Understanding Kidney Cancer
- Rick O’Keefe, of Little Rock, Arkansas, was diagnosed with stage 4 kidney cancer that spread to his collarbone—something he discovered after hurting his right clavicle during a tennis match.
- He has since underwent chemotherapy to shrink the tumor and had surgery to remove it. As he continues treatment, O’Keefe is determined to stay positive, continue playing tennis, and doing what he loves with his fiance.
- Kidney cancer develops when cells in the kidneys, a pair of bean-shaped organs each about the size of a fist, begin to grow out of control.
- Renal cell carcinoma is the most common type of kidney cancer, and the type O’Keefe was diagnosed with. About 9 out of 10 kidney cancers are RCCs.
- When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don’t hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.
Recounting the life-changing collarbone break, O’Keefe’s fiancée Elly Rumbach told Temple Health, “He connected on a backhand, and all of a sudden, he felt severe pain, with no impact and no fall.
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Not only was O’Keefe diagnosed with cancer, but he also was informed he had a rare congenital condition called a “horseshoe kidney,” meaning his kidneys were fused.
Despite the oral chemotherapy treatment initially working, O’Keefe was told his tumor would need to be surgically removed. He and his partner then sought a surgeon with experience operating on a horseshoe kidney.
According to the Urology Care Foundation, “Horseshoe kidney occurs in about 1 in 500 children. It occurs during fetal development as the kidneys move into their normal position.
“With horseshoe kidney, as the kidneys of the fetus rise from the pelvic area, they become attached (‘fused’) together at the lower end or base. By fusing, they form into a U shape, like a horseshoe. This is thought to happen more often in males than in females.”
After a successful surgery, O’Keefe’s treatment will continue for the cancer in his right clavicle.
Speaking to TODAY.com about the events leading up to his diagnosis and how his collarbone wasn’t healing like planned, O’Keefe said, “I knew from the pain and how it was throbbing that something else was wrong.”
Six weeks after the incident, he recalled an MRI finding that his right collarbone was “darker than the normal white,” which “threw up a red flag.”
He added, “That’s why the bone broke with no fall, no impact. It was just me striking a tennis ball.”
O’Keefe also said the the tumor, which was “roughly the size of the racket ball” was behind his navel, in the middle of his “fused” kidneys. His first plan of action was to reduce the size of the tumor with chemotherapy infusion, which changed to chemotherapy pills, but he eventually needed it surgically removed, which he had done this past March, after finding the right doctor.
Throughout his cancer journey, the Arkansas resident learned to play tennis with his left hand, allowing him to do what he loves despite having to recover.
He explained, “I was very successful last year playing left-handed. I didn’t miss a tournament. I played league. I play with my fiancé, we played mixed … I just didn’t want this to slow me down. You’ve got to have hope and you’ve got to have faith and you’ve got to be preserving.”
Learning About Kidney Cancer
Kidney cancer develops when cells in the kidneys, a pair of bean-shaped organs each about the size of a fist, begin to grow out of control. Renal cell carcinoma is the most common type of kidney cancer. In fact, about 9 out of 10 kidney cancers are RCCs.
According to the National Cancer Institute, 80,908 new cases of kidney cancer are expected across the U.S this year and it’s a disease which can develop in both adults and children.
“The main types of kidney cancer are renal cell cancer, transitional cell cancer, and Wilms tumor,” the institute explains, noting that some “inherited conditions” may increase a person’s risk of getting the disease.
Luckily, advancement in kidney cancer treatment has proven effective for people battling the disease.
The institute states, “NCI-funded researchers are working to advance our understanding of how to detect and treat kidney cancer. Much progress has been made over the last few decades, especially in identifying genes that can drive the development of kidney cancer.
“This knowledge has led to more effective treatments. Today, about 75% of people with kidney cancer will be alive 5 years after diagnosis.”
As for rrenal cell carcinoma (RCC), it “is the most common malignant tumor of the kidney and constitutes over 90 percent of all renal malignancies.”
Here are some signs of kidney cancer to look out for:
- Blood in the urine (hematuria)
- Low back pain on one side (not caused by injury)
- A mass (lump) on the side or lower back
- Fatigue (tiredness)
- Loss of appetite
- Weight loss not caused by dieting
- Fever that is not caused by an infection and doesn’t go away
- Anemia (low red blood cell counts)
According to the National Cancer Institute, the following types of treatment are used for someone battling renal cell carcinoma:
- Surgery
- Radiation therapy
- Chemotherapy
- Immunotherapy
- Targeted therapy
- New types of treatment are being tested in clinical trials
According to UCLA Health, kidney cancer can metastasize, or spread, to any part of the body through the blood or lymphatic system. When that happens, the first signs of cancer may not be specific to your kidneys.
Symptoms of metastatic kidney cancer may cause symptoms in the newly affected areas of the body including:
- The lungs, causing cough and shortness of breath
- The bones, resulting in bone pain or fracture
- The brain, presenting as headaches, confusion or seizures
That being said, all of these signs don’t necessarily mean you have cancer. Still, you should always bring up any changes to your health with your doctors.
“Traditionally, kidney cancer was diagnosed in people coming in with blood in the urine, a mass (in the) belly that was big enough that you could feel, or pain on that side,” Dr. Geoffrey Sonn, a urologic oncologist with Stanford Hospital and Clinics, previously told SurvivorNet.
“More recently because of the great increase in the use of imaging with ultrasound, CAT scans, MRI most kidney cancers (are) diagnosed incidentally, meaning a scan is done for another reason,” he added.
Dr. Sonn said that doctors finding a mass seen on imaging done for another reason is “the most common presentation” of the disease. Some patients without symptoms might discover their cancer through scans done for unrelated reasons, and other might discover the cancer after a scan to investigate abdominal pain.
Either way, it’s important to stay up-to-date on check ups and speak with your doctors about any possible signs of something being wrong.
“For localized kidney cancer, for relatively small masses that have not metastasized, most often patients feel nothing, and this is found on a scan done for another reason,” he explained. “For larger masses of the kidney they may have pain on that side, they may see blood in the urine or a routine urine test may show a microscopic amount of blood in the urine that’s not enough to be seen visually but still will prompt further testing with imaging that shows the kidney cancer.”
Overcoming Adversity
Overcoming adversity can seem daunting. But the experts we spoke with say focusing on the following steps can help you make meaningful change.
- Set a goal. No matter what the situation, create a new goal for yourself. If you have just been diagnosed with cancer or a chronic illness, perhaps one goal would be to educate yourself about the disease and the possible treatments as much as possible.
- Make a plan. How will you achieve this goal? Your plan will help you focus on that goal. Dr. Siddhartha Ganguly refers to this determined, focused mindset as “the eye of the tiger,” which can help people dealing with health problems, such as lymphoma and other cancers. “You have to have the eye of the tiger to go through this grueling process that is necessary these days to get rid of these virulent and aggressive cancers.”
- Rely on others. Spend time with people who show you unconditional support and encouragement. They will ease your stress and help you remember that you’re not alone in this. Dr. Samantha Boardman, a psychiatrist and author, shared a coping strategy with SurvivorNet that can be productive, which is simply to reach out and talk to others. Even if you feel that you’re not in the mood or don’t have the energy, you will feel better after that meet-up or call. Having support we know is really critical in the healing process.
- Use positive self-talk. Leave messages with affirmations in places you frequent. Put notes around your mirror or the computer screen that say “You got this!” or “Keep going!” Cut out inspirational quotes from people you admire and surround yourself with their words.” Dr. Boardman added. “Positive emotions have unique benefits above and beyond managing negative emotions.”
Powering Through Adversity
Finding Joy Outside of Cancer
When faced with a cancer battle it can be hard to focus on life outside of your disease. But it’s important to remember that your mental state can actually impact your success as a patient.
Determination & Hope Despite Setbacks Prevail in ‘Climbing Blind’
“I’m pretty good at telling what kind of patients are going to still have this attitude and probably going to live the longest, even with bad, bad disease,” Dr. Zuri Murrell, a colorectal surgeon at Cedars-Sinai Medical Center, previously told SurvivorNet. “And those are patients who, they have gratitude in life.”
Dr. Dana Chase, a gynecologic oncologist at Arizona Oncology, also advocates for cancer warriors to prioritize their mental health. She noted that emotional well-being has been studied as a factor in patient outcomes.
“We know from good studies that emotional health is associated with survival, meaning better quality of life is associated with better outcomes,” Dr. Chase told SurvivorNet in an earlier interview.
What Still Brings You Joy? Your Emotional Health is So Important
“So, working on your emotional health, your physical well-being, your social environment [and] your emotional well-being are important and can impact your survival,” she explained.
“If that’s related to what activities you do that bring you joy, then you should try to do more of those activities.”
There are no right or wrong answers, but Dr. Chase says doing things that bring you joy is important. She recommends writing down ten things that make you happy and intentionally making the time to do those activities throughout the day.
Contributing: SurvivorNet Staff
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