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Info please...Newbie: pT3, Fuhrman grade 2, papillary type

siluet
Posts: 12
Joined: Aug 2013

Dear All,

I have been reading the posts published in this website and I find it very supportive and encouraging.

Last month my dad underwent a radical nephrectomy due to a tumor in his left kidney. The pathology report showed that the tumor was 4cm, pt3, fuhrman grade 2, papillary type (got into the fatty tissue, but not to the lymph nodes/ renal veins). The doctor recommended that we do watchful surveillance and a CT scan 3 months post the surgery.

What I would like to ask is there anyone, long term survivors, who has experienced RCC stage 3 and did not require further follow up actions (like chemo etc)?  My dad's right kidney is failing, so since the surgery he had to go through dialysis, and I don't know if he will be strong enough to go through chemo etc. :(

Your information is highly appreciated. Thank you so much in advance.

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

Siluet,

 

I am not sure from what you have given us that your dad in fact has Stage 3, RCC. Usually 4 cm tumors are Stage 1.

 

I am an 11 year survivor of Stage 1 RCC . My tumor was 4,2 cm and I have never had to be on chemo. I am now 70 years old.. Faye across the street is an 18 year survivor and she is only 82.

 Hopefully the dialisis will be your Dad's only heath issue in the future,

 

 

Icemantoo

hydrangea's picture
hydrangea
Posts: 14
Joined: Oct 2012

Hi Iceman & Siluet,

I don't post much but this site is my daily reading for encouragement.  I also had a 4.2 cm tumor removed and it was indeed Stage III.  My pathology reports is very similar to Siluet's Dad's.  I had papilliary carcinoma type 2; Fuhrmann grade: IV; PT3a  (invaded  perinephric fat).  So I don't think the size of the tumor determined the stage.  My tumor was over 90% sarcomatoid and extensive necrosis.  Pretty nasty stuff for a small tumor. 

My surgery was 12/7/11 with 3 month checkups.  I have my next scans in September which I am dreading.  I had an allergic reaction 6 months ago to the CT scans with contrast so 3 months ago we switched to MRI w/contrast.  Oncologist feels that the MRI doesn't give the best picture so he wants me to get the CT scans with contrast again in September but this time w/ meds. I am very nervous about having the scans fearing I will have a severe reaction again.  I have been having night sweats, fever, tired and some pain in my back and flank; so I will risk it so we can determine if there is any reoccurance.

Guess we all have our ups and downs with this RCC!  I appreciate all of you on this site and thank you for being so informative and helpful.

Take good care,

Hydrangea

 

 

siluet
Posts: 12
Joined: Aug 2013

Dear Hydrangea,

Thank you for the information. If you don't mind me asking, did you have laparoscopic surgery or open surgery? Apart from the scans, did you have any follow up treatments after the surgery? Thanks a lot in advance.

Hope your upcoming scans will always bring good news.

Eims's picture
Eims
Posts: 423
Joined: Feb 2013

hi hydrangea,

i had a reaction to the dye the first time i had a scan and lets just say it wasn't a good look for me!!  when i got the letter for the scan that was scheduled for last week it said if i had a reaction to contact them which i did and they sent me out a prescription for steroids to be taken the night before the scan and the morning of!  i did what they said and i only got 2 big red patches on my body....a far sight better than the last time.  they will keep an eye on you and will keep you slightly longet afterwards to make sure you are ok.  hope that helps...

eims x

safado's picture
safado
Posts: 17
Joined: May 2014

Hoping to hear some good news/outcome!

Eims's picture
Eims
Posts: 423
Joined: Feb 2013

hi siluet,  i was thinking the same as icemantoo...mine was just under the 4cm and it was a T1 and Grade 3.....maybe your Dads is grade 3 not stage 3......i know its so hard to take in all the information especially when you are in shock but it might be worth just checking.    i have just had my first scan at 8 months and the follow up for me is ultrasound and x-ray.....

eims x

siluet
Posts: 12
Joined: Aug 2013

Dear Icemantoo and Eims,

 

Thank you for the reply. I have actually been reading about your stories and they are indeed inspiring - so thank you for that.

In my dad's case, the pathology said that the tumor was 4 cm, pT3, Fuhrman Grade 2, invasion to fat tissue, but not to lymph nodes and veins etc. The doctor said it was pT3 because the tumor has invaded the fat tissue.

I am not sure what pT3 means, I thought it was the stage of the tumor. Maybe anyone can enlighten me on this one? Thanks a lot before.

Eims's picture
Eims
Posts: 423
Joined: Feb 2013

siluet,  you are supporting your dad and getting information and that is fantastic....i know you probably feel like you can't do anything but just being there really matters and that is coming from someone who knows.  for the person going through it they has just to get on with it and it can be hard for family and friends looking on but you are doing the right thing and i guarantee your dad appreciates it and loves you for it more than you will ever know.

eims x

siluet
Posts: 12
Joined: Aug 2013

Dear Eims,

Your post almost made me cry (try not to since I am surrounded by people). Thank you so much for the support, I really hope and pray that we can all get through this.

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

p stands for pathologic and in the TNM classification system (which is archaic and should be dropped, but the inertia in the medical world guarantees its continuing way beyond its shelf life) T is for tumour N node and M metastasis.   So your Dad is stage 3 (for the reasons you've given) and grade 2.

Do please keep coming back for any help we can give you but on this occasion no-one here can help with your present question.  None of us is qualified to comment and even an expert doctor can't really give any meaningful reply.  We are all so very different in our medical profiles that it is futile to try to make predictions about a particular patient from the experiences of others.  With a bit of good fortune, your Dad's remaining kidney will pick up and function better but it's largely a matter of waiting and seeing.  Is he in the hands of an RCC expert?  If so, the guidance that expert will give, as to what he can or cannot take, is a lot more valuable than anything anyone here can offer (by comparison with their own experience).

If he's not being overseen by an RCC expert, make sure that he consults an appropriate expert.  However, the "watchful surveillance and a CT scan 3 months post the surgery" sounds sensible and suggests to me that he's in good hands.

 

 

mrs_blkjak's picture
mrs_blkjak
Posts: 92
Joined: Apr 2013

My understanding is that as long as they got the whole tumor and don't see any mets, this is pretty standard care. Kidney cancer does not respond to traditional chemo but there are some great meds out if he were to develop any mets. I wish him and you the best!

siluet
Posts: 12
Joined: Aug 2013

Dear Texas wedge and mrs_blkjaj,

 

Thank you for the reply. Yes, he is treated by a RCC expert - keep on praying that the surgery would be enough to remove all the tumor cells.

Thank you once again for the support.

foxhd's picture
foxhd
Posts: 2065
Joined: Oct 2011

Has been the norm for too many doctors and patients. Be sure that you are having regular follow ups and are investigating proactive options. Good luck. Dad's case sounds promising.

siluet
Posts: 12
Joined: Aug 2013

Thank you so much foxhd !

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

I'vebeen away a while on an extended holiday for getting things inperspective and getting some quality time with my family. I see you have been greeted very appropriately and given great information.

I am sorry for your need to be here but know you have found a caring family of survivors and caregivers.  Their skills and abilities span the range of needed treatment from the clinical to emotional support.

Stay with us. We do care. That is the main thing!

siluet
Posts: 12
Joined: Aug 2013

Dear MDCinSC,

 

Thank you for the kind welcome. 

izzycohen
Posts: 64
Joined: Aug 2013

I also had a 6 cm tumor on my left kidney.  The pathology confirmed it as a stage III.  I am now 6 weeks post surgery.  My plan includes no chemo nor radiation.  I do have a CT scan scheduled for October 4, which will be two months after surgery.  Assuming that the October scan is clean, the next scan will be done at the 3 month point.

 

Good luck to you and your Father.

Izzy

siluet
Posts: 12
Joined: Aug 2013

Dear Izzy,

My apology for the late response. I guess this web doesnt give any notification when there is a new post? Or maybe I'm just technologically behind.

I'm sorry that you had to go through this. How are you doing now? I hope you are in a good shape and good luck for next week. Hope the CT Scan is clean, not only next week, but for weeks, months and years to come.

safado's picture
safado
Posts: 17
Joined: May 2014

I'm right there with you Izzy.

7 cm - Stage 3.  4.5 weeks post-op - finally rolling over in bed but still hating pants!

MRI next week.  PET scan the following week.

At Tom Petty would croon..... "The waiting is the hardest part...."

 

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