Singapore, 19 September 2023 – Had she not fainted at a hawker centre and conveyed to Singapore General Hospital (SGH) in February 2021, Ms Lim would probably not have found out about a 9cm cancerous tumour in her left kidney.
It was a rude shock for the business development director in her 50's as she did not experience any pain or symptoms before the stage 2 cancer diagnosis. Ms Lim has been seeing a cardiologist at another hospital for regular checks, exercising frequently, and watching her diet.
In its early stages, kidney cancer may not have any signs or symptoms. It is also not clear what causes the cancer but high blood pressure, older age, obesity, for instance, may put one at higher risk. The standard of care for localised kidney cancer that has not spread to other organs or tissues is to remove the entire kidney. This was offered to Ms Lim when she sought the opinion of a urologist elsewhere.
But SGH presented her another option – partial nephrectomy, also called kidney-sparing surgery, using the robotic system. By preserving the kidney and its function, it reduces the need for dialysis in future and the risk of possible complications when kidney function declines with age or due to other medical conditions.
The Hospital first introduced robotic surgery in Singapore for prostate cancer 20 years ago. It is now offered in SGH as an option for selected minimally invasive surgeries such as partial nephrectomy which has proven successful in treating kidney cancer, and radical prostatectomy (removal of entire prostate gland) for prostate cancer.
"Collectively across various surgical departments, SGH has amassed many years of experience using robotic surgery, especially for technically challenging procedures that involve delicate structures," said Associate Professor Henry Ho, Senior Consultant, Department of Urology, SGH.
"While partial robotic nephrectomy surgery has many benefits such as lesser pain, faster recovery, and shorter hospital stay, it is not for everyone," cautioned Prof Ho. "In kidney cancer, we need to consider several factors such as size, location and stage of the tumour, patient's overall fitness and health, patient preferences and expectations, etc., before it is offered as a treatment option."
The average size of a kidney is about 10am to 12cm. Despite her 9cm tumour, the Department of Urology preserved nearly 70 per cent of Ms Lim's left kidney in March 2021. She had five small incisions of about 5mm to 8mm each in her abdomen which were sealed with surgical glue.
Kidney cancer, however, is more common in male than female. A possible reason is that female hormones, such as estrogen, may have a protective role in preventing kidney cancer. Estrogen levels decline with age, which could explain why females are often diagnosed at an older age than males.
According to the latest Singapore Cancer Registry Annual Report 2021 released last month in August, kidney cancer is the 7th most common cancer in male between 2017 and 2021. In fact, the number of kidney cancer cases in male is on an upward trend.
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