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CThughes
Posts: 21
Joined: Apr 2012

Hey everyone,
I haven't posted in a while but now I have a question.

I had a tumor between golf ball and tennis ball size in one kidney and they took it out almost 3 years ago. Diagnosed with Prostate cancer about a year ago and they took it out in January of this year.

I get the usual 6 month scans because of the kidney thing have been good until last month. Seems like a spot has shown up on my remaining kidney, and also the artery feeding that kidney has constricted and they are worried about that. Doctor says the spot could be a cist, or a hyperdense something or other. He says it's reall small, too small to tell what it is now, and he wants to wait until April, then do some kind of special renal scan.

Evidently my prostate cancer isn't gone as my PSa was 0.2 3 months after surgery, and has steadily climbed up to 0.47 now.

With that much going on, is it crazy to wait until April to decide what the spot on my kidney is? Or am I just being a big whiney baby? The Doc doesn't try to tell me how to do environmental geology, and I know I shouldn't try to tell him how to do urology, but I've only got one kidney left, and I'm of attached to it.

alice124's picture
alice124
Posts: 894
Joined: Mar 2012

Hi Todd,

I'm not knowledgeable about what else--other than wait and watch--they would do if the cyst is so small right now. And if it is a hyperdense cyst, that's not normally reason for concern.

The constriction in the artery may be something else, but take a look at the following website. Think it will help answer some of your questions until someone much smarter than me gets back to you.

http://www.kidneycancerinstitute.com/kidney-cyst.html

Take care and keep us posted.

MedScanMan's picture
MedScanMan
Posts: 108
Joined: Jul 2012

Hi,
I have a couple of questions for you.....might be able to help a little. What scan did you recently have that showed a "spot" on your remaining kidney, ultrasound or CT? Your renal artery comes off of the abdominal aorta and if it's constricted, this should have nothing to do with your Renal Cell. What was your original path report? If there is a constriction of the renal artery it can simply be fixed with a stent. The same type of stent used in the cath lab that has recently taken the place of balloon angioplasty. It's done in the radiology department of almost every hospital. I'm thinking your decimal points might be wrong here on the PSA test. If you typed it correctly then your PSA is under 1.......everybody would love to have that. If you'd like to, let me know about the testing you had to visualize the new "spot". If it was a CT scan, did you have it with contrast?
Regards, Jeff

CThughes
Posts: 21
Joined: Apr 2012

Jeff,
Thanks for getting back. They did the CT scan with contrast. I understand the artery thing should not be related to the RCC and that it can be fixed. It's the spot that has me kinda worried. "Paranoia strikes deep, into your heart it will creep" what song was that. Any way, I guess I'm a little jumpy with 2 different episodes of fun in three years.

And from what I can gather, after a radical prostatectomy, one does not love to have a PSA of 0.47. My pre-surgery PSA went from 4.3 to almost 12 (11.7 or 11.8) in about 3 months. From what I can gather from folks over in the PC board, anything over 0.2 is generally considered a recurrence.

MedScanMan's picture
MedScanMan
Posts: 108
Joined: Jul 2012

Well you taught me something this morning about prostate cancer and PSA numbers. Thank you for that. Let me explain your"spot" now. When we see something on or near the kidneys we put a measurement on it. This goes for the adrenal gland as well as every spot on the liver to show which are Mets and which are not. This measurement is called an ROI. It stands for region of interest. We take a trackball at the console and as the axial images come up we go threw them one at a time and as we spot the pathology we begin to measure. In the old days we would measure and film....measure and film....and so on. Today it's just measure because there is no filming. When you're done measuring you just send the exam from the scanner itself to whichever Radiologist is going to dictate what he sees. If the (spot....mass.....lesion....tumor......cyst.....I could go on all day as to what people call these things enhance on the delayed contrast images you're pretty sure if it's on the kidney it's an RCC. The first pass over you is always without contrast. When the ROI is measured on the non contrast images you know pretty much know if it's a cyst or not. If it measures water below zero it's a cyst.......if it measures fat, a little above that, it's a cyst......if it measures in the 30's or 40's with no contrast, you can expect it to light up on the venous phase. The reason it lights up is because the iodine that is injected follows the blood, and if the "spot" is vascular it will light. If I spilled a bottle of let's say Optiray or Omnipaque both used as an Iodine injection for CT scanning on an old chest x-ray cassette and took an x-ray of the cassette you would see a bright white liquid on the cassette. That's just the effect x-ray has on iodine meglomine (hence.....contrast) That would be the first pass while the injection is going in. A number between 50 and 100 and you pretty much know what it is. Then when the third phase (arterial) is over, a minute later you take another measurement. If the "spot” remains enhanced on these delayed images the doctor is going to call it an RCC. My question to you after all this, is did the technologist take the time to measure this spot. Was it so small that he couldn't even get the little circle on it, or did it in fact measure in the water/fat cyst region on both pre and post contrast images. These are some questions I'd ask. Depends how proactive you want to be. If you trust your urology oncologist and the radiologist he has reading your films then do everything he says.......move on with your life, knowing your Doctor is not worried. If you want to get more involved, ask all the questions you can. He owes you the answers. You'll never get an answer or even the possibility of approaching a Radiologist with a question, simply because they're either too busy reading films or in the middle of anger management classes. But your doctor could take this further. Find out what the ROI measurements were and post them here. I'd love to see that. I wish you all the luck..............

Jeff

Limelife50's picture
Limelife50
Posts: 445
Joined: Nov 2011

Cysts are liquid filled and tumors are dense tissue even more dense than the tissue surrounding a tumor.2 reasons why your Doctor has suggested you wait is 1 it probabally is nothing to be to concearned about and 2 even if it is a reacurance of RCC these tumors when small normally grow at a slow pace.Its probabally nothing to worry about CT but to be on the safe side when the time comes try to have your doctor determine what it is

CThughes
Posts: 21
Joined: Apr 2012

Jeff and everyone else,
Thanks very much for your time in responding. I appreciate the education on cysts vs hyperdense things vs whatever else it might be. I will keep you posted on what I find out and I will try to get more info from the doc. The more I ask ya'll questions the more I realize how little I really know about all of this stuff, which is pretty stupid when it's been part of your life for three years now.

Todd

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