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Kidney cyst and adrenal adenoma in RCC survivor...

Digger95
Posts: 59
Joined: Jun 2010

Hi and thanks for putting up with me as usual...

After having renal cell carcinoma and radical nephrectomy on my right kidney in 2000 my recent CT scans have turned up a 2.0 cm adenoma on my left adrenal gland and a 1.0 cm cyst on my left kidney. Obviously being a cancer survivor these findings freaked me out at first but over the past three years they have remained unchanged in size and my doctors have told me not to worry about them.

Do kidney cysts and/or adrenal adenomas ever turn into cancer or should I believe my docs that they are entirely benign and not anything to worry about? This is especially worrisome since I recently lost my job and will be without health insurance for at least a year or so.

Thanks for any input.

Jim

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

Things can change but benign cysts are so common that apparently many, if not most, of us evidently have trouble-free cysts on our kidney(s) all our lives so the advice you're being given is probably on the money and you can relax.

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

A cyst is not going to turn. If you had a CT scan with contrast and the mass on the adrenal is an adenoma that too is good. Doesn't mean you don't need f/u scanning but you sound good. I have had patients with ten or twelve renal cysts, and they would get scanned just to monitor for size. I've seen some the size of grapefruits. Nevertheless a cyst. An RCC will always enhance on imaging. Sorry to hear about the job and the loss of your healthcare. Just count down the 13 months left until 1/1/2014 and you'll be able to purchase whatever coverage you need. No more underwriting. All the best.
Jeff

Digger95
Posts: 59
Joined: Jun 2010

It's just really scary knowing that these things won't be looked at again anytime soon, but it does calm me somewhat to know that you all think they are benign as my doctor does. I just have to hope that they are benign anyway, since they won't be looked at again for quite some time. This will be the first time in my life that I have been with no health insurance whatsoever.

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

By then the Chinese will probably own this country, I wonder how we'll like their healthcare system?

Digger95
Posts: 59
Joined: Jun 2010

Jeff,

My doctor doesn't routinely order contrast for my annual exams now that I'm twelve years out from nephrectomy, in order to spare the load on my remaining kidney. However any new growths are automatically examined with contrast to check for malignancy, and this was the case with my cyst and adenoma. Once he felt comfortable that these were benign, he stopped ordering contrast again and now we simply monitor for size. I have always thought this to be a prudent policy regarding contrast usage and wonder if you would give your opinion on this?

Thanks,

Jim.

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

Jim, I have a small difference of opinion here.....but you must remember that I'm not an MD, nor do I play one on TV. Leave your GFR number out of the equation and just look at your BUN and your Creatinine. If the BUN is normal or just a bit high and your creatinine is 1.4 or below, I would have contrast at least every other exam. The amount of pathology picked up in CT scanning with contrast as opposed to without is immeasurable. The differences can be stunning. This goes especially for the abdomen and pelvis, which would be your full follow up tests. When it comes to the lungs a once a year chest x-ray is all my doctor has ordered for me, although my yearly follow up is coming up in about a month and I'm going to sneak in the CT Chest by asking my hematologist to order it. Then when I go to see my urology oncologist he might wonder why I did that and not wait for him to order the tests, that would give me a chance to play dumb and say I thought I'd have them done for you before our appointment. Sometimes you have to get a feeling which doctors will do what you ask without question and which might fight you. I think I've figured that out.....we'll see. Bottom line with everything is really how much do you trust your doctor? If you've put your life in his hands and you've done your research and discussed everything with him about all your concerns.....if you walk out of his office and you're not reaching for the Xanax then just do whatever he says. It's a relationship you need to keep in order. As I've said in other posts, I think if any doctor knows you want to be involved, he'll let you. Patients that don't get that courtesy are those that come in for their initial appointment and the conversation might go like this.

Mr. Smith, have you ever had heart problems..................I don't know ask my wife. Honey do I have heart problems? Or.....Mr. Smith do you have any allergies......who knows.....ask my wife, she knows these things. You may laugh but I've seen it over and over again. Have a great week end Jim

Jeff

Digger95
Posts: 59
Joined: Jun 2010

Appreciate your input.

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