Kidney Stones vs. Kidney Cancer: Your Diagnosis and Concerns

Kidney stones or kidney cancer?

Dear Dr.
Wu,
Hello! I have some questions that I would like your help with.

1.
Since my sophomore year, I have consistently had protein in my urine during health check-ups, which has caused me a lot of concern.
Almost every test I have done shows the presence of protein.
Recently, I went for another check-up, and surprisingly, the protein level in my urine did not exceed the threshold.
What could have caused this change?
2.
I recently visited a gastroenterologist for an examination, and the doctor performed an abdominal ultrasound, which revealed something unusual.
I was referred to a nephrologist.
I had previously undergone a kidney X-ray and a urinalysis for kidney stones at another hospital, and both tests were reported as normal.
This time, at a different facility, the nephrologist immediately told me that I have kidney stones.
When I asked if it could be kidney cancer, he replied that at 27 years old, the chance of having kidney cancer is one in a hundred thousand, and it is unlikely.
Should I trust the doctor? Is it possible to have normal kidney X-rays and urinalysis for kidney stones and still have stones detected on an abdominal ultrasound? Additionally, I drink 2500 to 3000 cc of water daily; how could I still develop kidney stones?
3.
I do not smoke, drink alcohol, or chew betel nut.
What can I do to avoid kidney cancer?
Thank you!

Kuai Le Bao, 20~29 year old female. Ask Date: 2015/08/25

Dr. Wu Jiyu reply Internal Medicine

1.
The examination of proteinuria can be categorized into coarse and fine assessments, and there are physiological proteinuria and pathological proteinuria.
It is recommended that you consult a nephrologist for a detailed examination to clarify the issue.

2.
Kidney stones are diagnosed through ultrasound, urinalysis, and X-rays.
It is possible for X-rays and urinalysis to appear normal while an ultrasound reveals kidney stones.
Kidney stones and renal cancer are completely different diseases, and a physician's expertise can distinguish between them.
3.
Risk factors for renal cancer include smoking, obesity, and other factors.
If you do not smoke, your chances of developing renal cancer can significantly decrease.
Thank you for your inquiry; the Nephrology Department at Changhua Hospital cares about your health.

Reply Date: 2015/08/25

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding kidney stones and the potential for kidney cancer. It's understandable to feel anxious when faced with medical uncertainties, especially when it involves your kidneys. Let’s break down your questions and clarify the distinctions between kidney stones and kidney cancer, as well as address your specific concerns.

1. Understanding Kidney Stones and Kidney Cancer Symptoms:
Kidney stones and kidney cancer can present with overlapping symptoms, such as hematuria (blood in urine), flank pain, and changes in urinary habits. However, the majority of kidney stones are asymptomatic until they cause obstruction or irritation. In contrast, kidney cancer may not show symptoms until it has progressed. While both conditions can lead to blood in the urine, kidney stones are more likely to cause acute pain, especially if they obstruct the urinary tract.

2. Diagnostic Imaging and Tests:
Diagnostic imaging plays a crucial role in differentiating between kidney stones and kidney cancer. Ultrasound, CT scans, and X-rays are commonly used. Kidney stones typically appear as calcifications on imaging, while tumors may present as masses. It’s important to note that imaging results can vary based on the timing of the tests and the specific techniques used. For example, a recent ultrasound may show a stone that was not visible on a previous X-ray due to its size or location.

3. Your Recent Test Results:
Regarding your urine protein levels, fluctuations can occur due to various factors, including hydration status, physical activity, and underlying conditions. A transient decrease in protein levels does not necessarily indicate a problem, but it’s essential to monitor this over time.
As for the ultrasound findings, if a doctor has identified a mass or stone, it’s crucial to follow up with the appropriate specialists. While your doctor mentioned that the likelihood of kidney cancer at your age is low, it’s always wise to pursue further evaluation if there are any concerns.
4. Preventive Measures for Kidney Health:
Staying well-hydrated, as you are doing with your water intake of 2500-3000cc daily, is one of the best preventive measures against kidney stones. Additionally, maintaining a balanced diet low in sodium and oxalates can help reduce the risk of stone formation. Regular check-ups and monitoring of kidney function and urinary health are also advisable, especially given your history of protein in urine.

5. Addressing Your Concerns About Kidney Cancer:
While the risk of kidney cancer is low in younger individuals, it is not zero. Factors such as family history, obesity, smoking, and certain genetic conditions can increase risk. To minimize your risk, maintain a healthy lifestyle, avoid tobacco, and manage any chronic health conditions with your healthcare provider.

In conclusion, while kidney stones and kidney cancer can share some symptoms, they are distinct conditions that require different approaches to diagnosis and treatment. It’s essential to trust your healthcare provider but also advocate for your health by seeking second opinions or further testing if you feel uncertain. Regular follow-ups and open communication with your doctor will help ensure that any potential issues are addressed promptly.

If you have further questions or concerns, please don’t hesitate to reach out. Your health is paramount, and staying informed is a key part of managing it.

Best regards,
Doctor Q&A Teams

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