Renal Cell Carcinoma (American College of Physicians PIER)
Renal Cell Carcinoma (RCC) has been called the "internist's tumor" because of the multiple possible presenting signs and symptoms. Small, localized tumors rarely produce symptoms, and for this reason the diagnosis is often delayed until the disease is advanced. Many patients with RCC are asymptomatic and present incidentally with a renal mass on abdominal imaging. A careful physical examination may detect an otherwise asymptomatic tumor or the presence of overt metastasis.

Consider potential diagnoses other than RCC in patients with a solid renal mass, including angiomyolipoma, lymphoma, onocyctoma, and inflammatory mass, among others. Understand that there are no reliable means (history, physical examination, urine or blood tests, imaging modalities, percutaneous biopsy) to differentiate benign and malignant neoplasms apart from surgery, and definitive diagnosis of a renal mass can be made only by pathologic examination of the surgical specimen.

In addition to diagnosis, this activity covers prevention and screening, consultation for diagnoses, hospitalization (for resection of tumor or for complications of disease or treatment), non-drug and drug therapy, patient education, consultation for management, and follow-up.

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New Developments with Targeted Therapies for Patients with Advanced Renal Cell Cancer: Targeted Therapy for Clear-Cell RCC (CME)
Although approximately 95% of RCCs occur sporadically, the relatively rare familial forms of RCC and their associated genetic abnormalities have provided insight into the molecular pathways involved in RCC development. Identification of these pathways has promoted the development of biologically targeted therapies in RCC.

Upon completion of this activity, participants should be able to identify the molecular alterations frequently seen in clear cell RCC in order to develop comprehensive treatment plans; develop individualized treatment plans incorporating biologically targeted agents to improve survival outcomes in patients with RCC, and evaluate potential biomarkers predictive of response to antiangiogenic agents in RCC in order to improve patient outcomes.

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