5th November 2014, The Highland Hotel, Stirling.
This was the fourth patient day organised by Kidney Cancer Scotland for Scottish patients and their families. The event was a resounding success; nearly 50 delegates came along to learn about the management and treatment of kidney cancer directly from health professionals and experts. For a copy of the slide presentation, please click on the titles below:
- My cancer - your cancer; Keith’s Story
- Systemic treatment of kidney cancer
- Management of side effects of TKIs
- The importance of diet and exercise for cancer patients
- Patient support
The treatment of kidney cancer with cryotherapy
Dr Des Alcorn, consultant radiologist from Gartnaval General Hospital, opened the day with a very interesting presentation on the use of ablation for treating small renal masses. In an aging population, the incidence of small renal masses has increased. Ablation is a good choice of treatment for elderly patients, who perhaps have high blood pressure or problems with their heart, and aren’t suitable for surgery.
There are 4 types of ablation; cryoablation (freezing), radiofrequency ablation (heating), microwave (heating), and a new technique called irreversible electroporation. Only cryoablation and radiofrequency ablation are used for kidney tumours. There is limited experience with ablation in the UK, and only a handful of centres offer this treatment.
Dr Alcorn suggested that cryoablation is superior to radiofrequency ablation; during cryoablation, an ice ball is formed around the tumour, which can be seen on a CT scan. This gives better definition of the treatment area and the doctor can be sure that the entire tumour has been incorporated into the ice ball and destroyed. With radiofrequency ablation, the treatment area is not so well defined, resulting in more residual disease and deterioration in renal function than with cryotherapy.
My cancer – your cancer; Keith’s story
Keith Rogers gave a very uplifting presentation about his kidney cancer journey. Keith was first diagnosed with advanced kidney cancer in July 2006, after discovering a small lump on his right side in October 2005. The small lump turned out to be a secondary tumour (metastasis); he had a small (3 cm), slow growing primary tumour on his right kidney. Keith decided not to have his kidney removed, and enrolled in a sunitinib (Sutent) trial in August 2006. After initially experiencing some quite serious side effects, mainly related to the drug’s effect on his liver, Keith has been on a low dose of sunitinib for the best part of 8 years, with a few breaks in treatment for two knee operations. The sunitinib has kept his cancer in check, and he is looking forward to celebrating his 70th birthday, golden wedding anniversary, and 10-year survivor of cancer!
Systemic treatment of kidney cancer
Dr Duncan McLaren, consultant clinical oncologist from the Edinburgh Cancer Centre, gave a very interesting presentation about the history of the development of drug treatments for kidney cancer, the use of the new targeted therapies, and the ongoing research to find new and more effective drug treatments for renal tumours.
Current systemic drug treatment for advanced kidney cancer is mostly targeted therapies, such as sunitinib, pazopanib (Votrient), axitinib (Inlyta) and everolimus (Afinitor); although immunotherapies, such as high dose interleukin 2 and interferon, are still used in a small minority of patients, despite severe side effects. The targeted therapies inhibit the growth of the tumour cells, and stop the development of blood vessels to the tumour, thereby starving it of nutrients and oxygen needed for growth. These drugs can control the cancer and extend life for about 2 years on average. Dr McLaren presented the results of a number of clinical trials with targeted therapies that prove their effectiveness and safety. He also discussed some ongoing trials looking at whether patients need to stay on tyrosine kinase inhibitors (sunitinib and pazopanib) forever (STAR trial), or whether surgery is necessary (SURTIME and CARMENA trials). He also mentioned the PREDICT trials, which are looking for biomarkers that can predict the effectiveness of different drugs for the treatment of kidney cancer.
Clinical trials are a good means to access new drugs before they are available through the NHS. Dr McLaren discussed some of the new advances in the treatment of kidney cancer, such as the PD-1 and PDL-1 clinical trials.
Management of side effects of TKIs
Nicola Thomson, Advanced Specialist Nurse from the Beatson West of Scotland Cancer Centre in Glasgow, gave a very informative presentation about the management of side effects to tyrosine kinase inhibitors (TKIs), sunitinib and pazopanib. At the Beatson, drug management is discussed in detail with the patient during their first appointment with the specialist nurse. Patients are given an information pack from the pharmaceutical company and asked to go home to digest the information; very rarely do patients start treatment at the first visit. Patients are also given contact details for the specialist nurse and the Cancer Treatment Helpline number, which gives advice at any time of the day. The centre conducts regular audits of how cancer drugs are used, and the side effects to cancer drugs, to enable the team to optimise their safe and effective use.
The importance of diet and exercise for cancer patients
Professor Annie Anderson, Director of the Scottish Cancer Prevention Network, gave a very interesting presentation about the importance of having a healthy diet and a healthy lifestyle to prevent the occurrence and recurrence of cancer. During her presentation, she gave a detailed explanation of a healthy diet, clarified portion sizes with respect to ‘5-a-day’, and discussed the importance of being active and maintaining a healthy weight when fighting cancer. However, she also mentioned that there is currently not enough evidence to prove that a healthy lifestyle will prevent cancer, but it has been shown that the risk of developing cancer is reduced by 19% for people with a healthy body weight.
Sharon Deveson Kell, Medical Publications for Kidney Cancer Scotland, highlighted the areas where Kidney Cancer Scotland can provide support for patients and their families, such as the Kidney Cancer Careline, the online patient forum, kidney cancer patient days and the patient grant scheme.