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Mass Detected - Update - Opinions Needed

love_of_my_life
Posts: 28
Joined: Jul 2012

Hello again,

We met today with a surgical oncologist here at Michigan Urological

It was a very good meeting and the Dr. was very open and answered all of our questions.

The good:
1. The Dr. feels strongly that my wife's tumor has been caught early enough. Again, this was discovered during an exit ultrasound after a stone in the other kidney. He said that it DID show up on the original ER CT scan and probably should have been reported so we lost a month or so.

2. The Dr. feels that with surgery, she should be fine with about a 3-5% of it reoccurring in her other kidney.

3. At this point, he is defining it as Stage 1 after studying the rest of the CT scan.

The not so good:
1. The proximity of the tumor is very close to the artery and vein. For this reason, he cannot do a partial removal and is recommending complete removal using laproscopy.

2. He is about 90% sure it is malignant based upon the differential CT scan.

Opinions Needed:
The Dr. says that we should schedule the surgery for August and keep it scheduled. In the meantime, he said that there are a couple of new markers that have been developed in the past year to point at the type of tumor if we want a biopsy. He is not opposed to doing a biopsy using these new markers just to be sure knowing that it the tumor is most likely going to come out. He said that if he assembled his partners, 50% of them would recommend a biopsy and 50% would recommend just taking the kidney.

Any experiences with a biopsy here on the board? Thoughts on this?

Thanks again for the prayers!

Tom and Holly

Limelife50's picture
Limelife50
Posts: 409
Joined: Nov 2011

I mean this when i say this because i lost a kidney last year and i know how heatbreaking it is to have to go thru what you and your wife are going thru now,i guess there is a small chance this tumor is benign but a greater chance it is not and these are my thoughts.

icemantoo's picture
icemantoo
Posts: 1479
Joined: Jan 2010

Tom and Holly,

Dr. Kernen of Michigan Urological did mine and I presume he is doing yours. Mine was a laproscoic full Nepherectomy. Thet were not doing partials than. Say hello to Dr. K for me. He knows of my writings. My thoughts on the biopsy would lean to no as it is a high probability of RCC anyway. Dr. K wrote a joke on my surgical report or discharge summary that I was pain free.

Icemantoo

love_of_my_life
Posts: 28
Joined: Jul 2012

Seems like there are a couple of Michigan Urological partnerships.

We are seeing Jason Hafron at MIU: http://www.michiganurology.com/doctors_info/jason_m_hafron_md/

Tom and Holly

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

Tom & Holly,

At the time of my dx over 2-1/2 years ago biopsy was not recommended because of the risk of seeding (releasing previously contained cancer cells) and an uncertainty that a biopsy result would be conclusive, perhaps things have changed but this is likely the reason for the 50 50 split. You already have a 90% probability (a conservative estimate) so what more would a biopsy tell you. Just my opinion, but I would skip the biopsy and go straight to the O.R. ASAP.

Godspeed,

Gary

icemantoo's picture
icemantoo
Posts: 1479
Joined: Jan 2010

Tom amnd Kelly,

Both our doctors are in the same pracitse at MIU. My Surgery was at Beaumont North where Dr K is now the chief of Urology.

Icemantoo

foxhd's picture
foxhd
Posts: 1873
Joined: Oct 2011

I see no point to a biopsy. The kidney is coming out anyway. Examine it then.

Minnesota Girl's picture
Minnesota Girl
Posts: 115
Joined: Jul 2011

I can empathize with you and your wife. I just passed the one year mark on my nephrectomy. I also had to have a laprascopic radical nephrectomy because of the tumor's proximity to the renal vein.

Before the surgery, my doctor REALLY encouraged me (like called me at home on a Saturday morning) to give the biopsy a try. He had a strong feeling I might beat the odds and have an oncocytoma, rather than cancer. Of course, removing the kidney to learn there was no cancer would have been a big bummer. He felt the concept of 'seeding' was an old notion (his words.)

It wasn't an easy decision, because I wasn't sure if I'd really trust the results, but we did go ahead with the biopsy. In the end, the biopsy came back as cancer. It made the surgery a no brainer - get that sucker out of me! I don't know that I would do the biopsy again, but the positive was that it made confident and ready for surgery. NO second guessing about whether or not to do it, or whether to 'wait and watch.'

Wishing you the best!!

Julie061
Posts: 18
Joined: Jul 2012

My partner is going through the decision making process now. Her mass is small, 1.9. Many docs have reviewed her scans and none will make a clear call as to cancer or oncocytoma. Her mass is too small to biopsy, but the interventionist actually said there is a risk of seeding with biopsy, and that was just a month ago. I thought I had read that a large percentage of kidney masses will eventually turn cancerous, so I think it should be removed. If you think it could be cancer, get it out!

Anyway, I was curious and wondered how large your mass was?

Thank you for sharing;)

Julie

Pacer412
Posts: 10
Joined: Jul 2012

I was told that if you have a mass in your kidney, never have a biopsy because one of the cells could get loose. Most experienced doctors can tell from a cat scan if it seems to be cancerous.

Stevewmass's picture
Stevewmass
Posts: 34
Joined: May 2012

No sorry, I didn’t have a biopsy because my urologist at Umass Memorial said that they are basically 2 types of Kidney masses. One that is a watery mass with no blood supply, the other has a blood supply that can be seen with enhancements, Mine light up like a Christmas tree. He went on to say the enhanced masses 20% are benign and the other 80% are malignant and most of the 20% over time will be become malignant. He recommended a partial nephrectomy, which was done on June 18th. My pathology report came back part of my (2.7 cm) tumor was benign and parts were malignant. I trusted my doctor and am happy with my decision. I have heard here many times that you have to trust your gut and due what feels right for you.

dhs1963's picture
dhs1963
Posts: 368
Joined: May 2012

What would you have done if the biopsy sampled the benign portion? If assume the whole tumor is benign, then the cancer would have eventually gotten you. If you take out the tumor anyway, what is the point of the biopsy?

FYI, my 6 cm tumor was removed on 6/19 with a radical nephrectomy. Recovery has been rough, but they got it all it seems. And my tumor was grade 4. I got lucky.

dhs1963's picture
dhs1963
Posts: 368
Joined: May 2012

What would you have done if the biopsy sampled the benign portion? If assume the whole tumor is benign, then the cancer would have eventually gotten you. If you take out the tumor anyway, what is the point of the biopsy?

FYI, my 6 cm tumor was removed on 6/19 with a radical nephrectomy. Recovery has been rough, but they got it all it seems. And my tumor was grade 4. I got lucky.

love_of_my_life
Posts: 28
Joined: Jul 2012

Well, Holly made the decision to have the biopsy. The doctor said that there are new techniques that will grab multiple samples. I was not 100% for it but it is her decision. She is scheduled for August 8th with the radical n. scheduled for the 23rd.

I will let you know what they find.

Tom

brea588's picture
brea588
Posts: 114
Joined: Jul 2012

Iwas just wondering why you would have a biopsy done with surgery to remove the mass Aug 23rd. Just trying to make sure it is cancer? I am having a partial neph on Aug 28th. Good luck on both the procedures. I sure am nervous about the whole thing and I'm sure she is too.

love_of_my_life
Posts: 28
Joined: Jul 2012

If the biopsy returns positive results (as in benign) then she will probably not proceed with the surgery.

Holly wants to know before she goes through with the surgery.

Thanks everyone for the prayers!

Tom and Holly

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

Tom & Holly,

Good luck on both procedures and may the month pass quickly for you. You are in my thoughts and prayers.

Godspeed,

Gary

icemantoo's picture
icemantoo
Posts: 1479
Joined: Jan 2010

Tom and Holly,

My conncern if it is benign and Holly does not have the surgery is that it may become cancerous over time. There have only been one or two posts here where the tumor has turned out to be benign on a pathology report following surgery. The good thing about the surgery is you can tell people that you had Cancer, not that you have it.

Icemantoo

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