Kidney

Kidney and Ureteral Stones

Prevention of Kidney Stone Recurrence

Some patients who have had kidney or ureteral stones may form more stones in the future. After your stone passes or is removed, your doctor will determine if you are at high risk of recurrence. To do so, he or she will need to analyse the stone. In addition, the doctor will consult the results of your blood and urine tests which were done before treatment.

If you have a high risk of recurrence (See Causes of kidney stones),  the doctor will run a series of specific blood and urine tests called metabolic evaluation. Depending on the test results, the doctor will recommend preventive measures or further tests.

General lifestyle advice to prevent stones

Even if you have a low risk of forming another stone, your doctor and nurse will advise you to make some lifestyle changes. These measures reduce the risk of you getting another stone and improve your health in general. The following advice is for adults.

Drink more

  • Make sure you drink 2.5 to 3 litres every day
  • Drink evenly throughout the day
  • Choose pH-neutral drinks such as water or milk
  • Monitor how much you urinate. It should be 2 to 2.5 litres every day
  • Monitor the colour of your urine: it should be light. Drink even more if you live in a hot climate or do a lot of physical exercise. This will help you to balance your fluid loss

Adapt your diet

Depending on your individual situation, your doctor may recommend that you adapt your diet. It is important to discuss this with the doctor first.

  • Have a balanced and varied diet
  • Eat lots of vegetables, fibres, and fruits (especially citrus fruits)
  • Try to eat more low-oxalate foods like eggs, lentils, white rice, peeled apples, grapes, cauliflower, squash, etc.
  • Make sure your diet contains a sufficient amount of calcium (about 1,000 milligrams a day). However be careful with calcium supplements and always ask your doctor or nurse for advice
  • Reduce the amount of salt in your diet (no more than 3 to 5 grams a day)
  • Do not eat too much animal protein, especially meat from young animals. Instead, eat more vegetable protein, found for example in avocado, cauliflower, or peas
  • Maintain a healthy weight (your Body Mass Index should be between 18-25 kg/m2)

Useful Link

Read more about how to adapt your diet in these Litholink brochures.

Healthy habits

Adopting a healthy lifestyle is always a good idea.

  • Try to exercise 2 or 3 times a week
  • Avoid stress
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Asymptomatic stones

Stones that do not cause any symptoms. They are usually found during imaging tests done for another condition.

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Bladder

Organ which collects urine from the kidneys.

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Calculi

Stones.

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Computed tomography (CT)

Imaging technique that makes a series of x-ray images of the body.

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Conservative treatment

Monitoring the progress of the stone disease or treatment with medication to ease the natural passing of stones.

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Contraindication

A symptom or condition that makes a certain treatment option undesirable.

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Decompression

Relieving pressure in the kidneys. A nephrostomy tube is placed directly in the kidney through the skin so that urine can leave the body.

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Endoscope

A tube-like instrument to examine the inside of the body. Can be flexible or rigid.

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Fragments

Pieces of the stone broken during a procedure.

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Intravenous urography

An imaging technique where x-ray contrast agent is injected into the vein, usually in the arm.

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JJ-stent

A tube that is temporarily placed in the ureter to make sure urine can flow from the kidney to the bladder.

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Kidneys

Two bean-shaped organs in the back of the abdomen that filter the blood and produce urine.

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Medical Expulsive Therapy (MET)

Medication that makes the natural passing of stones easier and less painful.

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Metabolic evaluation

Series of blood and urine tests for patients who have a high risk of forming stones.

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Nephrostomy tube

A tube placed directly into the kidney through the skin. This allows the urine to leave the body.

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Non-contrast-enhanced CT

Type of CT scan with low radiation exposure.

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NSAIDs

A group of medicines used to relieve pain. It is often used to relieve renal colic.

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Oxalate

A component found in many kinds of food which may be related to forming kidney or ureteral stones.

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Percutaneous

Through the skin.

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Percutaneous nephrolithotomy (PNL)

Treatment option to remove stones directly from the kidney by placing a tube through the skin.

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PH-value

A measure between 0.0 and 14.0 to describe if a fluid is acidic or alkaline. pH values close to 7.0 are neutral, anything above is alkaline, anything below is acidic.

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Renal colic

Severe pain in flank, loin, groin, or thigh caused by a stone blocking the normal flow of urine.

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Shock-wave lithotripsy (SWL)

Treatment option to break stones into smaller pieces using high energy sound waves. Stone fragments pass with urine after the procedure.

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Ultrasonography

Imaging technique that uses high-frequency sounds to make an image of the inside of the body (ultrasound).

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Ureter

One of the two tubes through which urine flows from the kidneys to the bladder.

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Ureteroscope (rigid or flexible)

An endoscope used for the urinary tract. It is inserted into the urethra and can move through the bladder, up the ureter, and even into the kidney.

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Ureteroscopy (URS)

Treatment option to remove kidney or ureteral stones. A ureteroscope is inserted into the urinary tract via the urethra to pull out the stone.

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Urethra

The tube which carries urine from the bladder and out of the body.

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Uric acid

A chemical that is created when the body breaks down substances called purines.

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Urinary tract

The organ system which produces and transports urine through and out of the body. It includes two kidneys, two ureters, the bladder and the urethra. The urinary tract is similar in men and women, only men have a longer urethra.

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Urolithiasis

Stone disease.

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Urologist

A doctor specialized in health and diseases of the urinary tract and the genitals.

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LUTS

Lower urinary tract symptoms. A term used for the symptoms caused by BPE which can also point to other diseases affecting the urinary tract (see also Urinary tract).

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Active treatment

Procedures to remove a kidney or ureteral stone.

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Adenoma

The enlarged part of the prostate.

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Anaesthesia (general, spinal, or local)

Before a procedure you will get medication to make sure that you don’t feel pain. Under general anaesthesia you are unconscious and unaware of what is happening to you. Under spinal or local anaesthesia you will not feel pain in the part of your body where the procedure is done. Anaesthesia wears off gradually after the procedure.

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Benign enlargement

Cell growth in the body which is not cancerous.

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Cystoscope

A type of endoscope which is used in the urethra (see also Endoscope, Urethra).

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Erectile dysfunction

The inability to get or keep an erection.

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Indwelling catheter

A tube placed in the urethra and bladder to help you urinate.

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Micturition

Urination.

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Minimally invasive procedure

A surgical procedure where there is no need to make an incision in the body. An endoscope is used to reach the part of the body that needs to be treated through the urethra (see also Endoscope).

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Nocturia

Waking up one or more times during the night because of the need to urinate.

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Physical

Having to do with or affecting the body.

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Post void residual urine (PVR)

The amount of urine left in the bladder after urination.

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Prostate

The gland which produces the fluid which carries semen. It is located in the male lower urinary tract, under the bladder and around the urethra.

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PSA (prostate-specific antigen)

A protein produced by the prostate which may increase in men with a benign prostatic enlargement, prostatic inflammation, or prostate cancer.

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Psychological

Having to do with or affecting the mind.

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Resectoscope

A type of endoscope used for minimally invasive treatment of BPE.

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Retrograde ejaculation

A condition when semen can no longer go through the urethra during orgasm but goes into the bladder instead. The semen later leaves the body during urination.

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Urgency

The sudden need to urinate which is difficult to postpone.

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Urinary incontinence

Involuntary loss of urine.

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Urinary retention

When you are unable to urinate. This condition can be chronic.

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Nocturnal polyuria

When the kidneys overproduce urine at night.

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Peripheral oedema

Oedema means swelling. Peripheral oedema refers specifically to swelling of the ankles and legs.

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Primary polydipsia

The sensation that your mouth is dry which leads you to drink too much.

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Obstructive sleep apnoea

Repetitive pauses in breathing during sleep, despite the effort to breathe, commonly paired with snoring.

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Benign Prostate Enlargement (BPE)

An enlargement of the prostate related to hormonal changes with age.

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Overactive Bladder Symptoms

A collection of urinary storage symptoms, including urgency, incontinence, frequency and nocturia.

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Transurethral resection of the prostate (TURP)

TURP is a standard surgery to treat benign prostatic enlargement (BPE). A part of the prostate is removed to improve the symptoms without making an incision in your lower abdomen. This type of surgery is known as minimally invasive treatment.

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Catheter

A hollow flexible tube to insert or drain fluids from the body. In urology, catheters are generally used to drain urine from the bladder.

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Urinary frequency

The need to urinate more often than usual, generally more than 8 times a day.

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Ablation therapy

A type of minimally-invasive procedure to remove abnormal tissue. The doctor destroys the abnormal tissue using heat (radiofrequency ablation) or extreme cold (cryoablation).

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Active surveillance

A form of treatment in which the doctor actively monitors the tumour or tumours and their growth, based on a strict visiting schedule. For each visit, CT, ultrasound or x-rays are taken, and other appropriate exams may be performed.

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Adrenal gland

The adrenal glands are organs that sit at the top of the kidneys. They are responsible for releasing hormones.

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Adrenalectomy

The surgical procedure in which the adrenal gland is removed.

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Anaemia

A lowered level of red blood cells. It is the most common disorder of the blood. It causes fatigue, weakness and poor concentration, among others.

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Antiangiogenic therapy

Therapy with drugs which prevent the formation of new blood vessels that feed a tumour and allow it to grow.

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Asymptomatic

Any condition which does not cause symptoms and is discovered incidentally.

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Benign tumour

A non-cancerous growth which will not spread to other organs.

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Biopsy

A medical procedure in which a small piece of tissue is removed from the body to examine it. This is done to get information for diagnosing, monitoring, and treatment.

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Chemotherapy

Is a treatment of cancer with drugs that are toxic to cells. Some are specifically toxic to cells that grow faster than normal, like cancer cells.

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Clinical trial

These are experimental research studies designed to answer specific questions about treatments or drugs. They generally test how well a treatment works among patients with specific characteristics.

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Contrast agent

A substance that increases the contrast of structures or fluids in the body. It is used in medical imaging (See also Imaging).

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Cryotherapy

Is the use of low temperatures in medical therapy, to treat either benign or malignant cell growth.

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Cytoreductive nephrectomy

Cytoreductive means reducing the number of tumour cells. This surgery is specific for metastatic kidney cancer. In this surgical procedure a tumour in the kidney is removed, while leaving distant metastases. The aim of the surgery is to reduce the total tumour cells in the body.

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Diagnosis

The doctor and nurses do a series of tests to understand what causes your symptoms.

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Embolization

A non-surgical, minimally-invasive procedure in which a blood vessel is blocked to prevent the blood flow from reaching a tumour.    

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Enzyme

Large biological molecules that are responsible for the processes of the metabolism.

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Fatigue

This means you feel more tired than usual, you are out of energy, and it doesn’t get better after you sleep. You may also experience pain in your joints, muscles, and chest.

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Fatty tissue

A type of connective tissue made of cells which store fat. Also called adipose tissue.

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Fuhrman nuclear grade

Analysing the aggressiveness of a tumour based on the structure of its cells.

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Hand-foot syndrome

A side effect of some types of drug therapy for cancer. It causes redness, swelling and pain on the palms of the hands and/or the soles of the feet, and in some cases blisters.

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Histopathological analysis

The examination of tissue under a microscope, to study the presence and characteristics of diseases such as cancer.

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Imaging

Taking images of the body with ultrasound, x-ray or other scanning techniques.

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Immunotherapy

A type of cancer treatment which boosts the immune system to fight tumour cells.

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Laparoscopic surgery

A minimally-invasive surgical technique in which the surgeon does not need to cut through skin and tissue. Instead, the surgeon inserts the surgical instruments through small incisions in your abdomen.

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Localized kidney cancer

A kidney cancer where the tumour is limited to the kidney and has not spread.

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Lymph nodes

Small oval-shaped organs that play a role in regulating how the immune system responds.

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Lymphadenectomy

The surgical procedure in which the lymph nodes are removed because they are enlarged due to the presence of a tumour.

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Malignant tumour

A cancerous growth which either grows continuously or in spurts. Malignant tumours can metastasize, which means they spread throughout the body.

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Metastasectomy

The surgical procedure to remove metastases. These are tumours that have spread to other organs of the body.

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Metastatic disease

When a tumour has spread to other organs or lymph nodes.

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MRI scan

Magnetic Resonance Imaging is a technique in which strong magnetic fields and radio waves are used to make images of the body.

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Multidisciplinary

A combination of different branches of expertise. In medicine, it means that for instance urologists, oncologists, psychologists or other medical specialists work together.

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Neoangiogenesis

The process through which new blood vessels form from pre-existing vessels. In cancer this process allows tumours to grow.

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Nephron-sparing surgery

Another name for partial nephrectomy, the surgical removal of a kidney tumour together with some of the normal kidney tissue. This surgery aims at preserving as much of the kidney tissue as possible.

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Oncologist

A medical professional who is dedicated to the diagnosis, therapy, follow-up and general care of a person with any type of cancer.

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Open Surgery

A surgical procedure in which the surgeon cuts skin and tissues to have direct access to the structures or organs.

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Palliative care

A concept of care with the goal to optimize your quality of life if you cannot recover from your illness. It involves physical, psychological, social, and spiritual issues.

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Paraesthesia

A prickling (“pins and needles”) or tingling (“falling asleep”) sensation of the skin.

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Paraneoplastic syndromes

Reactions that the body can have to any type of cancer and may include high blood pressure, weight loss, fever, anaemia, muscle mass loss, and loss of appetite.

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Partial nephrectomy

A surgical procedure in which a part of the kidney is removed.

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Pathologist

A medical professional who studies tissue, blood, or urine to understand the specific characteristics of diseases. In cancer treatment, the pathologist helps with the diagnosis and classification of tumours.

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Perinephric haematoma

A collection of blood next to or around the kidney.

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Perirenal fat

The fat that surrounds the kidney.

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Petechia

Lots of tiny red spots or bruises on your arms and legs, caused by a minor haemorrhage in the blood vessels of the skin.

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Primary tumour

The malignant cell growth located where the tumour first began to develop.

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Prognosis

The medical term for predicting the likely outcome of health after treatment.

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Radical nephrectomy

A surgical procedure in which the entire kidney is removed.

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Radiofrequency ablation

A medical procedure which uses the heat generated from high-frequency currents to treat kidney tumours.

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Radiologist

A medical professional who specialises in imaging techniques. In cancer, the radiologist analyses x-ray, ultrasound, CT, MRI, or other scans to diagnose or monitor the tumour.

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Radiation therapy

A type of cancer treatment that uses radiation to control or kill malignant cells.

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Recurrence

The return of cancer after treatment and after a period of time in which the cancer could not be detected. This can happen either in the place where the cancer first was detected, or somewhere else in the body. There is no standard period of time, but most doctors would consider it a recurrence if the cancer had not been detected again for at least one year.

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Renal

Related to the kidneys.

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Renal artery

The artery that carries a large portion of the blood flow that needs to be filtered to the kidneys.

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Renal artery clamp

An instrument used during surgery. The blood flow through the renal artery is blocked with a device called a clamp that compresses the artery.

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Renal cell carcinoma

Medical name of kidney cancer.

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Renal cyst

Fluid-filled sacs located on the kidney. Cysts can be malignant.

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Renal fascia

Also called Gerota’s fascia, it is a layer of connective tissue that surrounds the kidneys.

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Renal vein

This is the vein that carries the blood filtered by the kidney back into the body.

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Surgical robot system

An instrument to help doctors perform laparoscopic surgery. The surgeon controls the robotic instrument with remote control sensors.

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Targeted therapy

These are drugs that target the mechanisms that cancer cells use to grow.

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Thyroid

A gland found in the neck which controls how quickly the body uses energy, makes proteins and how sensitive it is to other hormones.

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TNM classification

The Tumour Node Metastasis (TNM) classification is an international classification used to classify tumours according to the size and invasiveness of the tumour (T), whether any lymph nodes are affected (N) and if the cancer has spread to any other parts of your body (M).

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Treatment pathway

One of the main management tools for doctors. The different tasks or interventions are defined, optimized and set in a specific order. With this the medical team can work on the health of a patient together.

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Tumour spillage

When tumour cells reach the blood or another organ during surgery. These cells may grow in a different location and develop into tumours.

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Tumour stage

This refers to how extended a cancer is in the body. It is usually based on the size of the tumour and whether the tumour has spread to the lymph nodes or other organs.

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Vena Cava

The large vein that returns blood with low oxygen from the body into the heart.

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Ultrasound

Imaging technique that uses high-frequency sounds to make an image of the inside of the body.

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Clear cell renal cell carcinoma

A type of kidney tumour with a high content of fat.

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Locally-advanced kidney cancer

A cancer where the tumour has grown out of the kidneys into surrounding tissue and invaded veins, the adrenal gland, or lymph nodes.

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Minimally-invasive surgery

A surgical procedure where there is no need to cut through skin and tissue. Small incisions are made in the abdomen to insert the surgical instruments.

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