Freezing Kidney Cancer: Hot Treatment Should Be New Gold Standard For Destroying Small Tumors

Freezing kidney tumors -- using a safe minimally invasive interventional radiology treatment that kills the cancer 100 percent effectively without surgery -- should be the gold standard or first treatment option for all individuals with tumors that are 4 centimeters in size or smaller. And, this treatment -- interventional cryoablation -- is a viable option for people with larger tumors, according to two studies presented at the Society of Interventional Radiology's 34th Annual Scientific Meeting.

"Interventional cryoablation is as effective as laparoscopic surgery (partial nephrectomy), the current gold standard treatment, and laparoscopic cryoablation surgery for treating renal cell carcinoma," said Christos Georgiades, M.D., Ph.D., interventional radiologist at Johns Hopkins Hospital in Baltimore, Md. "We can eliminate a cancer -- that once it metastasizes can be notoriously difficult to treat and has a low chance of cure -- with a simple outpatient procedure. Eliminating cancer at such an early stage is truly significant news for kidney cancer patients," he added.

It's important that individuals realize all their treatment options -- especially since the incidence of kidney cancer has been steadily increasing in this country over the past 30 years, said Georgiades. Approximately 54,000 people are diagnosed with kidney cancer each year -- with nearly 13,000 dying from it annually, according to recent statistics. Most people with this cancer are older, and the overall lifetime risk of getting kidney cancer is about 1 in 75 -- with men at higher risk than women. More than 75 percent of individuals who are diagnosed with kidney cancer have small tumors that are discovered incidentally. "Cryoablation is a great treatment option that doctors should discuss with patients early on," he explained.

The Hopkins studies, examining the safety and efficacy of percutaneous (no incision) cryoablation, show the treatment's powerful results. "Based on the results of our three-year study, we have shown that interventional cryoablation for kidney cancer should be the gold standard or the first treatment option for all patients whose tumors are 4 centimeters or smaller. It should be a viable option for patients whose cancer is even larger than that. And, ablation (or freezing) is a very effective option for patients who cannot or do not want to have surgery," noted Georgiades. Cryoablation's efficacy rate -- the ratio of how many patients' renal cell carcinoma was destroyed completely for localized tumors by size -- is 100 percent up to 4 centimeters (about 2 inches) and nearly 100 percent up to 7 centimeters (about 3 inches). Three localized 10-centimeter (about 4 inches) tumors -- large tumors that are typically removed surgically -- were treated; in two cases the tumor was successfully killed.

"This news is especially significant for individuals with small tumors, since more than 75 percent of patients who are diagnosed with kidney cancer have tumors that are 4 centimeters or less in size," said Georgiades. "These individuals can have their tumors treated completely, effectively, without surgery, with quicker recovery and mostly on an outpatient basis. Whatever the definition of 'cure' is, these results come as close to it as possible," he noted. "At Hopkins, interventional cryoablation is the first-line treatment for small tumors. Most of our patients go home the same day they receive treatment with minimal limitation on regular activities. With laparoscopic kidney surgery, a patient remains in the hospital for several days and recovery time can be from two to four weeks," he added. "Our studies highlight how effective interventional radiology treatments can be -- not just for kidney cancer -- but for other kinds of cancers and other diseases as well. Interventional radiology treatments will have a significant impact on the overall survival and benefits that patients can have from avoiding surgery," said Georgiades.

"There is no question that interventional cryoablation, which uses imaging to pinpoint tumors and probes to penetrate the skin to deliver freezing cold directly to a diseased tumor, works. This interventional treatment is not a widely known procedure yet, even to other doctors, and some patients are going to have to pursue it on their own," said Georgiades. The treatment is widely available in the United States at all major institutions and some smaller institutions as well; it is usually covered by health insurance.

Researchers followed kidney cancer patients who had received cryoablation for three years -- well beyond the established and well-accepted one-year benchmark within the medical community to gauge the success of a kidney tumor treatment option -- since most kidney tumors would be visible within a year with a CT scan or MRI. The use of percutaneous cryoablation should not be limited -- as it has been -- to patients who have other diseases that make surgery very high risk, cannot undergo anesthesia, have borderline kidney function, may only have one kidney or multiple recurring tumors or do not have any other option, said Georgiades. "There may be a bias in the medical community -- among surgeons, primary care doctors and urologists -- that cryoablation works only for certain patients with small tumors. This is not the case," emphasized Georgiades.

"Traditionally, laparoscopic surgery has been the main treatment option for all renal cell cancers; it literally cuts the cancer out. The good news is that individuals no longer need to have a kidney partially or completely removed to treat their cancer," noted Georgiades. When comparing the rate of complications between percutaneous cryoablation and surgery, Georgiades said that none of the patients who had cryoablation developed new or metastatic disease and they had fewer complications. The minimally invasive nature of interventional cryoablation means that it can be performed with minimal blood loss and without an incision, just a tiny hole in the skin. The interventional radiology treatment translates into significantly less pain, a shorter hospital stay and more rapid recovery. This safe treatment can be repeated, if necessary. The most common complication is a bruise around the kidney that goes away by itself, he said.

In studying cryoablation's efficacy, researchers looked at 90 tumors in 84 patients. Efficacy was determined based on a tumor's size at 3-, 6- and 12-month clinic visits and then yearly -- with follow-up imaging with CT or MRI scans. Both efficacy and three-year survival rates approach 100 percent overall.

In studying cryoablation's safety, Georgiades studied the results of 101 percutaneous cryoablations on 91 patients who either couldn't undergo surgery or elected the interventional radiology treatment. Using computed tomography (CT) imaging, researchers could view tumors and probes in real time. Interventional cryoablation "has an excellent safety profile," said Georgiades.

Cryoablation is typically performed under light anesthesia, known as sedation, by an interventional radiologist who has consulted with the patient's urologist. One or more hollow needles are inserted through the skin directly into a tumor. Interventional radiologists can observe and guide the insertion by combined use of ultrasound and CT. The needle, or cryoprobe, is filled with argon gas, which creates an ice ball, which rapidly freezes the tumor. The tumor is then thawed by replacing the argon with helium. The procedure consists of two freezing and one thawing cycle, seeking a frozen margin beyond the tumor edge to ensure death of the entire tumor. After the cryoprobe is removed, a small bandage is placed over the skin puncture site. Cryoablation, which can also be referred to as cryo or cryotherapy, is approved by the Food and Drug Administration for treating soft tissue tumors, such as renal cell cancer.

More information about kidney cancer, cryoablation and interventional radiology can be found online at http://www.SIRweb.org.

Source: http://www.medicalnewstoday.com/

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Kidney Donation: Less Painful than Childbirth

By Christine Cyr

Unusual Surgery: Jennifer Gilbert, center, received a kidney from Kimberly Johnson, at right in green. CNN.com

Surgery for an organ donor generally involves a lot of pain, long recovery, and scarring. Which is why doctors at Johns Hopkins Medical Center tried a new approach (literally!) last week; they removed a woman's kidney through her vagina. Strange as it may sound, the procedure is less invasive than traditional methods'and actually not so new.

Nonfunctioning and cancerous kidneys have been removed transvaginally before, and other organs have also been removed through natural orifices but this is a first for a healthy kidney slated for donation. "Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result," said Dr. Robert Montgomery, the chief of transplant surgery at Johns Hopkins.

Kimberly Johnson, 48, of Baltimore, donated the kidney to her 23-year-old niece. Four days after the surgery, Johnson (a mother of three) said the procedure was less painful than childbirth, and the pain she's now experiencing is "no worse than getting a tooth pulled."

Traditional kidney removal involves making several incisions in the abdomen, two to three days in the hospital, plus several weeks of recovery at home. But with this new procedure, only three pea-sized incisions were made in Johnson's abdomen'one hidden in her belly button'and one larger incision in her vaginal wall. After cutting the kidney free, doctors removed it through her vaginal opening with laparoscopic instruments. The entire procedure took 3 ?? hours, and Johnson was able to go home after a night in the hospital.

Doctors at Johns Hopkins hope this less invasive surgery will attract more donors. According to the United Network for Organ Sharing, more than 78,000 people are currently waiting for kidney transplants in the United States, and the wait can last years.

source: http://www.iconocast.com

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Kidney Cleanse for Optimum Energy Level

The kidneys are among the organs of purification. They are responsible for filtering the blood, removing waste products, excess water, and electrolytes. About 20% of the blood pumped by the heart is passed through the kidneys everyday. Generally, the large amount of blood supplied to your kidneys allows your kidneys to remove the wastes from as well as regulate the composition of the blood, stimulate the production of red blood cells, and maintain the body's calcium levels. Within the kidney, a complex chemical process takes place as the wastes extra water, and electrolytes are extracted from the blood, turn into urine, pass through the ureters and finally into the bladder. There, it is stored until it is eliminated from the body.

However, when the fluid and various acids and minerals in the urine are out of balance, kidney stones are likely to form. This mostly happens when the urine does not have enough fluid to dilute the calcium and uric acid components. Also, some of the components in the urine are able to crystallize. Now, if the urine contains insufficient substances to keep crystals from sticking together, it is likely form into stones as well. Thus, kidney stones are more prone to develop in highly acidic or highly alkaline urine.

Each year, many people suffer from renal failure, undergo dialysis, or kidney transplant. One way to prevent having one is through kidney cleanse. Mainly, colon cleanse refers to any method that involves drinking a huge amount of liquid and having a better diet. Also, having a colonic treatment can assist in the prevention of kidney failure. How? Since the bowel is one of the leading sources of toxins, the efficient removal of the toxic wastes can alleviate the toxins that enter the bloodstream.

On the other hand, some people may opt to drink kidney cleanse teas and supplements, while others may prefer juice fast watermelon cleanse. Whichever way, these methods will surely help tone and rejuvenate the kidneys for optimum functioning, giving the body more energy to perform at a maximum.

The watermelon cleanse is the easiest and most natural way to cleanse the kidneys. However, it is not advisable to diabetics. The watermelon cleanse requires one is to sit in a tub filled with water and eat 20 to 100 kg of watermelon the entire day. You simply have to eat the watermelons continuously and drain the bladder into the water.

A kidney cleanse is not at all difficult nor is it time consuming. All you have to do is keep a good track of what you eat, and at the same time drink a lot of water. This will not only keep one's energy high, it especially helps keep the urinary tract as well as the prostate healthy.

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Article Source: http://www.articlesbase.com/alternative-medicine-articles/kidney-cleanse-for-optimum-energy-level-566756.html

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Donors And Kidney Transplant Patients Matched Using New Computer Models

New computer models can now link strangers in a life-saving chain of kidney transplants, promising to increase the number of transplants and overcome obstacles posed by logistics or donors who renege, a team of researchers report in the current edition of the New England Journal of Medicine.

Designed to optimize the "matching market" principles involved in kidney transplantation, donor registry software programs sift through thousands of pairs of recipients and their living donors, analyze participant characteristics, then construct an optimal chain of transplant pairs, report the co-authors, many of whom helped pioneer the creation of donor chains.

For the approximately 70,000 U.S. patients in need of a kidney transplant, the data-driven approach to transplantation pairings should shrink the rolls of patients on waiting lists.

The donor chains start with a single "altruistic" volunteer donor.

"The Good Samaritan who comes forward to donate a kidney serves as the catalyst for a series of donations in a much more efficient system," says Boston College Assoc. Prof. M. Utku Unver, a theoretical economist. "It is not an easy decision to give up a kidney to help a stranger. These advances may encourage more donors because they now know they can save many lives."

The approximately 4,000 living donor kidney transplantations that take place in America each year rest upon a fragile balance of donors and recipients engaged in a "matching market" where volunteers provide life-saving organs without monetary compensation, says Unver, who has been examining kidney exchange for five years.

The computer-generated chains provide a viable alternative to the relatively new strategy of paired donation, where organs are exchanged between two donor-recipient pairs during simultaneous surgeries.

Paired donations are prone to breakdowns because a willing donor is not a compatible match, a recipient is too far away or a donor backs out of the extremely personal transaction.

Unver and his fellow researchers highlight a chain of kidney transplantations that started with a 28-year-old Michigan man in July of 2007 and led to 10 transplantations coordinated during 8 months by two large paired-donation registries, the 25-state Alliance for Paired Donation and Incompatible Kidney Transplantation Program at Johns Hopkins Hospital.

The transplantations took place at six medical centers in five states. Three kidneys from living donors were shipped - two using commercial flights - rather than requiring donors to travel to the recipient's hospital.

The computer models assign values to the characteristics of donors and recipients stored in massive databases. The programs then generate pairings based on with similar scores, imposing an order on these exchanges by overcoming issues that disrupt a market

"Economists have been looking at solving the 'mechanism design' problem of paired donations by using data to increase efficiency," says Unver, whose early work on these models with fellow BC economist Tayfun Sonmez led to the founding of the New England Program for Kidney Exchange. "As work progressed, people began to see this was a way of overcoming the problems involved with paired donations."

Paired kidney donation surgeries are performed simultaneously to reduce the possibility of a donor backing out once a friend or relative has received a kidney.

A donation chain allows for greater flexibility, since not all surgeries must take place at the same time in the same hospital.

The researchers conclude further that kidney donor chains could shorten wait times on lists of unmatched patients in line for deceased-donor organs. The scope of the databases can pair these patients with suitable living donors, who account for approximately one-third of the 14,000 kidney transplantations that take place annually in the U.S.

Notes:

Unver was joined by co-authors Michael A. Rees, M.D., Jonathan E. Kopke, Ronald P. Pelletier, M.D., Dorry L. Segev, M.D., Matthew E. Rutter, M.D., Alfredo J. Fabrega, M.D., Jeffrey Rogers, M.D., Oleh G. Pankewycz, M.D., Janet Hiller, Alvin E. Roth, Tuomas Sandholm, and Robert A. Montgomery, M.D.

For more information about Prof. Unver's work, please see his website at: http://fmwww.bc.edu/ec/unver.php.

Source: Ed Hayward
Boston College

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