Kidney Cancer

[worriedcbb]

Recently during ultrasound it was discovered I have a benign tumor on my right kidney. This is all new to me and I'm worried. Does anyone have suggestions or knowledge if the growth will turn cancerous?

[dwjake]

How do you know that it is benign? Is it a solid mass or a fluid filled cyst? If it is a solid mass, I suggest you go in and have a CT scan or MRI done for them to get a better look. Biopsy is not a good idea due to the potential risk of spreading the cancer cells, if that is what it turns out to be. According to the Urologists and Oncologists that I have spoken with, according to actual statistics, chances are that 70-90% of all solid masses on a kidney are malignant tumors (cancer). I am a 39 year old male in good general health....and just recently discovered a 5.5 CM tumor on my right kidney. I am going in for a partial nephrectomy at Northwestern Memorial Hospital in Chicago.

[worriedcbb]

Dear Dwjake,

Thank you for replying to my post. I am scheduled for a CT scan this Thursday. What a coincedence to receive your email on the week I'm scheduled.

You pose great questions? I didn't know there was a difference if fluid filled or solid mass. I'll have to find out. Scary the percentage is so high it could be cancerous if it's a solid mass.

What is a partial nephrectomy? I will say a prayer for you all this week (I don't know the day of your surgery) that the procedure will go smoothly and all will turn out healthy for you.

Sincerely,

cbb

[dwjake]

Hello, I hope you received good information from your CT Scan last week. Either way, just make sure that whoever is guiding you on this, has the expertise necessary to make sound decisions. You should be seeing a Board Certifiied Urologist.

I had a partial nephrectomy on Wednesday morning last week, 1/28. In a partial nephrectomy, the surgeon removes only the tumor plus a margin area around the tumor. Basicly, they have to cut in to good, healthy kidney tissue to make sure that they have it all. The procedure (which I will simplify), is a as follows: make large 8" incision (just under rib cage in my case). scan the tumor with ultrsound wand to see where it starts/ends. From this they mark the reception area (where they will cut). Mine was a higher risk procedure than most due to its proximity to the renal artery. After they cut out the tumor, they have to seal everything up and minimize blood and urine loss from the kidney. They also have to get all of the plumbing reconnected so that the kidney filters the blood properly and delivers the urine properly to the bladder. Procedure took around 4 hours. I have about 60% of my kidney still functioning on side....and 100% of the other.

In my situaion, the tumor was 5.5 CM and was still confined to the Kidney....Stage T1B. Pathology came back (after removal of tumor) and confirmed that it was Clear Cell Carcinoma (most common type), Grade 2. Based on this information, my doctor said that I am cured....and that statistically, my chances of recurrence are only 10%. That is still obviously higher than I would like....but what certaintly do we have any anything...other than death and taxes.

So far, the worse part of the recovery for me has been the narcotics used to fight the pain. They have made me lethargic....and I am constantly sweating. But I will probably be going home today or tomorrow.

Let me know how things turned out on your test...and if you have any other questions for me.
DWJ

[camper37]

I am very happy to hear that you are returning to normal although now you'll end up spending the rest of your life in jail for drug use! Only kidding!

I was diagnosed by way of MRI with a 2.4cm tumor on my kidney last July (08). I just had an MRI (Feb 09) and it still remains the same size - hasn't grown but hasn't disappeared.

In talking to the Urologist, he told me to have the entire kidney removed since 80% of all tumors in the kidney (I am 64 yrs of age) are cancerous. He told me that a biopsy would not prove anything since they cannot be sure that they are getting cells from the 'tumor'.

How did your doctor determine that it was cancerous? How big was your tumor? Was there any blood in your urine? Did you have abdominal pain?

I am helathy and as the doctor said 'very fit' but I really do not want to donate my kidney to science if I do not have to.

I would like to hear your input.

Gary

[gborin]

Dear Camper 37/Gary, I was a more than a little upset when I read your 2 posts about your reluctance to have surgery. At age 59, 6.5 years ago I went under the knife with a 2.6 cm tumor on my kidney that the doctor said had a 90% chance of being cancerous. After the kidney and tumor were removed a pathologist did a biopsy on the tumor and cofirmed that it was Cancer. I am sure that the surgery does not get any easier as you get older. It was bad enough for me at 59. You are 64. Are you going to wait until you are 69 or until the tumor gets bigger and they can no longer remove it laporscopically or it spreads before the surgery, All of these things work against you. The surgery is no fun, but it beats the alternative. The biggest surgery I had before this was stiches and tonsils at age 3 so I was not prepared, but some things you have to do in life for you and your family. The one good thing about the surgery is that if they remove the tumor before it spreads you will die of something else. Having said all this check and see if the Doctor will order a CAT scan as I understand that they provide a better diagnosis. Also if your Urologist does not do this surgery (most do not) get a second opinion from a sugeon and/or oncologist. Good luck.
Garry

[camper37]

Thank you Garry for wake up message. I suppose I am trying to elude the inevitable. How are you feeling? How long did it take for the recovery? What problems should I look forward to?

Your input is greatly appreciated.

Thank you, Gary

[dwjake]

Gary, I agree with your last message. You need to face the reality of the situation and have it removed. It would be disappointing to find out after the fact that it was benign. I hoped for that while i was waiting for pathology. However, the odds of that happening are less probably less than 10%.

You need to find a urologist or surgeon that you are comfortable with. You need to understand all of your options and the short and long term risks associated with each option. You need someone that has a lot of experience with kidney cancer...and that has performed lot of surgeries. A good urlogist should be able to help you make a good decision on whether or not you do a laporoscopic or open procedure...and what makes more sense given your age fitness level, a radical or partial nephrectomy. Also, prior to making the decision, you may want to do a renal scan so that they can check the functionality of your other kidney.

I met with three urologists prior to making a decision on who I would use. My tumor was 5.5 cm and from the CT scan and MRI, it looked to be very close to the renal artery. The size of the tumor and proximity to the artery made this a much higher risk procedure (blood loss potential if the artery was hit, and possibly death to the kidney if the artery get closed off while trying to stop blood loss)....that many urlogists would not be able or willing to handle. The first one that I met with said that he would perform and open radical nephrectomy, taking the entire kidney and adrenal gland. The second one that I met with said that he would peform a laporoscopic radical, leaving the adrenal gland. The third said that he could do the the laporoscopic radical, but that the other option was an open partial. So much for reaching a consensus to make an easier decision! It seemed that the higher up the food chain I went with doctors, the more and better options that I had.

For many reasons, I opted for the open partial. Doctor number three was a big believer philosophically speaking in preserving renal function. The more research that I did seemed to support the idea that more renal function is better. He also told me that if something were to happen to my other kidney, that you can typically avoid dialysis if you have 25% of one kidney. I am 39 years old and in generally good health, not really overweight. I work from a home office. I decided that the only reason for me to not pursue the open partial was that it would be a more difficult, slower recovery process. My doctor felt going in to it that we had a 70% chance of having a successful partial....30% chance that it would be converted to a radical.

My surgery was 5 weeks ago today. I was working again full time after only two weeks. I have definitely had a better recovery than I or the doctors had expected. I was told that I can resume normal activities with regard to excercise at 6 weeks. To this point, my only excercise has been walking.

The worse part of recover for me (as I mentioned in earlier post), was the narcotics in the hospital. Once I came home and stopped taking those, after 5 nights in the hospital, I was in much better shape. I had barely any pain...and took ibuprofen or tylenol on a few occasions. You are not supposed to do any lifting above 10-20 pounds or any physical activity that will stress your abdomen. I have done both...and I can feel it later. Now the main sensation is just a tightness or lumpy feeling along the incision....due to scar tissue forming and the like.

Again, get educated, feel comfortable with your decision and get this taken care of.

Good luck and God Bless!
Derk

[gborin]

Gary, You requested information about my surgery and recovery. Please read my post under the Surgery topic. Good luck. Garry