Um estudo nacional sobre o Câncer Renal (Encare), realizado pela Sociedade Brasileira de Urologia (SBU) aponta que 73% das pessoas receberam diagnóstico de câncer de rim depois de passar por um ultrassom abdominal por outro motivo. Por isso, o diagnóstico precoce faz a diferença. É que esse estágio, o percentual de cura em tumores pequenos ultrapassa os 80%. No entanto, de acordo com o Encare, quase 40% dos casos de câncer de rim, por exemplo, são diagnosticados quando o tumor está nos estágios avançados e com poucas chances de cura.

As causas para o surgimento do câncer de rim não são totalmente conhecidas. Sabemos que cigarro, obesidade, herança genética e hipertensão são fatores de risco para o desenvolvimento da doença. Dados do Encare apontam como principais vilões nessa patologia a hipertensão e a obesidade em 46% e 18%, respectivamente.

Com uma representatividade de cerca de 85% dos tipos de tumores nos rins, segundo a Sociedade Americana de Oncologia Clínica, o carcinoma de células renais (CCR) é um tipo bastante agressivo e, até pouco tempo, com poucas opções de tratamento. A doença representa aproximadamente 2% dos novos casos de câncer e causa cerca de 100 mil mortes anualmente no mundo.

Em relação aos tratamentos para o carcinoma renal, a cirurgia para retirada do tumor é a forma mais indicada nos casos mais precoces. Porém, apesar da remoção por cirurgia, o tumor retorna em 33% dos pacientes. Nestes casos, outras terapias podem ajudar, mas somente um médico pode prescrevê-las adequadamente.

Uma nova e grande aliada no combate aos diversos tipos de câncer é a terapia-alvo, que tem como principal característica a seletividade da ação. Esse tratamento atinge preferencialmente partes importantes das células tumorais e age diferentemente da quimioterapia tradicional – que ataca todas as células que se multiplicam rapidamente, sem fazer diferenciação entre as saudáveis e as tumorais. Por ter ação tão específica, esse tipo de tratamento (inibidores de tirosinoquinases, inibidores mTOR e anticorpos monoclonais) provoca menos efeitos colaterais.

Nos últimos cinco anos, o tratamento do câncer de rim está entre os que mais avançaram. Isso só foi possível em razão do desenvolvimento de novos medicamentos, elaborados a partir de uma maior compreensão da biologia do tumor de rim. Com isso, os pacientes ganharam mais opções terapêuticas e, consequentemente, estão vivendo mais e com melhor qualidade de vida.
Leia mais: Câncer renal / Câncer de Rim

Cirurgia Laparoscopica para o tratamento de tumores renais

Drs. Landman, Rosenblatt and Clayman:

Jaime Landman, M.D.

Professional Biography

The University of California, Irvine School of Medicine is pleased to announce the appointment of Dr. Jaime Landman as new chair of the Department of Urology. He brings to UC Irvine Medical Center highly valued expertise from his former position as the director of minimally invasive urology in the Department of Urology at Columbia University College of Physicians and Surgeons in New York. Dr. Landman has extensive clinical expertise in laparoscopic renal and prostate surgery and endoscopic management of urinary tract pathology. He has pioneered technology and techniques for minimally invasive management of renal malignancies and has developed novel techniques that are used globally for laparoscopic partial nephrectomy. Dr. Landman is an expert in the management of kidney cancer and is a pioneer and internationally recognized expert on the application of minimally invasive techniques for ablation of kidney cancer. He is the director of the American Urological Association courses on management of kidney cancer and on kidney and prostate ablation. Dr. Landman developed and tested novel ablation devices, which are currently used for minimally invasive ablation of renal tumors and malignancies. He has also invented novel technologies for the diagnosis of kidney cancer. His research focuses on stone disease, and he pioneered the combined antegrade and retrograde approach for treatment of complex kidney stones.

Ralph V. Clayman, M.D.

Professional Biography

Dr. Clayman is world renowned for his expertise in minimally invasive surgery for kidney stone disease, kidney cancer and strictures of the ureter, and is listed among the Best Doctors in America® for urology. He is a graduate of Grinnell College and the University of California, San Diego School of Medicine. Following general surgery and urology training at the University of Minnesota, he spent two years at Southwestern Medical School in Dallas pursuing his interests in renal cancer research, kidney stone disease and minimally invasive urology. Clayman spent 17 years at Washington University School of Medicine in St. Louis, rising to become a professor of urology and radiology, director of the Midwest Stone Institute and co-director of the Division of Minimally Invasive Surgery. In January 2002, he joined UC Irvine’s School of Medicine as chair of the newly formed Department of Urology. For the last six years UC Irvine Medical Center’s urology program has been rated among the top 50 in the country. In 2009, Clayman was named dean of the School of Medicine and stepped down as department chair. He continues his clinical work, albeit limited to renal cancer and kidney stones.
In 1990, Clayman and his associates performed the world’s first laparoscopic removal of a kidney for a tumor, as well as the first laparoscopic removal of a kidney and ureter to treat cancer. They also developed a balloon catheter to treat obstruction of the ureter and performed pioneering work on percutaneous and endoscopic therapy for ureteral and kidney stones. He established the nation’s first fellowship program in minimally invasive urology in 1984; trainees of his program now occupy academic positions at universities throughout the United States, Canada and Israel. Clayman is the author of textbooks on laparoscopic and percutaneous urologic surgery, and has published more than 400 peer-reviewed papers and book chapters. He is co-founder and co-editor of the Journal of Endourology and has 14 minimally invasive surgical instrumentation patents to his name. He has received numerous national and international awards.

Drs Landman and Rosenblatt among other fellows: