Nursing Care of Client with

Kidney Cancer
By Efris Kartika Sari
 Each year, nearly 65,000 people in
the United States are diagnosed with
kidney cancer. This type of cancer
accounts for about 3 percent of adult
cancers (Jonasch & Messner, 2012).
About 90% of kidney cancers are
renal cell carcinomas (Jemal, Siegel,
Xu, & Ward, 2010)
 Definition
Renal cell carcinomas are tumors
that originate in the renal cortex.
These tumors are often
asymptomatic, have diverse clinical
manifestations, and can be
associated with hereditary
syndromes.

(Patel, Ahmed, & Ellsworth, 2012)

Risk factors
 Smoking: the most significant factor.
Age: renal cell carcinoma occurs most commonly in people sixty and older.
Sex : men > women.
Obesity
Genetics
Family history of the disease
Overuse of painkillers
Excess use of phenacetin
Prone to kidney stones, especially in men
Hypertension High blood pressure increases therisk but it isnt clear why.
Treatments for kidney failure
Chemicals in the workplace
von Hippel-Lindau syndrome, a hereditary disease that affects the capillaries
of the brain. This inherited disorder is likely to develop several kinds of
tumors.
(Cohen, 2009)
Classifications
Stage of Kidney cancer

Jonasch & Messner, 2012)

Clinical Manifestations

Jonasch & Messner, 2012)

 Diagnostic Tests
Laboratory tests: CBC, LDH, metabolic panel
(creatinine, electrolytes, AST, ALT, alkaline
phosphatase, bilirubin, INR, PTT, calcium,
magnesium, phosphate, albumin), urinalysis and
urine cytology
Imaging
Primary tumour
i. Abdominal/pelvic CT with and without
intravenous contrast
ii. Abdominal MRI if CT suggests caval thrombus or
because of a contrast allergy or renal insufficiency
 Metastatic evaluation
i. Chest radiograph, consider CT
chest if stage T2
ii. Bone scan, if clinically indicated or
elevated alkaline phosphatase
iii. Brain MRI, if clinically indicated
(Canadian Kidney Cancer Forum, 2008)
 Treatment
The treatment options for RCC are
surgery, radiation therapy
(palliative), targeted therapy
(bevacizumab, sumitinib, sora fenib,
everolimus, temsirolimus), biological
therapy (immunotherapy),
chemotherapy and combinations of
these (Campbell & Lane, 2012).
 Immunomodulators, such as
lenalidomide, a derivative of
thalidomide, inhibits vascular
endothelial growth factor (VEGF),
stimulates T and natural killer cells
and inhibits inflammatory cytokines.
Currently in phase 2 trials, this drug
showed an antitumor effect in
selective cases (Choueiri et al., 2006;
Patel et al., 2008).
Nursing Care
Masalah Keperawatan:
Nyeri
Gangguan pemenuhan nutrisi: kurang
dari kebutuhan tubuh
Kelemahan
Ketidakefektifan perfusi jaringan perifer
Distress spiritual
Gangguan gambaran diri
 Palliative care is an approach that
improves the quality of life of
patients and their families facing the
problem associated with life
threatening illness, through the
prevention and relief of suffering by
means of early identification and
impeccable assessment and
treatment of pain and other
problems, physical, psychosocial and