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When to Remove Tumor/Mass?

Smarty99's picture
Smarty99
Posts: 13
Joined: Jun 2012

This is going to sound like a strange question. I have been putting off going in for a follow up US on the complex mass on my right kidney. I postponed US because of the Holidays. Anyway, the complex mass was both solid and fluid. I don't know what that matters if any. Here are the questions:

Under what circumstances should I have this removed? I mean, does it have to grow  "x" amount before removing? Do I just leave it because it is both fluid and solid?

Should I be seeing someone besides a GP? I have right kidney pain that comes and goes more frequently. No blood in urine. I have night sweats, but hey, I'm menopausal-lucky me, lucky hubby!!I'm on highest HRT possible for me.

 

Thanks for the help,

dhs1963's picture
dhs1963
Posts: 394
Joined: May 2012

the size to remove as many variables.  If it is solid and above 3cm, get it out.  It will kill you.  Not right away, but eventually.  in some cases, it say be advisable not to have surgery for smaller masses, but for most people, get anything that is a solid mass out.  You need to see a urologist, not a gp.  if the gp did not refer you to a urologist, you need a new gp.

icemantoo's picture
icemantoo
Posts: 1658
Joined: Jan 2010

Smart99,

 

I agree with dhs1963 except I would lower the threshhold of getting it out way below 3 cm. Not only get to a Urologist, but a Urologist that specialises in Kidney Cancer.

 

The Surgery is not fun, but it beats the alternative suggested above. All of us members in this club have had the surgery as part of our initiation.

 

We are all here to help you on your journey. Been there, done that 10 and 1/2 years ago.

 

Icemantoo

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

Smarty.....When you say "follow up", what do you mean?  Follow up from what, a previous Ultrasound?  If you have a complex mass on your right kidney another Ultrasound will do you no good.  You need to have a CT scan of your Abdomen both with and without contrast.  The Ultrasound will never be definitive.  If you're not on this path, I'm guessing your Primary Care Physician is a DO.  No offence to the Osteopaths of this world...............wait, I take it back.  As Iceman says, get yourself to a good Urology/Oncology physician who will get on top of this.

 

Jeff

 

Gordon Charles's picture
Gordon Charles
Posts: 91
Joined: Jun 2012

Greetings smarty99:If I understand you correctly, you joined this CANCER survivor website in June of 2012.  I assume you weren't just bored and looking for something to do.  Now, more than six months later you are wondering what to do about a mass on your right kidney.  You wonder if a someone other than a GP should be looking at you.  Who ordered the followup ultra sound?  What is it a followup for?  I mean absolutely no disrespect, but these facts don't seem to add up.  If you've already had an exposure to cancer that brought you here in June then you should know that indecision helps nothing.  This is not the movies and these things don't just go away.  I had a malignant tumor on my right kidney and had it removed.  A year or so earlier I had an adenoma (non-malignant) growth taken off my left adrenal galand.  It started about 4cm and was about 7cm when taken out.  Not cancerous or not I didn't want something that big and getting bigger to be in my body.  Even if they aren't malignant at one time that doesn't mean they can't convert.   All of this is my convoluted way of strongly suggesting that you find the best kidney doc you can see and make a plan.  Get moving !

Smarty99's picture
Smarty99
Posts: 13
Joined: Jun 2012

Gordon,

Yes, I joined a while ago and the radiologist recommended active surveillance. I was calculating the rate if growth for small masses, but my dilemma was knowing under what circumstances it needs to be removed. Since it is neither completely cystic-in which case I would ignore it unless it caused some issues, nor is it completely solid indicating cancer from what I've read.  If the weight of the decision lies primarily on the size and the rate of growth, I thought I probably have a couple of years before it has to be removed since small ones rarely metastasize. After reading the posts, I am glad I asked and I think I'll go ahead and get the US scheduled sooner than later.   ; )

brea588
Posts: 129
Joined: Jul 2012

As the others above have said to go see a urologist asap this is something that you need to see to and not put off due to size.  I am a RN  and yes even the small ones can spread.  I had a 2 cm cancerous tumor removed in aug 2012  and my urologist/Oncologist told me then that I could wait and scan again in 2 months but was not recommended because 2 percent of the people with these masses that wait,    the cancer can get its act together and spread and then there is no cure.  I seen a man last month as a home health pt. and he had about the same size mass as mine and had partial kidney taken out in July 2012.  In aug he started having pain in his left hip and after scans he had renal cell carcinoma in the bone.  He passed away about 2 weeks ago. So regardless of the size it can spread and does spread so what I am saying to you, Is  I care about you  and wish you the best as you have this checked out.

Smarty99's picture
Smarty99
Posts: 13
Joined: Jun 2012

Brea,

It's a coincidence that you should mention that about the hip bone. I started having hip bone pain in my left hip back in November. it travels down to my knee. Tough time crossing legs or sitting for long periods. Anyway, I had an x ray done at onset and it didn't show anything and the hip isn't as bad anymore. I feel better/stronger than I have all year, but yes I am definitely getting an appt. made.

Thank you all so much for your help.

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

First, a few questions.  I guess you're 48 or maybe 49?  Are you still under 9 stone? How has your GP explained your 15% weight loss - that's quite a bit and calls for explanation (assuming it wasn't something you brought about by choice).  Have you regained some/all of that weight?  How are your neck glands? Are your liver function figures OK? Are you still asymptomatic for kidney cancer and colon cancer?  What specialists have you seen so far, apart from your GP and radiologist?  You've had CT - was it with contrast? You've also had US but who suggested that your next scan should be US  and not CT with contrast?

The advice you've received, with a very small, possibly benign lesion - watch and wait - may very well be vindicated and you may never need surgery.  The chances of your having any sort of mets at this time are, virtually, infinitely remote and your hip pain has, thankfully, remitted.

HOWEVER,  you're plainly anxious for re-assurance about your present status and the key messages above are that you should get referred to a urologist and/or an oncologist specialising in RCC and, subject to their counsel, you should have another CT with contrast - of thorax, abdomen and pelvis - which should tell what you need to know.  With a bit of luck you're not needing any treatment but it makes sense to investigate thoroughly now just in case that isn't the situation.  If due investigation shows that you do need treatment, now is a good time to find out and make a plan.  Good luck and I hope it's all a storm in a teacup but do go and find out for sure.

 

 

shep124
Posts: 7
Joined: Dec 2012

Don't mess around head to houston tx to MD Anderson have your doctor refer you to a doctoer Woods in the Genitourinary Cance center  in the Mays clinic . These guys are the best & and when you need help the best is where you go.

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

May be a totally harmless cyst.  May disappear spontaneously.  May remain unchanged for life. 

Somewhat premature to even consider rushing off to see the world's most renowned urological surgeon!

foxhd's picture
foxhd
Posts: 2066
Joined: Oct 2011

There has been no one on this board whose tumor ever went away by denying it's existence. I'll bet 10 to1 you are more afrad of medical procedures than finding out what is going on. That approach will substantially shorten ones life expectancy. I can't recall anyone here who has died from kidney surgery. There are many here who are alive from kidney surgery. You've taken a bit of a beating because of your slow reaction time. Why do you think that is? In any event, we ALL want to see you live long and healthy. We are a vicarious bunch here. We live each others collective experience and share it's ups and downs. Take care of business. Tout suite.

Smarty99's picture
Smarty99
Posts: 13
Joined: Jun 2012

He-he, lol. Yes, I'm going for an ultra sound on Wednesday. I'll find out if there are any changes to it, and go from there.

Im thinking if there aren't any changes, I'm in the clear and can forget about this whole thing and put it behind me.

Thanks

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

I'm going to put my two cents in here one more time.  You do not need a follow up ultrasound.  It will do you no good.  It is a waste of your time.  It may show a different size measurement but if you want to know if you have cancer, have your physician order a CT scan of your abdomen with and without contrast.

foxhd's picture
foxhd
Posts: 2066
Joined: Oct 2011

I was about to add what scan man wrote. So I'll reiterate it. US is worthless for this. Cancel it. Have the CT scan with and without contrast. Do the right thing my friend.

Fox.

Smarty99's picture
Smarty99
Posts: 13
Joined: Jun 2012

Okay, I'm a wuss. I'm just going by what the radiologist advised my GP, who passed it on to me. I had the CT with contrast in the beginning which found this by accident. Then a US was ordered. So, quite honestly (and I am not one to cuss) but I don't know what the hell I'm suppodid to do if anything. That's why I am looking for some clearly defined quidelines. Such as: no change means leave it alone and check again in one year. Or any change means remove. The only info I've gotten from ANYONE is from you guys. I had to flippin' join to post any questions and I'm really sorry the dumb questions.  If you sense my frustration, I'm sorry but it is what it is. I am very frustrated. I do appreciate everyone's help immensely.

Take Care

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

99,

Whatever it is, it is small and you don't need to rush into anything, you have time, but RCC can be very sneaky.  Wait and see may turn out to be the right option in your case, but before that can be determined you need to do everything you can to get a better definition of what you are dealing with.  Find a doctor with expertise in this area, normally a urologist, they will likely order a CT with/without contrast, its your best shot at knowing without something invasive.  If there is even the slightest risk that it is RCC, don't mess with it, get it out while its small and spend the next 50 years being grateful that you did.  The surgery is not nearly as bad as you are imagining it to be, not fun, but much better than the alternative.  If you get an expert opinion to wait and see, great, but if not you will have caught it early with nearly a 100% chance that surgery alone will cure you.

Good luck and Godspeed,

Gary

roaddr23's picture
roaddr23
Posts: 77
Joined: Jan 2013

I am new to this board but this my second rodeo with Kidney Cancer.In 2002 I had a left nephrectomy my tumor was 7-8cm. Luckily for me it was encapsulated or it would have been bad and I would not be sitting here writing this right now. Kidney cancer has such subtle symptoms, back pain..yep, I had that I was a medic of course my back hurt. Then one morning I got to pee and the toilet was nothing but blood. Went to Dr, immediately sent for US and then CT scan. and I only peed a little blood one other time..things some people blow off. This time not feeling good, thinking my gall bladder is kicking up...GP sent me abdominal US and they found the two tumors but said I needed to have a CT asap...My tumors are both around 2 cm and "appear" to be encapsulated on the CT...however, even at that size they could open and release cells...My surgeon also said the best reason to remove them when they are small is because is causes the least amount of trauma to the kidney, therefore giving it a much better chance of healing well and functioning normal.Makes sense to me especially since I don't have another spare. Let everyone else says, I am not trying to be disrespectful but YOU do not have to FOLLOW ORDERS. It is your body and your health and you and only you are in charge of how you are going to receive treatment. The days of the Drs know best that our parents and we grew up are over now...Cancel the US and tell them you are opting to have a CT with and without contrast because that will make you feel more comfortable with the results.

dhs1963's picture
dhs1963
Posts: 394
Joined: May 2012

If not, get yourself to a urologist.  If the complex mass is cancerous, it will eventually kill you.  A gp is not qualified for thisinnovation one on this board Is qualified to tell you what it is.  I went to a specialist the day the mass was found.  My 5-6 cm mass (stage one, grade 4) has metastasized to my lung.

Having a cancer diagnosis is not fun, but it is survivable if caught and dealt with early.

NewDay's picture
NewDay
Posts: 182
Joined: May 2012

I'll just pass along that my 29 yo nephew was found to have a 2cm tumor.  The urologist wanted to remove it even though she was sure it wasn't cancer.  After the partial nephrectomy, she was shocked to find it was RCC.  So small ones can be cancer.

About ultrasounds, I had an ultrasound 2 months before my CT scan and the US came back ok.  2 months later a CT scan shows a 9cm tumor.  Maybe I had a bad radiologist, maybe not.  

When I asked the genetics counselor at NIH if I should try to retreive old ultrasounds from the past, she said my type would have been hard to see on an ultrasound.

My two cents is get it checked out.  Even if you don't do it because of the urging here, do it for your own peace of mind because it is worrying you or you wouldn't be here.  I'm sure nobody here will mind if we are all proved wrong in the end.  That would be great news.

 

Kathy

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

Well argued Kathy. Let's hope Smarty justifies her pen-name and takes it all on board.

GSRon's picture
GSRon
Posts: 1306
Joined: Jan 2013

Smarty... OK you are a wuss... me too...   The first CT Scan I had, was without Contrast... no pain, simple, took like 20 minutes..   It showed a bunch of issues..   Then I got to a great Kidney Surgeon...  He insisted an both a CTScan and an MRI, yes with Contrast on the scan...  Not only did it confirm the problems, it also eliminated some of the unclear parts of the first scan, and told the true tale of what I needed....  Yes it was surgery... but I have to tell you it was all a piece of cake... the fear was 10 times worse than the reality....

Plus if the tumor is small, then the sugery can most likely be done through a small slit...  done late.. well, I  have a very large scar...

 

Follow the advice the others have given.. go see a proper doctor...  as stated a US is a wasted of time...  Good Luck

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