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I have just been Diagnosed with Stage 1 of RCC

acaby
Posts: 1
Joined: Feb 2009

I will be 65 years old in April.I was diagnosed last week with stage 1 of RCC on my right kidney.It was found by accident in the ER scanning for another possable problem when I went in with a high fever and I was Immediately scheduled for an IPV CT. The IPV CT revealed a 2cm tumor INSIDE the kidney. My Urology Doctor is saying that because it is INSIDE the kidney the whole organ needs removed and I do not qualify just for tumor removal only. The procedure he will to do is the the robot procedure, not sure of the medical term, where they put a few holes and a small incision and remove the kidney from there.

My question is Why can they not just remove the tumor only instead of the whole kidney as the IPV CT scan revealed that the cancer was contained in the tumor only and had not spread anywhere.

I guess my real question is Do I need a second opinion to see if the tumor only can be removed or should I just take his advice and let them remove the whole Kidney. My left kidney is in good condition.

Thanks,
acaby

nonnatoo
Posts: 34
Joined: Nov 2007

Hello Acaby,

I had stage 2 RCC of my left kidney in October 2007. My surgeon was uncertain about whether or not he could save a part of my kidney or the whole thing because of the location of the tumor. He also could not tell me whether or not the surgery would be performed laparoscopically or a full incision. I was fortunate that he was able to save half of my left kidney and am on a yearly checkup. I was very comfortable with his plan and so I went ahead. I guess that what I am saying is that if you are not completely comfortable with the surgeon, get another opinion. You sound as though you aren't quite sure, and you need to be. It's okay to get a second opinion and your doctor shouldn't mind. Good Luck. Nonnatoo

nonnatoo
Posts: 34
Joined: Nov 2007

Hello Acaby,

I had stage 2 RCC of my left kidney in October 2007. My surgeon was uncertain about whether or not he could save a part of my kidney or the whole thing because of the location of the tumor. He also could not tell me whether or not the surgery would be performed laparoscopically or a full incision. I was fortunate that he was able to save half of my left kidney and am on a yearly checkup. I was very comfortable with his plan and so I went ahead. I guess that what I am saying is that if you are not completely comfortable with the surgeon, get another opinion. You sound as though you aren't quite sure, and you need to be. It's okay to get a second opinion and your doctor shouldn't mind. Good Luck. Nonnatoo

donna_lee's picture
donna_lee
Posts: 406
Joined: Feb 2009

I guess I would say you are very lucky. Get that second opinion and get the surgery and start healing. Probably the size indicates they need to check a larger area in the kidney-which can destroy tissue.
Mine was stage 4-already mets to the liver and a set of nodes when it was discovered on some routine tests in 2006. It has recurred in nodes in 2006 and 2007, and maybe in my liver this year. You can live with one kidney, but need to watch the BP, sugar, weight and all the stuff that goes with an impaired immune system. Don't know where you are, but I am in Oregon and Oregon Health Sciences University has a great bunch of drs. and facility. Good Luck. PS I turn 66 in a month.
donna-lee

wordnerd
Posts: 7
Joined: Feb 2009

I am 31 years old, 5'4, and 115 pounds and had my softball size tumor and right kidney removed 4 weeks ago today (I was five pounds heavier then!). When discussing options with my urologist, I had the same question: wouldn't you want to keep your kidney if you could? His response was twofold. First, my highly vascular (lots of blood vessels) tumor was pretty much enveloping my kidney, so removing the tumor and not the kidney would be incredibly difficult. Second, keeping the kidney significantly increased my chances of a recurrence in that kidney. Given the high function of my left kidney, he highly recommended removing the right kidney for my general health.

I admit that I was a bit upset with this. I wanted to keep all my body parts! However, now reading more about recurrence, I am glad I had the radical nephrectomy (GIVEN the good health of my other kidney). However, it is never a bad idea to get a second opinion. Even if the second doctor says nothing different, it is helpful to hear the same thing from a different person. This is an incredibly frightening time. I recommend doing everything you can to feel as informed and in control as you can. Go for the second opinion. You can always go back to the first doctor. If you decide on the second opinion, I also recommend making this appointment ASAP so you can make the decisions you need to make quickly.

On a final note, I had my surgery done laparoscopically, though the doctors weren't sure they would be able to go all the way through the surgery this way. If it is at all possible, I would push for this approach! I had my surgery on Wednesday and went home Saturday morning. Home, by the way, is on the second floor and there are no elevators. :)

Best wishes,
wordnerd

mbates09
Posts: 6
Joined: Feb 2009

Your tumor is small, but sometimes when it is in the center or cortex of the kidney there is a risk that it has invaded more of the kidney and the blood supply to the kidney, so they have to take the whole kidney then. I have a cousin-in-law who had a small RCC and because it was at the edge of the kidney, they could just remove the tumor and leave the kidney. Yours must be in the cortex, as I said above, and that will require its complete removal (the kidney, that is). Sorry for that but I am living just the same with one as I did with two. I urinate just as frequently if not more so, and I eat anything I want and feel wonderful 15 months after the surgery. I am glad you are having the smaller surgery and the tumor is smaller, as the open laparotomy was a painful, painful experience. I have had arthroscopic surgery on my shoulder and the scars are nearly invisible and were within one year and the recovery would have been really fast if not for the loss of mobility. My kidney scar still shows, but when I look at it I just thank my Heavenly Father for the fact that I am alive and well. I see it as a badge of victory over a very frightening point in my life. God bless you as you go through the surgery and recovery.

mbates09
Posts: 6
Joined: Feb 2009

I will be 61 in June and am interviewing for a job in a brand new career!!! Life is great :)

Doc P
Posts: 4
Joined: May 2009

acaby,

I think the answer to "Why can they not just remove the tumor only instead of the whole kidney" is for you and the medical professionals. I agree on getting a second opinion unless you trust the doctor who you are seeing. I am one week post-op from a left partial nephrectomy and was fortunate to have the Da Vinci robotic surgery. If there is one in your area I recommend it. I have six, one inch incisions in my abdomen and my mobility is getting better and better each day.

Also, if your other kidney works fine why take the chance? One kidney can easily do the work of two and you will be reassured that the encapsulated tumor is gone from your body vs. the doctor and you hoping it was all cut out.

starman
Posts: 15
Joined: Sep 2009

Acaby, I am in your situation also. I'm confused by the people (some of my doctors and the people on this forum) that say things like "heck, if you have one good kidney, get rid of the one with cancer". First of all, we all know how hard it is to get a kidney transplant so if anything ever goes wrong with the remaining kidney you could be in big trouble. Second, check your glucose levels. Mine have been creeping up and I might become diabetic at some point, so having one kidney could complicate this situation. And finally, if a tumor develpoed on one kidney, it seems like the odds are good that it might go after the other. I know that this is all speculation but I am surprised that more people don't take the attitude of trying to do EVERYTHING possible to save your kidney first and only consider removing it as a last resort. Right now it seems like most people consider it a "first resort".

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