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CANCER


THE RECENT KIDNEY CANCER AWARENESS WEEK HIGHLIGHTED THE NEED FOR EARLY DIAGNOSIS. NOW, KIDNEY CANCER UK HAS CALLED ON PHARMACISTS TO HELP IN ITS CAMPAIGN TO DIAGNOSIS KIDNEY CANCER EARLIER.


A DISEASE THAT’S DIFFICULT TO IDENTIFY


By Dr Rebecca Case-Upton BSc (Hons), PhD T cancer in the UK1


he incidence of kidney cancer is rising. In 2014, 12,523 people were diagnosed with kidney , a number which is


steadily increasing. Since the 1970s, kidney cancer incidence rates have increased by 166 per cent1


. Amongst


men kidney cancer is the fifth most common cancer and seventh when both sexes are included. In 2014 there were 4421 deaths from kidney cancer, with only 50 per cent of people surviving more than ten years.1


Kidney cancer is often caught too late. Forty-four per cent of people are diagnosed with advanced disease (stage III or IV) which has a poorer prognosis.2


Only seven per cent of


people diagnosed with stage IV kidney cancer will survive five years3


,


so we are very keen to improve the early diagnosis rates of kidney cancer and we believe that pharmacists


52 - SCOTTISH PHARMACIST can have an important role in this.


KIDNEY CANCER IS DIFFICULT TO DETECT


Kidney Cancer UK’s latest survey suggests that 70 per cent of people did not feel unwell with kidney cancer symptoms prior to diagnosis. So it is no surprise that kidney cancer is often not diagnosed until it is too late. In fact, nearly half of people (43 per cent) were diagnosed ‘by accident’ during an unrelated medical scan. Kidney cancer is quite often a silent cancer, in an organ which is rarely considered in day-to-day life.


Nineteen per cent of people were diagnosed via A&E, which we feel is too many. This may illustrate the sudden and distressing onset of symptoms, in a situation where the kidney cancer is often picked up at a very late stage. This data could also


reflect on the stress that our general practice system is currently under due to a lack of funding and a low number of doctors. People being diagnosed via A&E is not a desirable situation for either the patient or the NHS.


KIDNEY CANCER TREATMENT The vast majority of people with kidney cancer are treated with surgery. If the cancer is caught early enough, the tumour can be resected with a nephrectomy or cryotherapy (frozen) and hopefully this will be the only treatment required - along with careful surveillance. However, if the tumour has already spread (stage III or IV), systemic treatment will probably be the next treatment, such as tyrosine kinase inhibitors (sunitinib, pazopanib or axitinib), which aim to stop blood vessel formation and tumour growth. Or the newly recommended immunotherapy nivolumab, which


aims to lift the PD-1 receptor inhibition on the immune system, boosting the body’s own ability to kill the tumour. Systemic treatment, although continually developing, is not without side effects for the patient, doesn’t work for everyone and costs the NHS large sums of money. It would be better for everyone if the cancer was caught earlier and fewer people had to rely on drugs for advanced disease.


KIDNEY CANCER SYMPTOMS TO LOOK OUT FOR


A collection of twelve symptoms are described by people with kidney cancer, many of which are unspecific and could have multiple diagnoses. So viewing symptoms collectively is very important.


We understand that pharmacists have medical contact with many patients with ill health and would


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