risk of developing them increases with age. Deaths in Italy from kidney cancer are approximately 3,400 each year, of which 2,100 men and 1,300 women. Overall, cancer is responsible for about 1.5 percent of total cancer deaths in men and just under 1 percent in women.
The causes of renal cell carcinoma
Although it is not possible to prevent kidney cancer, highlights the AIRC, there are significant risk factors able to unleash it. The main one is the smoking habit (twice the probability of getting sick compared to non-smokers), but also obesity e hypertension they play a significant role in increasing the risk of getting sick. The Humanitas Institute indicates that other risk factors include lifestyle, the presence of chronic pathologies (such as diabetes) and also occupational exposure to toxic chemicals, such asasbestos and the cadmium. The MSD Manuals indicate that among the substances capable of triggering the pathology there are also those used for leather tanning eh petroleum products.
Other people at risk are those undergoing dialysis and develop the cystic kidney disease, as well as some patients with genetic conditions, such as “von Hippel–Lindau syndrome and tuberous sclerosis complex,” the MSD Manuals experts point out. “Since there are no effectively effective primary prevention strategies, the advice is to reduce risk factors as much as possible, therefore stop smoking, reduce body weight in case of overweight and lead a healthy and active lifestyle, following a balanced diet”, highlights the Humanitas Institute.
Metastatic kidney cancer
Like other neoplasms, kidney cancer can also go through various stages until it reaches the form evil e metastastica. As explained by the AIRC, in the stage I the tumor mass is confined to the kidney and has a diameter of less than 7 centimeters; in stage II it is always limited to the kidney, but the dimensions are greater than 7 centimeters; in stage III the cancer is already in a metastatic stage, but the diseased cells have not yet spread to organs far from the kidney; in stage IV, metastases of renal cell carcinoma have also reached distant organs. Since it is mainly metastases that determine cancer mortality, the more advanced states are naturally the most serious and difficult to treat, often resulting in terminal stage for the patient (though not always).
Kidney cancer diagnosis and treatment
In 60 percent of cases, kidney cancer is diagnosed incidentally during abdominal checks for other conditions, for example through a computed tomography (TC) of un’ultrasound. It is sometimes spotted during a surgery. The MRI it is typically used to confirm the diagnosis after a suspicion has arisen. Other checkups such as blood tests, bone scans and other scans may be requested to check for the presence and spread of metastases. If the tumor is confined to the kidney, survival five years after diagnosis is over 90 percent, but the average is around 70 percent, precisely because it is very often diagnosed late. “More than 50 percent of patients who receive an early diagnosis recover,” explains the AIRC. If the tumor is identified early, the risk of recurrence is reduced after treatmentor “less than 10 percent in the first 10 years after diagnosis”.
A remedial action can be the complete removal of the diseased kidney (radical nephrectomy), in case the cancer has not spread elsewhere. Indeed, one can live with only one of these organs. Among the other treatments provided are focal therapy (ablation of the tumor mass with heat or cold); chemotherapy e immunotherapy. In some cases, for example of very elderly patients, the active surveillance. In Michela Murgia’s case, the renal cell carcinoma was stage IV, this means with metastases spread to other organs such as the liver, lungs, bones, etc.