Radiation Exposure | Carcinomas of Kidney & Urinary Tract

 

Events that have been followed by an increase in carcinomas of the urinary tract:

(1) Hiroshima and Nagasaki

(2) Chernobyl

 

Types of exposure:

(1) acute exposure during the initial radiation release

(2) chronic exposure to Cesium-137 (which is excreted via the kidneys) and other radioactive compounds released into the environment

 

Radiation-associated tumors may involve:

(1) renal cell carcinomas

(2) the renal pelvis

(3) the ureters

 

The onset of tumors is often 25 or more years after exposure. The relationship to the radiation exposure is easier to make in patients less than 55 years old.

 

Tumors tend to be seen in patients with radiation exposures high enough to cause cancer but not high enough to cause a more lethal radiation-associated complication (leukemia, etc).

 

Features of the tumors:

(1) The rate of tumors is increased with greater radiation exposures.

(2) The patient may have evidence of radiation nephropathy.

(3) The tumors tend to be more aggressive with a higher grade.

(4) K-RAS expression may be increased.