From the Guidelines
Muscle weakness in patients with renal cell carcinoma (hypernephroma) is a significant concern that affects their quality of life, and addressing it requires a comprehensive approach that includes exercise, nutrition, and cancer treatment. When considering the association between muscle weakness and renal cell carcinoma, it is essential to recognize that cancer patients, in general, report low levels of physical activity, and both inactivity and cancer treatment have serious adverse effects on muscle mass 1.
Key Considerations
- A recent systematic review concluded that both aerobic and resistance exercise improves upper and lower body muscle strength more than usual care, and there is some indication that resistance exercise perhaps is more effective for improving muscle strength than aerobic exercise 1.
- Cancer treatment and inactivity can lead to muscle weakness, emphasizing the need for early intervention and a multidisciplinary approach to manage muscle weakness in patients with renal cell carcinoma.
- While the provided evidence does not directly link muscle weakness to renal cell carcinoma, it highlights the importance of physical activity and nutrition in cancer patients, which can be applied to managing muscle weakness in the context of hypernephroma.
Management Approach
- Exercise, particularly resistance training, should be considered as part of the management plan for muscle weakness in patients with renal cell carcinoma, given its benefits in improving muscle strength.
- Proper nutrition is also crucial, as it supports muscle health and overall well-being in cancer patients.
- Addressing the underlying cancer through appropriate treatment, such as surgical removal of the tumor, and managing any paraneoplastic syndromes or direct effects of the cancer on the body, are critical for improving muscle weakness associated with renal cell carcinoma.
From the Research
Association between Muscle Weakness and Renal Cell Carcinoma
- Muscle weakness can be associated with renal cell carcinoma (RCC) as a paraneoplastic syndrome, which is a condition caused by the immune system's response to a cancer, but not due to direct local effects of the tumor cells 2, 3, 4.
- A case study reported a patient with RCC who developed progressive gait disturbance and muscle weakness, which improved after tumor resection and immunoglobulin therapy 2.
- Another study presented a case of myasthenia gravis, an autoimmune neuromuscular disease characterized by fatigable muscle weakness, in a patient with stage IV RCC 3.
- Cancer-associated muscle weakness can be caused by multiple factors, including the malignancy itself, the tumor environment, chemotherapy, radiotherapy, and malnutrition, leading to impaired intrinsic capacity, neuromuscular disconnection, and muscle atrophy 5.
- Bone metastases from RCC can also contribute to muscle weakness by disrupting normal bone remodeling and releasing growth factors that act systemically to cause muscle weakness 6.
Paraneoplastic Syndromes in Renal Cell Carcinoma
- Renal cell carcinoma is unique among genitourinary malignancies in that close to one third of affected patients show signs and symptoms of a paraneoplastic syndrome 4.
- The paraneoplastic syndromes associated with RCC can range from constitutional symptoms to specific metabolic and biochemical abnormalities, and their presence is not necessarily indicative of a poor prognosis 4.
- Understanding the pathophysiology and biology behind the paraneoplastic syndromes associated with RCC is important for clinical evaluation and treatment options 4.