a malignant neoplasm of the renal parenchyma or renal pelvis. Factors associated with an increased incidence of disease are exposure to aromatic hydrocarbons or tobacco smoke and the use of drugs containing phenacetin. A long asymptomatic period may precede the onset of the characteristic symptoms, which include hematuria, flank pain, fever, and the detection of a palpable mass. Diagnostic measures include urinalysis, excretory urography, nephrotomography, ultrasonography, renal arteriography, and microscopic and cytologic studies of cells from the renal pelvis. Adenocarcinoma of the renal parenchyma accounts for 80% of kidney tumors, occurring twice as frequently in men as in women; transitional cell or squamous cell carcinomas in the renal pelvis account for approximately 15% and are equally frequent in men and women. Radical nephrectomy with lymph node dissection is usually recommended for tumors of the parenchyma; nephroureterectomy is usually recommended for operable tumors of the renal pelvis. Radiotherapy may be used preoperatively or postoperatively and as palliation for inoperable tumors. Chemotherapeutic agents that may induce temporary remission are cyclophosphamide, bleomycin, hydroxyurea, and vinblastine.

DR SOON is a medical practitioner. He holds four degrees. MBBS (University of Malaya), MBA (University of East Asia), LLB (Hons) (University of Wolverhampton), Master of Medicine (Edith Cowan University)