The following came out of a review of newer literature quotations regarding what’s new regarding kidney cancer.
In Ref. 3 almost 8000 firefighters in Philadelphia were followed between 1925 and 1986. For firefighters who were active in their profession (and exposed to toxic gases) for 20 years or more the following cancers were found to be increased: colon cancer, kidneys, non-Hodgkins lymphoma, multiple myeloma and benign tumors.
- Is it possible to develop a vaccine against kidney cancer? That is exactly what Ref. 4 is examining. In this technically very informative, but complicated paper the authors describe that it is possible to transfer messenger RNA from kidney tumor cells and change a previously very weak immune response into a powerful tumor rejecting response, which attacks not only the primary tumor, but also metastases. Future possible developments for other cancer vaccines are also discussed. For firefighters who were active in their profession (and exposed to toxic gases) for 20 years or more the following cancers were found to be increased: colon cancer, kidneys, non-Hodgkins lymphoma, multiple myeloma and benign tumors.
- Cytotoxic T lymphocytes can be modulated to amplify a previously weak response into a stronger immune response. This is explained in detail in Ref. 5. Monoclonal antibodies were used to specifically amplify the immune response to various kidney cancer surface antigens.
- Another way to stimulate the immune system is to utilize the immune system mediator, interleukin-2 (IL-2). The authors of Ref. 6 explain that IL-2 alone was leading to a certain immune response, but hemoglobin depletion and other side-effects were limiting. One of the crucial observations in prior investigations was that kidney cancer metastases were growing due to formation of new tumor vessels in these metastases. This was due to a growth factor, called “vascular endothelial growth factor” or VEGF for short. A bone marrow stimulating hormone, called erythropoietin, which originates normally from a healthy kidney, suppresses circulating VEGF in the blood.This phase II clinical trial was conducted on terminal kidney cancer patients with metastases. It consisted of injections of a mixture of low dose interleukin-2 and erythropoietin. Several parameters were followed in these patients such as hemoglobin levels, VEGF levels as well as the growth pattern of the kidney cancers. Out of 12 such terminal kidney cancer patients 4 turned into stable disease, one had a partial response and 7 continued to have progressive disease (= non-responders). Toxic side-effects of IL-2 were very minimal, hemoglobin levels were stable or increased and VEGF was decreased. This line of immunotherapy will likely be improved upon in phase III clinical trials.
- Vitamin A and Vit. A derivatives (called retinoids) are often lacking in patients with kidney cancers. Ref. 7 deals with these issues and the fact that Vit. A and derivatives can be used to treat and improve survival of such patients.The authors concluded from tissue culture experiments and by comparing cancer patients versus normal kidney biopsies that kidney cancer appears to develop as a result of a defect in the Vit. A metabolism. This in turn seems to cause an aberrant differentiation into cancerous rather than normal cells. The hope of this line of research is that some day new drug therapies may influence this cancer differentiation pathway and bring it back to a normal pattern.
- For many years there was a notion that occupational or recreational physical activity could prevent or reduce the risk of cancer of the kidneys. This theory was put to the test by a very large cohort of 17,241 twins in Sweden by the Karolinska Institute (see Ref. 8).Twin studies have the advantage that environmental and genetic factors can be separated. There were 102 cases of kidney cancers in this group of twins. There was no significant difference due to exercise levels. The evidence regarding kidney cancer therefore speaks powerfully against exercise as playing a role. This makes sense when we consider that the kidneys are elimination organs that detoxify the body. It would therefore be more logical that poisons such as metabolites from cigarette smoking and other industrial chemicals would cause kidney cancer as they travel through the kidney (see earlier in this chapter).
- Finally, there are inherited factors, which have been investigated recently in an extensive epidemiological study from the Karolinska Institute in Sweden. Kidney cancer is one of the cancers that was found to have a significant inherited component to it.
- Lycopenes, the red color of tomatoes has been linked as a preventative for kidney cancer: top lycopene consumers among the Women’s Health Initiative were followed for more than 10 years and were found to have 39% less kidney cancer than the group that took in the least amount of lycopenes.
References:
1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Cancer of the kidney and ureter.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the kidney and ureter.
3. D Baris et al. Am J Ind Med 2001 May;39(5):463-476.
4. A Heiser et al. Cancer Res 2001 Apr 15;61(8):3388-3393.
5. A Gati et al. Cancer Res 2001 Apr 15;61(8):3240-3244.
6. P Lissoni et al. Anticancer Res 2001 Jan-Feb;21(1B):777-779.
7. X Guo et al. Cancer Res 2001 Mar 15;61(6):2774-2781.
8. A Bergstrom et al. Int J Cancer 2001 Apr 1;92(1):155-157.
9. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
10. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc
