Question

The 56 year old African-American woman is admitted for treatment of newly diagnosed renal cell carcinoma. You find her daughter in the hallway crying. She has heard that her mother has undergone genetic testing related to her cancer diagnosis and wonders if she is at increased risk for the same condition. She was with her mother during the renal scan before admission and is also worried that this exposure to a radioactive isotope will cause cancer in her.

Is renal cell carcinoma commonly inherited, and why is genetic testing done?

Do renal scan radioisotopes require radiation precautions? Why or why not?

What risk factors are associated with renal cell carcinoma?

How can you evaluate whether your information was understood by the daughter and if follow-up is needed?

Answer 1

Renal cell carcinoma can run in the families but it is very rare. Inherited type of renal carcinoma occurs due to the specific type of genes. Familial non -VHL clear cell renal cell carcinoma is one of the genetic condition that inherited in the families due to specific genetic mutation and rearrangement of chromosomes. Genetic testing helps to identify the particular genes or chromosomes disorder in the suspected person and to confirm the chance of developing genetic disorder to the families. Genetic testing helps to identify the person's risk of cancer, and an in-depth understanding of cancer problems. It helps to educate the other family members to protect from the potential risk of cancer.

Precautions to be followed before renal scan isotopes are

• Remove all jewels, dentures and any other metal items.
• Stop the blood pressure medication prior to the 3 days of the test.
• Empty the bladder
• Diuresis can be administered to increase the work of the kidney.
• After the scan, have plenty of fluids to get hydrated.

Risk factors associated with renal cell carcinoma

• Smoking increases the risk of cancer for about 25%.
• Black people are at higher risk than others.
• More risk at increased age of people.
• Obesity and high blood pressure have a high risk.
• Exposure to cadmium and overuse of certain medications such as analgesics increases the risk of cancer.

Daughter level of understanding can be evaluated by asking the question regarding the renal carcinoma. Ask her to restate the conditions. Ask her to inquire more about this condition. Ask her to demonstrate healthy behaviors.