According to urologist and kidney transplant surgeon Dr Murali Sundram Mikaail Abdullah, Malaysia records about two kidney cancer cases per 100,000 people annually, or roughly 700 cases in a population of 35 million.
“The disease typically affects older adults, particularly those over 50, and is more common in men, especially those who are overweight or smokers,” he told Bernama.
Other high-risk groups include patients with kidney failure on dialysis, and individuals with a family history of kidney cancer or certain genetic disorders.
“In the early stages, kidney cancer presents no symptoms. There may be small traces of blood in the urine tests, but there is no specific blood test that can detect it. Most cases are diagnosed incidentally during imaging done for other reasons,” Murali noted.
He said abdominal ultrasound or CT scans done during health screenings or for unrelated issues often reveal the presence of kidney tumours. As the disease progresses, symptoms such as visible blood in urine, persistent back pain, or abdominal swelling may appear.
Murali said treatment depends on the size and location of the tumour. “If it is small, a partial nephrectomy can often be performed to remove just the tumour, preserving the rest of the kidney,” he said.
In advanced cases, a total nephrectomy – removal of the entire kidney – is necessary. Surgery, he said, can be done via open surgery, or through minimally invasive methods like laparoscopy or robotic surgery.
One of the most complex scenarios is when the tumour extends into major blood vessels, a condition known as a tumour thrombus.
“This occurs in 4-10% of kidney cancer cases and makes surgery extremely challenging because the tumour can extend all the way into the heart,” he said.
In such instances, a customised surgical plan is required, often involving a multidisciplinary team that might include anaesthetists, cardiothoracic and vascular surgeons, urologists, oncologists, nephrologists, radiologists and intensive-care specialists.
Murali said standard laparoscopic surgeries usually require a hospital stay of two to three days and a full recovery in four weeks. Surgeries involving the heart, however, require longer hospitalisation – typically 10-14 days – and up to three months for full recovery.
He also addressed misconceptions surrounding kidney cancer, stressing that routine blood tests cannot detect the disease.
“The most effective and cost-efficient screening tool remains the abdominal ultrasound, while CT scans are the gold standard for confirming solid organ cancers,” Murali added.