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tests given after partial nephrectomy

VeryAnxious
Posts: 67
Joined: Sep 2010

So confused. What are the normal types of tests to expect the first year after a partial. So far, at 3 months I have had a nuclear renal blood flow scan and blood tests. At the next 3 month interval my surgeon wants me to do more blood tests and a chest xray. AT a year he wants a CT scan. After asking why, I was told because of all surgery and different things placed in me bcauxse of it it is best to wait a year. They get the best reading that way. I may not be explaining this right. I always thought the first 6 months they want to do a CT scan. It made lots of sense when it was explained, but then I got to wondering. I guess I need to stop this second guessing my surgeon, but once you are diagnosed with cancer, you always worry.

Von55's picture
Von55
Posts: 57
Joined: Aug 2010

I havn't read back over your posts, but am assuming that you had clear margins after your Partial? As you know, kidney cancer is slow growing- surgeons seem to be more concerned with early mets after surgery than with the possibility of a rapid regrowth of the primary tumour. A CT at 12 months sounds about right, but don't hesitate to voice your concerns to your doc- it's their job to give you as much info as you need AND to make sure you understand what has been said, regardless of their opinion of your understanding. You've been through a lot with this rotten thing, and any extra anxiety will only delay healing & your return to a peaceful life.
Thinking of you!
Von xx

icemantoo's picture
icemantoo
Posts: 1653
Joined: Jan 2010

Very Anxious,

Each of us as survivors was scheduled for various tests following the surgery. While there is much in common about the scheduked tests each are tailored to each patients recovery and risks. Take care and may all of your tests show nothing (abnormal).

Best regards, Icemantoo

VeryAnxious
Posts: 67
Joined: Sep 2010

Thanks to both of you. Yes it was RCC stage 2. Does the anxiety ever really get any better. I think if I had good family support, it would not be so bad. My surgeon is insistent that a yearly screen for me is appropriate and his reasoning sounds okay,but I hear so many people getting 3 month tests.I guess the chest xray worried me for metasses. Thanks again for your feedback.

lbinmsp's picture
lbinmsp
Posts: 266
Joined: Jun 2006

First, are you seeing an oncologist? Or is it your urologist who is following you? Either way, if you feel uncomfortable the first thing to do is ask questions - lots of questions. My urologist (who specializes in renal cancer) followed me initially - with CT's and blood work every 3 months for the first year. Then the same evey 6 months for the next 3 1/2 years. At that point I switched to an oncologist due to an early breast cancer diagnosis and he continued with close followup.

It's normal to worry - a cancer diagnosis just flat-out knocks the stuffing out of you! All I can say is that you're not alone - there's generally someone here on this board who has been where you are and we're all willing to reach out a hand of support!

VeryAnxious
Posts: 67
Joined: Sep 2010

Actually he is a urologic oncologist. His reasoning being I will worry needlessly since the radiologist will say the scan is abnormal to cover their _______ (from all of the scarring etc. He wants to see me every 3 months. the next set of tests are a chest xray and more blood tests. I do keep asking questions and he feels very strongly about too early Ct scans. I just do not know anymore. When I talk to him, his reasoning seems good, but when I see others having constant scans I really worry. thaks for posting.

lbinmsp's picture
lbinmsp
Posts: 266
Joined: Jun 2006

your worry - I guess the key is - do you trust your doctor? If you do, then continue. However, if you continue to feel uneasy, find an oncologist. I think sometimes oncologists prefer to err on the side of caution (meaning more and frequent testing). Good luck to you!

Jamie1.3cm's picture
Jamie1.3cm
Posts: 188
Joined: Jan 2011

I think it all depends on the nature of your first tumor. If they know that it has already metas'd to other organs, then of course more tests will be necessary at sooner intervals. If the tumor was small (under 3 cm) then it usually has not metas'd and doesn't pose as much of a threat and you can have fewer tests further apart. As someone mentioned, kidney cancer is a slow-growing cancer, generally speaking. For example, my tumor was spotted in December, but I'm not having surgery until June (I'm a teacher, so timing is everything.)

Some people will just need really close monitoring, and others won't. I'd say it's a good sign if you aren't being screened compulsively, but I completely understand your concern.

Moreover, there's much debate about getting too many ct scans too close together. You don't want to radiate yourself into another cancer. btw, U of Michigan med school is even recommending a med to take before a ct scan if they're using IV contrast, just to protect the remaining kidney.

VeryAnxious
Posts: 67
Joined: Sep 2010

Thanks all. I go back for the 6 month testing soon. Just blood and chest xrays. Pose a question. Does anyone know if surgeons do not like to see other suregons patients. So essentially do cancer patients usually not switch doctors

Jamie1.3cm's picture
Jamie1.3cm
Posts: 188
Joined: Jan 2011

I don't think they mind so much if the docs are not at the same hospital, or certainly not in the same "group." But in my experience, switching docs who are associated in some way is not appreciated in the medical culture. I tried doing that once, and the second doc, seeing who I was "really" working with, would barely speak to me, was dismissive, and it turned out to be a waste of time.

You definitely need to work with someone you're comfortable with, so I would say that if you need to switch docs, go to a different hospital altogether, and not just another branch of the same main hospital either.

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