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Husband Diagnosed with Kidney Cancer, Stage 4

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Hello everyone. I've been a lurker on your discussions for the past couple of weeks and was a little intimidated to submit as everyone here seems very knowledgeable about options, tests, labs, etc. and I'm pretty much clueless. But I do believe sharing information and getting it out there is part of the key to some day find answers. And since my husband isn't ready to post just yet, I've decided to start without him and perhaps he'll join in. I'll start with a little history. First, John, my husband, was diagnosed with Stage IV kidney cancer on October 15, 2011, after being referred to an internist at Johns Hopkins Hospital in Baltimore. The reason for the visit was weight loss, which had been occurring since the beginning of the year. However, other than weight loss and an occasional cough, he felt fine. And the cough didn't cause great concern because his siblings (3 sisters and brother) all have a cough of unknown origin, though they have been tested extensively. Anyway, since the weight loss started John has seen his primary doctor numerous times and had blood work done, thyroid testing, colonoscopmy, endoscopy, xrays, etc. and everything was perfectly normal -- excellent in fact. However, the weight loss continued and his primary suggested he see an internist. His appointment with Dr. Wooster, a Hopkins Internist, was scheduled for October 14, 2011. Dr. Wooster ordered catscans amd scheduled John to return in a week. But later that same day, he called John and asked him to meet with him at noon the next day and to bring me. When John called me at work and told me that I became physically sick, knowing this couldn't be good. The next day Dr. Wooster showed us the catscans with a very large tumor on the right kidney and several nodules in his lungs. Next meeting was with a renal surgeon at Hopkins, Dr. Allaf, who scheduled kidney surgery on November 1. John underwent a radical nephrectomy of his right kidney. Next visit was with Dr. Hans Hammers of Hopkins who after several visits told John he believed he was an excellent candidate for IL-2 therapy. So his first high dose IL-2 treatment began on January 3, 2012. During the first round he had 14 doses, an incredible feat according to Dr. Hammers. However, once he came home that weekend, he experienced edema, terrible itching, extreme fatigue, etc. for several weeks. In fact Dr. Hammers postponed his second round which was scheduled to begin on January 26 to January 31. During his second stent, he received 10 doses. Again, upon coming home from the hospital, the side effects were tough. Again terrible itching, some nausea, thrush, and again extreme fatigue. Dr. Hammers commented that John was kind of unique in that his body tolerates the quantity of doses well, but the side effects and the length of time it takes for him to bounce back are longer and more difficult than it is for most. Now we're waiting to have the catscans to see if the IL-2 has helped. He's scheduled for March 15. Do you believe he chose the "ides of March?" But it's also his mom's birthday, hopsfully that makes it okay. . . Will keep you posted. Sorry if I've left out pertinent info; I'm new at this.

icemantoo's picture
icemantoo
Posts: 1528
Joined: Jan 2010

Alice123,

Your husband is in good hands at Johns Hopkins. A family member of mine had surgery there over 20 years ago. I for one would not want to comment medically regarding your husband's treatment other than to observe in my 9 and 1/2 years as a survivor that the outlook for those with stage 2, 3 and 4 has substantially improved. Others may chime in who are familiar with the treatments your husband is receiving. Hopefully he is on the road to recovery.

Best wishes,

Icemantoo

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Icemantoo,

Comments like yours make me feel I've come to the right place. Thank you.

alice 124

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Alice, sorry you're both having such a rough time.

We're only a little more informed than you are and only because we've been here for a bit, learning from each other and researching what we can. A cancer diagnosis has a wonderful way of focussing one's attention! Before long you'll be as "expert" as we are.

I'm a little surprised that your Husband has been hammered with IL2 treatment. Was it explained fully why this treatment was selected? Let's hope it was the best choice and pays off. Do you know what Grade his tumour was, aside from being Stage 4?

Do keep us posted so we can offer what thoughts and support we can muster between us.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Dr. Hammers explained that this was the best option because is was the most difficult treatment, and--if he were to start other medications--he probably would not be strong enough to undergo IL-2 at a later date.

Here's the info from his lab report: Fuhrman grade 4 with focal sarcomatoid features. Tumor size was 7 cm. pT3b.

Thanks for your response and interest.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Thanks for the info. Alice. That sounds a strange rationale to me.

Ironically, I may have more interest than either of us anticipated. My path. report is: Fuhrman grade 4, almost entirely sarcomatoid, tumour size 9cm and pT4. Your Husband's histology is probably clear cell -? (Mine chromophobe -> sarcomatoid).

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Sorry I thought I had written that, clear cell w/sarcomatoid features. I can't tell everyone how thankful I am for the response to my posting. I've joined a couple of groups prior to this and this one is much more active and triggers me to be more active, as I believe it will John once he sees how responsive and knowledgeable this group is. Plus John too was an active golfer prior to the nephrectomy. He decided to take temporary leave from the Club after the operation as he just didn't feel strong enough. I know he'll be envious of all of you still swinging away. I told him this morning about joining and about the response and he asked "what is my login?" Touchdown!!!

PK_Chicago
Posts: 29
Joined: Mar 2012

That's the whole idea of a discussion forum!

My advice is ask a lot of questions and do your homework! The web can be a comfort and a curse - you'll read one thing that's positive and the next that's not.

When I was diagnosed I started a Word document where I would snip things I came across on the web and used it as a reference for doctor discussions. It also helped to create a calendar and track everything. If you keep organized it won't seem so daunting.

Most important - stay close to your husband! Talk about things - everything! I don't know what I would have done without support from my wife! She has kept my spirits up the entire time - it will be a lifelong battle!

Good luck!

PK_Chicago

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Thanks PK-can't tell you how valuable I'm finding this forum. I am trying to do what I can for John and we talk, talk, talk (probably more than he wants me to). Thanks for being there for everyone.

garym's picture
garym
Posts: 1651
Joined: Nov 2009

Alice,

You need not worry or feel intimidated here, all are welcome and we try very hard to help each other, especially the new members like you, as much as we can. In many ways RCC can be harder on caregivers than actual patients, you experience the same fears and emotions, but while we are allowed to kick, scream, get angry, and vent, you likely have been maintaining a brave and calm front. You can come hear to kick, scream, be angry, and vent whenever you need to, we understand. We'll also try to help with any questions you might have.

I would echo what the iceman has said, you are in very good hands. Trust the team that you have picked and stay the course. I don't have personal experience with IL2, but it is one of several newer treatment options showing promise against RCC that were not available just a few years ago. Much progress has been made and we all hope the "magic bullet" is just around the corner.

Good luck and Godspeed,

Gary

livealive's picture
livealive
Posts: 127
Joined: Feb 2012

Johns Hopkins is one of the best places for this, not that this is a match - but take comfort in knowing he is being treated by someone who knows and understand this.

IL2 I thought is usually for clear cell, but we don't know the pathology grade.

http://www.youtube.com/watch?v=Ga2fKAD5-uU

Tex - I think it makes sense the way the doctor handled this, Dr Dutcher in the above video says IL2 is the best shot at a cure, should it be needed. I am NOT qualified to write this, but, you know, hey, I wrote it anyway. Many minds, many opinions.

Alice, we feel the fear, the anxiety, not for someone else, but for each one of us ourself. It has been huge for me, but what can I do, so at some point I have to reconcile (new word, learned from Tex today) to what has happened factually, and what do I do now?

Do what you can, ask for help, question everyone, be cynical. If you'll have good doctors, great.

Raj.

foxhd's picture
foxhd
Posts: 1899
Joined: Oct 2011

You've come to the right place. Keep reading posts. Many of us understand the stage 4 concept well. As Iceman says, treatments have improved. Believe me. I know. Continue with your support. It IS harder for a loved one than the patient. Knowledge is power. Good luck.
Fox

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

fox - thanks. I can only say that while it may be hard, having this group available makes it easier. thanks for posting.

jjf25
Posts: 4
Joined: Jan 2013

I WAS ASKED TO LOOK AT YOUR MAIL. Please help. Read my mail of january as i do not want to keep writing. it all over again. You have  been very strong and have moved forward despite being told about. like expectancy.

I have a decision to make  i have paralysis in my legs. This happened after a dose of Radiation.

  I want to go on the drugs Avastin and tarceva but afraid the side effects will make my quality of life unbearible.  Do i stop taking all drugs as the oncologist has said a matter of months or defeat him and take the drugs to survive longer than his predictions. Who can tell ypu how long you have.

I need news from someone who can give me that power to make the correct decision I pray and know that the Blessed Lord will help me.

I am 35

Please give me the information of the drugs you were on .MDX 1106. What are they and will i be able to get them in the uk. We do not seem to have a system like you people in America

A quick reply with useful information will be truly appreciated.

Thank you

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

JJ - this is a duplicate response to make sure you get it.

_____________________________________

JJ,

Tex's advice about joining the ACOR site is good advice. There is more expertise and experience there. I don't recall anyone on this Board sharing experience recently regarding immobility issues, but there are a lot less people on this Board than on ACOR. And, if my memory is correct, one of the moderators on the ACOR Board is from the UK. So she may be able to answer questions more specifically about the UK.

As far as searching for Fox's experience on this Board I'd suggest you use the CSN search box (at the top of Kidney Cancer discussion board) and enter FOXHD or MDX-1106. You'll likely have to read through the different sites but he has a lot of information out there, so you won't be bored. You'll find his writing inspirational; you'll find him inspirational. He was given a very dire diagnosis in the beginning (believe it was in 2011) but he continues to beat the odds and--like you mention--"continues to live a normal life." (If you call what he does normal Laughing.) I wish I could be more helpful but I know you are looking for a quick turnaround in responding.

So--for now--join the ACOR site following Tex's instruction in post and read Fox's history.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

thanks for reference; just watched it. I also follow Chris Battle's postings who underwent IL unsuccessfully but is knowledgeable and has the same Dr. as John. If anyone is interested in IL2 or other kidney cancer treatments (because he's had several), he's a good source and a good read. thanks again.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Thank you Gary. In lurking around, I have seen quite a few of your postings and not only appreciate your knowledge, but your sense of humor. You're therapeutic for us all.

Roggy
Posts: 10
Joined: Mar 2012

Good luck to you both !!

rae_rae's picture
rae_rae
Posts: 266
Joined: Oct 2010

Alice and John,

You will both be in my prayers. This is a great forum. I am glad you are posting and not lurking anymore. There is a lot of encouragement to be found here, along with humor and golf banter. Keep the faith.

God Bless,

Rae

LISAinTN's picture
LISAinTN
Posts: 143
Joined: Aug 2011

Hi Alice,

I am glad you found this site and glad you have joined in here. I hope John, (if he hasn't already) feels like joining us soon. There is comfort here, for us all, in talking with other's that have walked in our shoes. It's not just a little community, but a family here. You are both in my prayers.

Blessings,
Lisa

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

thanks for the nice words everyone. I feel very fortunate to have found you (kidney cancer survivors). The warmth, hope, and information given here is a gift and so comforting.

With John's catscan scheduled for Thursday, I have butterflys and am sure it will only get worse as the minutes tick by. John I believe is ready to join. He already knows a lot of you by signon name and will ask me what's new on the site? I'll continue to encourage but don't want to push too hard. I want it to be his decision.

I know he is nervous about Thursday; we just deal with that nervousness differently. He has a tendency to get a little quiet (or maybe it's his absorption in the golf tournament) and I become the energizer bunny, unable to sit still.

Thanks again for continued support and prayers. Back to you all!

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Alice, believe me, it will be the golf tournament.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

think you're right!

wall478t1
Posts: 8
Joined: Jan 2013

This is the same exact thing that happened to my father. He had his scans done yesterday and we will know on 1/7/13 if its working.  I am really praying that this treatment work for him.  The only difference in the story is that my Father did not have his kidney remove.  The onconlogist feel that he will be stronger with both kidneys.  How is your husband doing now?

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Welcome wall478t1 (with that pen-name it sounds as though you're a robot!).  You will get a lot of help here so do ask all the questions you want to and we'll all try to help you to do the best for your Father.

Thank you also for posting on this thread - it's entertaining to re-visit the debut of the lovely Alice, who has become so much part of the (elegantly upholstered) furniture here and to see older posts by some of my favourite members who joined in on this thread which she started.  A lot of water has flowed under the bridge since then and we're all a little older and, one hopes, a lot wiser from being on this forum.  Now you've joined us you'll make some good friends here, where patients and caregivers (like you and Alice) are very much appreciated.

wall478t1
Posts: 8
Joined: Jan 2013

Thank you so much.  My father is so anxious to know if the treatment is working, he had me call today, but the nurse did not answer the phone, I hung up and did not leave a message. I notice no one ever said whether the treatment worked for them, I guess thats a good thing because you dont want those who waiting on results like my father to lose hope.  I hope everyone is doing well as the continue to fight the ugly disease.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Keeping my fingers crossed for your dad. IL2 was tough on John and he did not achieve a partial or complete reduction from the IL2. However, as Tex has pointed out, there's increasing evidence on the positive latent effects of IL2, e.g., increases the likelihood of the success of subsequent treatments. (So even if he doesn't respond, the IL-2 may set him up to better respond to other treatments down the road.)

 

Right after the IL2, John entered a clinical trial at Hopkins of Nivolumab and Votrient and has achieved a total of 46% reduction in his tumor burden. He has another scan on the 16th of January; so we're hoping for continued progress or at least stabilization. 

How has your dad tolerated the IL2? Side effects? How is his overall physical condition? Keep in mind that there are other treatments if IL2 is not a total success, though you,of course, want it to be. Tell us more about your dad's tumor grade, stage, etc. Knowledge is power and we all learn from each other.

Know we're in your and your dad's corner!

 

wall478t1
Posts: 8
Joined: Jan 2013

My Father was have a 7cm mass on his right kidney and several cyst on his lungs.  He was diagnose in Chicago, the urologist that he was referred to by his primary doctor wanted to immediately remove the kidney.  We visited an oncologist in Chicago who stated it was not urgent that the kidney was removed.  My father has had the same primary doctor for 14 years. My father had lost 60 pounds in a year of unexplained weight, so finally she did a CAT scan.  I brought my father to a doctor in Louisiana where I stay for a second opinion.  I had no knowledge of the IL2 treatment but the oncolongist gave us information on the treatment and said my father would be a perfect candidate. My father is 69 years old with no health problems except the cancer.  My father is not on any meds for ANYTHING. To make a long story short, he has completed his second round of IL2.  He recovered quick from the first round, but the second round is taking much longer for him to recover.  After the second round, he had a lost of appetite. I called the doctor who provided a prescription. He have not quite got his strength and he gets tired really quickly just performing daily activities such as putting on clothes and walking.  Its very hard to see someone go through this treatment, when I first saw my father go through the rigors, I went out the room and just cried.  I know anything is possible and I believe that this treatment will give my father a great response.  My mother was diagnosed with breast cancer 20 years ago, I was only 15, and now she is 20 years in with no NED. 

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

You are absolutely right; watching someone you love go through the IL2 is brutal. I know John lost his appetite too and actually started to have food phobias. In fact, he was so sickened by hospital food, he would eat nothing that had been served in the hospital for months afterwards, including eggs, tomato sauce, etc. He slowly got his appetite back and supplemented it with Ensure.

When you say your dad has several cysts on his lungs, does that mean his doctors do not believe they are related to his kidney cancer? When I first read your post you wrote cysts but my brain read "nodules" and I wondered why they would not remove the kidney if they thought it had metastisized to his lungs. Did they assign your dad a stage and grade?  What area of the world are you from?

Keep your spirits up and those of your dad. That's a big part of this fight, being  bigger and stronger than the cancer and keeping that kick butt spirit. You and your dad both sound like strong individuals; you're going to beat this one way or the other! Trust me.

P.S. One more thing. Don't go randomly googling and pulling up OLD info on kidney cancer. Most information out there is old and outdated and will scare the dickens out of you. I know because I did and became unnecessarily depressed and sad. So don't do it. Timely information can be gleaned through ACOR and sites like this one. Keep your thoughts and research focused on positive.

 

 

wall478t1
Posts: 8
Joined: Jan 2013

IL2 did not work for my Dad, but I'm not giving up hope.  Its several nodules on both sides of his lungs that come from the kidney.  This oncologist is strongly against removing the kidney.  He said that removing the kidney is not going to help  whats going on in his lungs.  He said that my father blood work all came back good.  The only way he would remove the kidney if my father was in pain, blood in stool, or blood work not normal.  Do you know of anyone who have had the kidney removed and it cleard up the lungs? I live in Louisiana.  What treatment is your husband taking now?  My father will start a new treatment on the 15th and I'm praying it works.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

We are patients or caregivers on this forum, not doctors. So, what I am about to say is only my thoughts, not an expert opinion. 

Your Dad was unlikely to benefit from HD IL2  without having his kidney tumour and most or all of his kidney removed first.  The experts talk about "reducing the tumour burden".  The tumours will be putting a lot of strain on your Dad's immune system.  If he can have his primary tumour (and part or all of his kidney) removed as soon as he is well enough recovered from the IL2, it will enable his immune system to cope better.  That will probably not clear up the lung mets but it will improve his chances when those nodules are treated, whether that is by surgery, cryoablation or drugs.

Does your Dad have other problems that made the oncologist say he shouldn't have his kidney removed?

 

Alice and John - there are several new messages on KIDNEY_ONC by people who have had HD IL2 and are now on targeted therapies and reckon the IL2 has improved their response to the targeted therapy, even though IL2 seemed not to have worked for them.  (There are also some on targeted therapies who hope it may be a precursor to a shot at HD IL2 - a scenario for which I continue to have a very slim hope).

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

I'm sorry IL2 didn't work, but--to be honest--your dad's treatment has me confused. I agree with Tex regarding removal of the kidney.

My husband, John, has been a patient at Hopkins in Baltimore since being diagnosed. When his first CT scan revealed the tumor in his kidney and the nodules in his lungs, his doctors--Internist, Oncologist, Urologist--agreed that the first line of defense was to get the root tumor out (kidney tumor). Then start treatment. He had it out within two weeks.

Given you don't mention any medical condition that would prevent your dad from having that tumor removed, I don't understand his doctor's rationale. But, again, I'm no Doctor. But I'd strongly urge you to find out why hia doctor is not removing the kidney.

John had his kidney removed prior to the IL-2 and--like your dad--IL-2 was not successful. But we both believe that the latent effect of IL2 has made his repsonse Nivolumab/Votrient trial mroe positive.

I can remember when John's Urologist removed the kidney and came out to me in the waiting room, he said, "it went well; we believe we got it all." He said, "Stay positive.  Sometimes when we get the root of the problem, good things happen." And both his Oncologist and Internist agreed, it was the right thing to do.

My understanding of kidney cancer is this. Kidney cancer is a tumor in the kidney. As it grows, so does the  risk for it metastisizing (going to other organs) such as the lungs. So why leave it?

If I'm missing something here, please tell me. But I really don't understand the doctor's reluctance to remove the tumor.

 

 

 

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

I'm sorry IL2 didn't work, but--to be honest--your dad's treatment has me confused. I agree with Tex regarding removal of the kidney/tumor.

John had his kidney removed prior to the IL-2 and--like your dad--IL-2 was not successful. But we both believe that the latent effect of IL2 has made his repsonse Nivolumab/Votrient trial mroe positive.

My husband, John, has been a patient at Hopkins in Baltimore since being diagnosed. When his first CT scan revealed the tumor in his kidney and the nodules in his lungs, his doctors--Internist, Oncologist, Urologist--agreed that the first line of defense was to get the root tumor out (kidney tumor). Then start treatment. He had it out within two weeks.

Given you don't mention any medical condition that would prevent your dad from having that tumor removed, I don't understand his doctor's rationale. But, again, I'm no Doctor. But I'd strongly urge you to find out why his doctor is not removing the tumor.

I can remember when John's Urologist removed the kidney and came out to me in the waiting room, he said, "it went well; we believe we got it all." He said, "Stay positive.  Sometimes when we get the root of the problem, good things happen." And both his Oncologist and Internist agreed, it was the right thing to do.

My understanding of kidney cancer is this. Kidney cancer is a tumor in the kidney. As it grows, so does the  risk for it metastisizing (going to other organs) such as the lungs. So why leave it?

If I'm missing something here, please tell me. But I really don't understand the doctor's reluctance to remove the tumor.

 

 

 

wall478t1
Posts: 8
Joined: Jan 2013

The oncologist said that if he is not having any complication from the tumor in the kidney, that he wouldn't recommend removing the kidney.  My father is 69 years old, the oncologist stated that my father would be stronger with both kidneys going through the IL2 treatment.  My father is not in any pain.  The oncologist said in past experiences when the kidney is removed the disease spread faster.  Its a roller coaster because my family is stuck between a rock and a hard place.  It's be damn if you do and be damn if you don't.  Maybe I should get a second opinion.  I just want my father to live longer and not suffer.

foxhd's picture
foxhd
Posts: 1899
Joined: Oct 2011

I don't think anyone here has ever heard such a thing as " cancer spreads faster with the primary tumor removed." That just sounds bizarre. However, I believe there are cases where once the primary tumor was removed, secondary tumors have disappeared without further treatment or they have more easily responded to drug treatment. I'll be corrected if I am wrong.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Wall - I get what you are trying to do, and I applaud it. I just don't  understand the doctor. Does the doctor not consider the lung nodules a complication from the tumor in the kidney?

I know everyone is different, but I can say unequiviocally in John's experience that the IL-2 was much, much harder on him than the removal of the kidney.

wall478t1
Posts: 8
Joined: Jan 2013

I don't understand either. I may need to go back to Chicago for second opinion.  I dont understand why he is against the kidney being removed. 

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

It certainly sounds as though you need both an understandable explanation and also a second opinion.  

Fox, I have heard that idea, though I wouldn't know how to rapidly recover material on it. I believe the theory relates to changes in signalling systems when the mets are no longer 'under the control' of the primary tumour, or something like that.  Do you have ready access to the opposite effect- of the immunse system, relieved of the main burden, seeing off the mets without further intervention?

jhsu's picture
jhsu
Posts: 78
Joined: Sep 2009

You can follow the link of MDAnderson to read Advanced RCC treatment options:

http://www2.mdanderson.org/depts/oncolog/articles/12/5-may/5-12-compass.html

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Thank you for sharing. I had not read that.

wall478t1
Posts: 8
Joined: Jan 2013

The oncologist couldnt say it enough not to remove my father kidney.  My father has so many lesions in his lungs the doctor said he didnt count them all.  I kinda read between the lines when the doctor said "he didnt count them all".  My sister Husband had cancer and went to MD Anderson, and they referred him back to this same oncologist here and said he was one of the best in Louisiana.  I know he has his reasoning behind not removing the kidney.

 

Surgery

Among the first tasks in weighing a patient’s treatment options are to assess whether the disease is resect able and to determine the patient’s ability to tolerate surgery. Resectability depends largely on the location and distribution of primary and metastatic disease. Dr. Matin said that surgery to excise disease (nephrectomy and metastasectomy) is a reasonable consideration for a patient whose disease is primarily in the kidney with a small metastatic burden—perhaps a solitary metastatic lesion—or for a patient who presents with a solitary metastasis after a previous nephrectomy. Conversely, a patient with a small primary tumor and a larger metastatic burden—perhaps multifocal metastases—is less likely to benefit from surgery.

Additional considerations can help identify patients who will benefit from surgery and spare others from an ineffectual operation. The following risk factors—which were identified in a study led by Christopher Wood, M.D., a professor in and deputy chair of the Department of Urology—indicate that surgery is not likely to help, as survival outcomes are about the same for patients with more than three of these factors regardless of whether the patients do or do not undergo surgery:

  • symptoms from metastases,
  • elevated lactate dehydrogenase (LDH) levels,
  • metastases in the liver,
  • retroperitoneal lymph node involvement,
  • supradiaphragmatic lymph node involvement, or
  • a locally advanced primary tumor.

For some patients, nephrectomy may be indicated to alleviate symptoms, notably pain and hematuria.

 

wall478t1
Posts: 8
Joined: Jan 2013

Thank you so much for sharing this, it made me feel a little better.

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