In a startling incident that underscores the silent nature of some cancers, a seemingly healthy 32-year-old man discovered he had kidney cancer during a routine corporate health check-up in September. The young man, who was fit, cheerful, and showed no symptoms, walked into the Outpatient Department (OPD) for what he believed was a standard annual exam offered by his company.
The Incidental Discovery That Changed Everything
During a routine abdominal ultrasound, the radiologist noticed something unusual and called in the consulting doctor, Dr. Manav Suryavanshi, Head of Uro-Oncology at Amrita Hospital, Faridabad. The scan revealed an irregular mass in the upper pole of the right kidney. Although faint, it was large enough to be concerning but fell into the early detection category. A follow-up contrast CT scan confirmed the dreaded diagnosis: renal cell carcinoma (RCC), the most common type of kidney cancer.
The patient was in shock. "Doctor... I don't even feel unwell. I don't smoke much. I'm only 32. How can I have cancer?" he asked, his voice unsteady. Dr. Suryavanshi explains that this is a reaction he encounters increasingly often. Many kidney tumours are 'silent' and are discovered incidentally during scans for other issues. Kidney cancer is typically seen in men above 50, making this case particularly notable for the patient's young age.
Precision Surgery and a Path to Cure
The tumour was classified as T1a (less than 4 cm), which, when caught early, offers an excellent chance of a complete cure. For a young patient, the priority is to remove the cancer while preserving as much healthy kidney function as possible. Dr. Suryavanshi recommended a robotic partial nephrectomy – a precision, minimally invasive 'keyhole' surgery.
This advanced procedure involves mapping the tumour, temporarily controlling blood flow to the kidney, excising only the tumour with a slim margin of normal tissue, and then reconstructing the organ. The surgery lasted three hours. Remarkably, the patient could sit up straight by the evening, started walking the next day, and was discharged home on the third day.
The pathology report brought immense relief: it was a clear cell RCC confined to the kidney, with negative margins and no spread. This meant the young man required no further chemotherapy or radiotherapy. Surgery alone had cured his cancer.
A Crucial Genetic Twist and Lifelong Vigilance
During post-operative counselling, a review of family history revealed a critical detail: the patient's grandmother had also been diagnosed with a kidney tumour in her 40s. This prompted the doctors to recommend genetic testing.
The blood test came back positive for a mutation in the von Hippel–Lindau (VHL) gene. This is a hereditary condition that significantly raises the lifetime risk of developing kidney tumours and certain other tumours. Each child of a person with this VHL gene change has a 50% chance of inheriting it. While not everyone is affected the same way or at the same age, structured surveillance is crucial for early detection of any future problems.
Dr. Suryavanshi highlights that modern medicine offers tools for managing such genetic risks. For VHL-related tumours, drugs like Belzutifan (an HIF-2α inhibitor) can shrink tumours and potentially delay or avoid repeat surgeries. For advanced RCC, treatments include VEGF/tyrosine kinase inhibitors (TKIs) like sunitinib, pazopanib, and axitinib, which cut off the tumour's blood supply, and immunotherapy (checkpoint inhibitors like nivolumab or pembrolizumab).
This case serves as a powerful reminder of the life-saving potential of routine health screenings, even for asymptomatic individuals. It also stresses the importance of a detailed family medical history and the role of genetic counselling in comprehensive cancer care.
