Chromophobe Renal Cell Carcinoma: Causes and Symptoms

What Is Chromophobe Renal Cell Carcinoma?

If you are dealing with chromophobe renal cell carcinoma, you are looking at a specific type of kidney cancer. It is actually the third most common subtype of renal cell carcinoma.

In the 1980s, scientists first identified this specific cancer type. The name "chromophobe" just describes how these cancer cells look under a microscope when your microbiologist uses special dyes on them.

This cancer starts in the tubes inside your kidney. Tubes that typically help your body get rid of waste from your blood and make urine. When your doctor finds chromophobe RCC, it is usually still hanging out in the kidney where it started. It does not often spread to other parts of your body.

What Is the Staging of Chromophobe Renal Cell Carcinoma?

When your doctor talks about cancer stages, they are using a numbering system from 0 to 4 to help you understand how far your tumor has progressed.

By staging the tumor, your doctor will assess the size of your tumor, determine if it has spread to nearby tissues, check if it has reached distant lymph nodes, and evaluate if it has metastasized to other organs in your body.

• Stage 1:

It means you have a tumor that is no bigger than 2.76 inches, and it is only affecting one of your kidneys.

• Stage 2:

Your tumor is larger than 2.76 inches. The cancer might have spread into the tissue right around your kidney or into the blood vessels that feed your kidney, but it has not reached your lymph nodes or other organs yet.

• Stage 3:

Your tumors can be any size, and the cancer may have moved beyond your kidneys to nearby lymph nodes. But it is still contained within something called Gerota's fascia (a protective wrapper of tough fibrous tissue that surrounds your kidneys).

• Stage 4:

It is when things get more serious. At this point, your cancer has broken through that protective Gerota's fascia and might be growing into your adrenal gland (that little gland on top of your kidney). It may or may not have reached nearby lymph nodes and has not spread to the lymph nodes far away from your kidney.

What Are the Causes of Chromophobe Renal Cell Carcinoma?

Doctors are not entirely sure about the cause of CRC. But, just like with other cancers, it happens when your cells' genetic instructions get scrambled, and they start multiplying.

There is a connection to this rare genetic condition called Birt-Hogg-Dubé syndrome. If you have this syndrome, you will develop harmless skin bumps, but it also puts you at higher risk for kidney cancer, especially the chromophobe type, and it can show up earlier than usual.

Scientists have discovered that chromophobe renal cell carcinoma is associated with mutations in specific genes, TERT (telomerase reverse transcriptase), TP53 (tumor protein), and PTEN (phosphatase and tensin homolog) genes. When these genes mutate, they can set the stage for the development of this type of kidney cancer.

Risk Factors:

What puts you at higher risk for chromophobe renal cell carcinoma? There are a few things that can hike your risk.

• If you are a smoker, that is one factor.

• Your weight matters too.

• If you have high blood pressure, you are at a higher risk.

• And if kidney cancer runs in your family, you might be more likely to develop it yourself.

• While most people get diagnosed with kidney cancer around age 64, chromophobe renal cell carcinoma tends to show up earlier. You will typically see it in people between 40 and 50 years old.

• Women actually get this type more often than men do.

What Are the Symptoms of Chromophobe Renal Cell Carcinoma?

Many people do not experience any symptoms when they are diagnosed. But when symptoms do show up, you might notice:

• Pain in your lower back (some call this "flank pain").

• Blood in your urine.

Now, if the cancer has spread to other parts of your body (that is, metastatic cancer), you will likely experience different symptoms.

• You might notice you are losing weight without trying.

• Some people get persistent seizures or run high fevers.

• You could have sweating episodes at night, develop a cough, or feel pain in your bones.

• There could be a mass you can feel in your side or back.

• You may also experience fatigue, night sweats, kidney issues, or swelling in your legs and feet.

How Is Chromophobe Renal Cell Carcinoma Diagnosed?

Your doctor can find out about your medical history. They will ask you about the symptoms you are experiencing right now and any health issues you have had in the past. When they combine this information with a physical exam, it might point them toward kidney cancer as a possibility.

Now, while these medical tests cannot give you a definite answer, your doctor will rule out other reasons for your symptoms by doing some tests:

1. Urinalysis:

Urinalysis is when they check your urine sample to see if there is any blood or other unusual things going on.

2. Creatinine Test:

This one checks how well your kidneys are working.

3. Alkaline Phosphatase Test:

This enzyme test can show if there is any unusual bone activity happening.

4. Imaging Tests:

These are important for figuring out what is going on. They can help your doctor identify any abnormalities in your kidneys. You might have one or more of these imaging tests:

• CT (Computed Tomography) Scan:

This is the imaging method used to examine your kidneys.

• Intravenous Pyelogram:

It is an X-ray that uses a special dye to provide a clearer view of your urinary system.

• Kidney Ultrasound:

A simple scan of your kidneys.

• MRI (Magnetic Resonance Imaging):

Another way to get detailed images of your kidneys.

When you put all these tests together, your doctors can get a good idea of whether you have kidney cancer. However, to confirm this, your doctor needs to examine a tissue sample from the suspicious area under a microscope.

Sometimes, based on all the other signs, your doctor might be confident it is kidney cancer. In that case, they might go ahead and remove your kidney (or just part of it) through surgery. After surgery, a sample of the tissue will be sent to the lab. A pathologist will examine the cells to figure out if it is cancer and what type it is. This is when you might get a specific diagnosis like chromophobe RCC.

Sometimes, if your doctors are not quite sure whether it is cancer, you might have a kidney biopsy before any surgery, in which a sample of your tissue is taken and sent to the laboratory, where a specialist can confirm whether you have chromophobe RCC or not.

How Is Chromophobe Renal Cell Carcinoma Treated?

When you are dealing with chromophobe renal cell carcinoma, your treatment depends on what stage you are at. If you have stage 1, 2, or 3 cancer, surgery is the main step. Your surgeon might suggest taking out your whole kidney (radical nephrectomy). But if your tumor is small, you might get away with just removing part of your kidney instead.

There are other options other than surgery. Your doctor might use ablation treatments to zap that tumor. They could freeze it with cryotherapy or heat it up with radiofrequency ablation to destroy those cancer cells.

If you are facing stage 4 disease, things get more complex since the cancer has already traveled to other parts of your body. Surgery alone won't cut it anymore. Treatments like chemotherapy, radiation, ablation therapy, and pain management are needed to tackle this thing from all angles.

There is some hope with newer drugs called checkpoint inhibitors, including Nivolumab and Pembrolizumab; they help your immune system fight cancer more effectively by blocking certain proteins.

Your doctor might also try angiogenesis inhibitors, including Sunitinib and Everolimus, which stop tumors from growing new blood vessels and slow down their spread.

Conclusion

Chromophobe renal cell carcinoma is a type of kidney cancer you might not even know you have. Most people discover it by accident when they are being scanned for something completely different. Your doctor will confirm it through imaging tests and a biopsy. If they find it early, you will likely need surgery to remove part or all of your kidney. For advanced cases, you will get medications that help stop the cancer from spreading further. If you would like to learn more about its treatment, consult a kidney specialist for further guidance.

Key Takeaways

• CRCC, a type of kidney cancer, and you might not notice any symptoms at first. But if they do show up, you could see blood in your urine, feel pain in your side, notice a lump in your belly, or experience weight loss.

• When it comes to treatment, you will usually need surgery to remove part or all of your kidney.

• If you have been diagnosed with it, your outlook is typically quite positive.