Qian uncle over 60 years old, just retired, free to run every day teahouse chess room both, the small life is not happy. The last six months to urinate accidentally found twice blood in urine, but every time to eat some anti-inflammatory drugs after it is fine, old money thought he was strong, this bleeding does not hurt and does not itch should not be a big problem, also did not take it seriously. Recently, experts from a large hospital came to the street to carry out services for the people, and Lao Qian took this opportunity to reflect his hematuria to the doctor, who immediately arranged for him to have an ultrasound examination, and the result was that he was suffering from left kidney cancer. Kidney cancer, also known as renal cell carcinoma, has a high incidence at the age of 40-65, more in men than women. Kidney cancer originates from renal tubular epithelial cells and can occur in any part of the kidney parenchyma, but it is most common in the upper and lower kidneys, with a few invading the whole kidney and equal chance in the left and right kidneys. Kidney cancer is not a rare tumor, and its incidence rate has been increasing year by year in recent years, and now it ranks among the top ten tumor incidence rates in China. As the early symptoms of kidney cancer are not obvious, nearly 30% of the patients are already in advanced stage when they are found, missing the best treatment time, so it is called the invisible killer in human body. The clinical manifestations and diagnosis of kidney cancer can have no symptoms in the early stage. Hematuria, back pain and lumps are considered as the three typical symptoms of kidney cancer, but the appearance of these symptoms often indicates that the tumor is not at the early stage. Sometimes kidney cancer can also show some non-urinary extra-renal manifestations such as high fever, abnormal liver function, anemia, hypertension, erythrocytosis and hypercalcemia. Some patients with kidney cancer have already progressed extensively in the body and metastasized to lung and bone when there are no obvious symptoms. In recent years, the diagnosis of kidney cancer, especially the detection rate of early kidney cancer, has been greatly improved, thus enabling kidney cancer patients to obtain satisfactory treatment results, which is mainly attributed to the promotion and development of people’s health checkups and B-ultrasound examination. As the initial screening means, B ultrasound has outstanding advantages, such as sensitive, specific, convenient and inexpensive. When a tumor is found or suspected, the next examination is often an enhanced CT scan to clarify the presence or absence of tumor, its location, size, scope, nature and the presence or absence of metastasis. Imaging examination can not only provide the most direct diagnostic basis, but also can accurately estimate the tumor stage, which is crucial to the choice of treatment methods in the future. If the diagnosis is still not clear after ultrasound and CT examination, magnetic resonance imaging (MRI) and renal angiography can be used to help the diagnosis. At the same time, CT and MRI examination can clearly show the distribution of blood vessels and the relationship with tumor in a non-invasive situation by using digital subtraction technology, which can provide valuable basis for the implementation of radical surgery of kidney cancer with preserved kidney units. It is believed that chemical carcinogens excreted through kidney can induce kidney cancer, hormones, radiation, viral infection, smoking, long-term use of finasteride drugs, long-term exposure to lead-containing substances and certain chronic kidney diseases may be related to the occurrence of kidney cancer. Therefore, it is necessary to develop good living habits, quit smoking, stay away from radioactive sources, do not consume moldy and rotten pickled foods, eat lightly and live regularly. Since kidney cancer patients usually have no symptoms, it is easy to miss or misdiagnose the disease. The kidney is hidden and most of the kidney cancers have no obvious symptoms in the early stage. Therefore, people should pay special attention to the usual health checkups and routinely receive ultrasound examination of kidney from the age of 30-40. It is right to consider oneself as an important person and have a comprehensive physical examination 1-2 times a year, which is the most crucial point in early diagnosis. In fact, there are a considerable number of patients whose kidney cancer is detected by ultrasound physical examination every year in clinical practice, when they have no discomfort symptoms. And these kidney cancers detected by physical examination screening are in the early stage of tumor, which often have good prognosis after timely treatment. It is important to pay attention to the clues that appear in order to get timely treatment. Since the main connection between kidney and the outside world is urine, hematuria is the most common symptom to detect kidney cancer, but the appearance of hematuria can only occur when the tumor has invaded the renal pelvis and calyces, so it is no longer an early symptom. There is another kind of hematuria, i.e. blood in urine which cannot be seen by naked eyes, but when microscopic examination is done in hospital, it is found that there is an increase of red blood cells, which is called microscopic hematuria. When a patient has microscopic hematuria without any reason and it does not improve even with general medication, it should be taken seriously. It should also be known that sometimes kidney cancer patients have intermittent hematuria, which can be relieved naturally after a few days, or they may take some drugs to stop the hematuria temporarily, then they often neglect and think that the disease is cured, and do not make detailed examination in time. The tumor will continue to grow and erode the surrounding kidneys during this period of time. Such patients often have a very poor prognosis and the lessons learned are very painful and profound. Therefore, when a patient finds hematuria, regardless of the condition, he should have a detailed examination by a specialist and should not be paralyzed. How to treat kidney cancer? At present, radical nephrectomy is still the most effective and basic treatment method for kidney cancer. The scope of surgical resection includes perinephric fat, fascia, upper ureter and lymph nodes of the kidney tip. For kidney cancer with metastasis, the affected kidney should also be resected to reduce the tumor load and improve the efficacy of other treatments. When advanced kidney cancer can no longer be removed, interventional therapy is often used to control bleeding, relieve pain and reduce tumor size after injecting anti-cancer drugs and embolizing the renal artery. Biological immune support therapy can be given after surgery according to the actual situation of patients. Since kidney cancer is not very sensitive to radiotherapy and chemotherapy, radiotherapy and chemotherapy are generally not recommended. Can kidney cancer be preserved with open surgery? In recent years, the implementation of kidney unit preservation surgery is more respected internationally for smaller tumors, and its 5-year cancer-related survival rate is basically similar compared with traditional radical kidney cancer surgery, which can preserve more kidney functions while effectively controlling the tumor. However, not every kidney cancer patient is suitable for kidney preservation. For patients with isolated kidney cancer, double kidney cancer, one side of kidney cancer with severe renal insufficiency, and one side of kidney cancer with contralateral renal failure or patients with chronic kidney disease tendency, kidney unit preservation surgery is particularly meaningful. This surgery not only can achieve the purpose of complete removal of the tumor lesion as traditional radical kidney cancer surgery, but also can preserve the normal renal parenchymal unit to the maximum extent, which can provide guarantee for the reserve of kidney function and avoid the occurrence of renal insufficiency and uremia. This procedure is generally limited to tumors less than 4 cm in diameter and confined to the margins or upper and lower poles of the kidney. For kidney cancer patients with isolated kidney tumors that are large and close to the central part of the kidney, if conditions permit, isolated bench surgery can be performed to remove the tumor followed by autologous kidney transplantation. It should be said that kidney preservation surgery is technically demanding and has very strict surgical indications, the most important premise of which is that tumor resection should meet the requirements of tumor surgery. Laparoscopic kidney cancer surgery In recent years, laparoscopic technology has developed rapidly, and general radical kidney cancer surgery can be done under laparoscopy. The surgical scope, requirements, safety and efficacy of laparoscopic radical kidney cancer treatment are exactly the same as those of open surgery radical kidney cancer treatment. The surgical incision (kidney removal) of laparoscopic radical kidney cancer treatment is relatively small, and has become the international gold standard for the surgical treatment of smaller kidney cancers. Laparoscopic surgery to preserve the renal unit can also be performed, but the technical requirements are relatively high and the main problem at present is the inability of effective local cooling to reduce renal unit damage due to blood flow control. Minimally invasive treatment of kidney cancer is performed under ultrasound guidance through skin puncture or in laparoscopic puncture, and radiofrequency ablation and cryotherapy are performed on smaller kidney tumors. Since this method truly achieves minimally invasive treatment of kidney cancer, and its 5-year survival efficacy is basically similar to that of kidney unit preserving surgery, it has become the latest and biggest hot spot and direction of small kidney cancer surgical treatment in the international arena at present. For patients with intermediate to advanced kidney cancer that cannot be completely removed by surgery or have metastasis, some medical treatments can be used. The commonly used ones are methotrexate, interferon and interleukin-2, which have very limited efficacy response. New targeted therapies sunitinib, sorafenib, and mTOR blockers, which were introduced in the last 2 years, can effectively prolong the progression-free survival (PFS) of the disease. Existing studies have shown that a 1-2 month improvement in PFS can improve the overall survival time of patients by 2.5-7.5 months, and can improve the quality of life during survival. Thus, although such drugs are particularly expensive to treat, they have strong clinical implications.