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Oncology Questions

cjm11
Posts: 11
Joined: Jun 2013
Below is a copy of what I posted in another thread.  Just got to thinking about oncology.  Do I need to see an oncologist before surgery?  How do I go about finding an oncologist that specializes in RCC?  As the uro surgeon I will be seeing also does clinical trials, should I still get a second opinion?
 
I've noticed some of you have said you wish you would have known something before you did something else first, etc.  In other words, knowing what you know now, how would you go about your treatment if you were just starting out now, like I am.
 
Thanks for your input. You all are great!
 
 
 
 

Hey again. Looking for any additional input you all may have from the CT scan results.

 

Findings: 1) There is a complex mass involving the upper pole of the right kidney with sigificant enhancement as well as low attenuation probable necrotic areas. This was not seen on any of the previous exams and measures 3.4x2.8x2.9 cm. This is most likely a renal cell carcinoma.

2) There is an abnormal upper pole left renal mass anteriorly which is exophytic and high attenuation on the unenhanced and enhanced images measuring 19.7x13.8x16.2 mm. This was seen back in 2007 and has not shown significant change in size. This may be a complex cyst or proteinaceous cyst.

3) There are very tiny right-sided retroperitoneal lymph nodes at the level of the right kidney. The largest node is an anterior aortocaval node measuring 9.4x7.2 mm. This node was present in 2009 and 2007 and is stable in size.

4) I do not see evidence of any sclerotic or lytic skeletal metastases.

Impression: repeats the above and also adds: Recommend bilateral renal MRI without and with contrast.

Does it seem to have spread to the lymph nodes? Does this help differentiate between open or laproscopic nephrectomy or partial nephrectomy? I am adjusting to the fact that I most likely have cancer. Now I'm anxious to see the stage and what type of surgery I will need to have. I respect everyone's knowledge and look forward to hearing your opinions. Thanks!

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

But  the only thing that shows growth, in what I read, is the mass in the right kidney. It says the adrenal masses were found in 2007 and seen again in 2009. No growth. Same on the large cyst in the left.  I'd go for more diagnostics, talk with your urologist, then make a decision about an oncologist.

Of course, that's me.  I'm sorry you may be joining our little group here, but we are always glad to help wherever we can!

Good luck!

Michael

Galrim's picture
Galrim
Posts: 274
Joined: Apr 2013

Doesnt look like lymph node involvement based on the wording. But this is something you should ask in detail about when meeting you urologist. The cystic mass doesnt sounds worrying either. For both mainly because stationary conditions is concluded by the radiologist over several years.

Impact regarding open vs lap nephrectomy depends on specific positioning and especially any major vein involvement. Nothing is mentioned in the report and with a relatively small tumor you should be a candidate for lap nephrectomy. But again, your urologist can tell you more.

Until you get the details broken down by the pros, try to find some comfort in the fact that IF its RCC you were caught early which really is the alpha and omega when it comes to surgery being curative with this sneaky disease.

best wishes and good luck

/G

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