Help with questions for onco appt

daisybud
daisybud Member Posts: 541 Member

Hi Guys,

Background first.. 

I had partial nef on 2/16, 8 weeks ago.  Stage one.  I had the surgery done by a urologist who I really liked, but not a onocologist.  He wants me to get a renal scan which is scheduled to be done in May.  I go back to him on June 1.

Went to my GP for the followup that the hospital wanted me to do after being discharged.  I told him again about the pain I have been having in my thigh.  Had it for about a year and it has been getting worse.  I already tried stopping the statin I am on so that wasn't it.  He had me get a bone scan and xray of femur.  Both tests were negative for anything.  So, don't know what the heck is wrong with my thigh at this point till I go back for appt to talk to him again. 

I just feel better asking oncologist about follow up bc surgeon was just a urologist.  I am going to ask about what is the followup protocol for rcc and want talk about the path report.  Is there anything else you guys think I should be asking that I might have not thought about? Did anyone have there bladder checked or is that not something to be concerned about? I also inquired if he has seen people with rcc so that I am talking to someone with experience.  I am going to the local hospital with a Fox Chase Center, so the dr is affiliated with Fox Chase. 

Any help or suggestions would be greatly appreciated!

One more thing, yesterday I did some much needed house cleaning which I have only been fluffing over for the last few weeks.  I felt good so I was doing it most of the day.  Last night and today my back flank and lower back hurt.  How long till you didn't have all these aches and pains or is it something that I will have from now now?

Thanks ahead of time for you help,

Kim

Comments

  • APny
    APny Member Posts: 1,995 Member
    If you had a bone scan and

    If you had a bone scan and x-ray of your thigh and they were clear then it’s not mets, thank God. And if the statins aren’t causing it then it could be pulled muscle, tendon, just about anything. It could even be left over from surgery where they put your body in all kinds of unnatural positions. Or perhaps a nerve was injured and it’s affecting your thigh. Discuss it with the oncologist.

    Aside from follow up protocol and your path report I can’t see anything else to discuss; maybe others have suggestions. Let us know how it goes with the onc! Wishing you the best.

    Oh, and no, I did not spend the day doing housework 2 months after surgery. No wonder you’re sore.

  • Hd67xlch
    Hd67xlch Member Posts: 151 Member
    As far as the pain

    from housework, Im 10 days post a lung lobectomy from rrc, and yesterday I decided to vacumn, big mistake, I have to 2 wolf hybrids and its shedding season, Im alot soarer today than I was pre vacumning. I have pain pills but refuse to take them. When I had my kidney out in 2011 it seems it took me about a month to get back to fully normal. Im going back to work for better or worse a week from today, I cant stand sitting around the house like I have been for 5 days now.

    As far as the bladder I believe when they do a lower abdomen  ct scan it would show the bladder. Im just the opposite of most here I trust my urologist/surgeon more than my oncologist, but thats a personal thing

    Good luck

  • daisybud
    daisybud Member Posts: 541 Member
    Hd67xlch said:

    As far as the pain

    from housework, Im 10 days post a lung lobectomy from rrc, and yesterday I decided to vacumn, big mistake, I have to 2 wolf hybrids and its shedding season, Im alot soarer today than I was pre vacumning. I have pain pills but refuse to take them. When I had my kidney out in 2011 it seems it took me about a month to get back to fully normal. Im going back to work for better or worse a week from today, I cant stand sitting around the house like I have been for 5 days now.

    As far as the bladder I believe when they do a lower abdomen  ct scan it would show the bladder. Im just the opposite of most here I trust my urologist/surgeon more than my oncologist, but thats a personal thing

    Good luck

    So, they changed my appt till

    So, they changed my appt till next Thursday now. 

    The urologist/surgeon only told me that he would have me do a kidney scan in 6 months.  I asked if it would be the whole abdomen and chest and he said just kidneys. Thats the reason I wanted to see what the medical onocologist protocol would be. 

    Thanks for the feedback.

    :)) Kim

  • APny
    APny Member Posts: 1,995 Member
    daisybud said:

    So, they changed my appt till

    So, they changed my appt till next Thursday now. 

    The urologist/surgeon only told me that he would have me do a kidney scan in 6 months.  I asked if it would be the whole abdomen and chest and he said just kidneys. Thats the reason I wanted to see what the medical onocologist protocol would be. 

    Thanks for the feedback.

    :)) Kim

    In case it helps, I was stage

    In case it helps, I was stage 1 also and my protocol is kidney scan and chest x-ray every six months. My surgeon is also an oncologist and an expert in RCC so I'm comfortable wtih that follow up.

  • NewDay
    NewDay Member Posts: 272
    APny said:

    In case it helps, I was stage

    In case it helps, I was stage 1 also and my protocol is kidney scan and chest x-ray every six months. My surgeon is also an oncologist and an expert in RCC so I'm comfortable wtih that follow up.

    Urologist vs. Oncologist

    I definitely don't trust my urologist for followup.  I only had a CT of the abdomen 6 weeks prior to surgery.  Even after telling me a had a very large, grage IV, very aggresive tumor, he only said I would have another CT in 6 months and said that I did not need an oncologist.  I could have been walking around with a tumor in my lungs and would not know it for 6 months.  This is even though he is the director of minimually invasive surgery at a major teaching hospital.  He should have known better.  My lung nodules did not show up until 18 months later, but if they had been there at the time of surgery, I would not have known it.  Urologists are experts at removing kidneys.  Most are not experts with kidney cancer.  People have different opinions on this.

    Also, my case was different from yours in that I had a large, aggressive tumor.  Yours being Stage I means that you will need followup, but not as often as some of us.

    I don't have any suggestions about your thigh pain but can tell you that I had off and often flank pain for about a year.  Give yourself time and don't overdo.

    Kathy.

  • daisybud
    daisybud Member Posts: 541 Member
    APny said:

    In case it helps, I was stage

    In case it helps, I was stage 1 also and my protocol is kidney scan and chest x-ray every six months. My surgeon is also an oncologist and an expert in RCC so I'm comfortable wtih that follow up.

     
    Apny,
    When you say kidney

     

    Apny,

    When you say kidney scan do you mean cat scan or ultrasound?  And only of your kidneys not abdomen?  I had two prior ultrasounds and neither saw the tumor. 

    I took off till now and starting back at subbing at school next week.  Looking forward to seeing the kids again..  :)   

    Kim

     

  • daisybud
    daisybud Member Posts: 541 Member
    NewDay said:

    Urologist vs. Oncologist

    I definitely don't trust my urologist for followup.  I only had a CT of the abdomen 6 weeks prior to surgery.  Even after telling me a had a very large, grage IV, very aggresive tumor, he only said I would have another CT in 6 months and said that I did not need an oncologist.  I could have been walking around with a tumor in my lungs and would not know it for 6 months.  This is even though he is the director of minimually invasive surgery at a major teaching hospital.  He should have known better.  My lung nodules did not show up until 18 months later, but if they had been there at the time of surgery, I would not have known it.  Urologists are experts at removing kidneys.  Most are not experts with kidney cancer.  People have different opinions on this.

    Also, my case was different from yours in that I had a large, aggressive tumor.  Yours being Stage I means that you will need followup, but not as often as some of us.

    I don't have any suggestions about your thigh pain but can tell you that I had off and often flank pain for about a year.  Give yourself time and don't overdo.

    Kathy.

    Hi Kathy,
    I had a ct and mri

    Hi Kathy,

    I had a ct and mri of abdomen and chest xrays before surgery, but that was my GP doing all of that and then sending me to the urologist for the partial nef.  Urologist reviewed those and then did the surgery.  I asked him if I should see onoc and he said no but if I felt I needed he would refer me.  I then talked to my GP who I really like and have been with him for 20 yrs and he suggested if I wanted to see onco he would refer me, which he did.  Honestly, my gp has been fantastic and on the ball.  For me I Just want to see onco now for follow ups.

    KIm 

     

     

  • APny
    APny Member Posts: 1,995 Member
    daisybud said:

     
    Apny,
    When you say kidney

     

    Apny,

    When you say kidney scan do you mean cat scan or ultrasound?  And only of your kidneys not abdomen?  I had two prior ultrasounds and neither saw the tumor. 

    I took off till now and starting back at subbing at school next week.  Looking forward to seeing the kids again..  :)   

    Kim

     

    Ultrasound is only as good as

    Ultrasound is only as good as the equipment, the technician doing the scan, and the doctor interpreting it so it's possible that some are better than others. My protocol is US of the kidney only and I get that done at Sloan Kettering where I had my surgery. It's picked up tiny cysts and a couple of what they think are angiomyolipomas that are well under a centimeter so I think it's pretty sensitive. But I always felt everyone should do what they're most comfortable with so if you believe a CT scan would be better, certainly ask for that. So far I'm fine with my follow up but if I weren't I'd insist on a CT scan. And at the very least do get chest x-rays every six months.

    Good you're going to back to work but take it easy!!

  • hardo718
    hardo718 Member Posts: 853 Member
    APny said:

    Ultrasound is only as good as

    Ultrasound is only as good as the equipment, the technician doing the scan, and the doctor interpreting it so it's possible that some are better than others. My protocol is US of the kidney only and I get that done at Sloan Kettering where I had my surgery. It's picked up tiny cysts and a couple of what they think are angiomyolipomas that are well under a centimeter so I think it's pretty sensitive. But I always felt everyone should do what they're most comfortable with so if you believe a CT scan would be better, certainly ask for that. So far I'm fine with my follow up but if I weren't I'd insist on a CT scan. And at the very least do get chest x-rays every six months.

    Good you're going to back to work but take it easy!!

    Hi Kim

    My follow-ups for partial neph, also Stage 1 are CT's with & without contrast & labs. I'm seen by a uro/onc doc. 

    If you were cleaning all day, I'm not surprised to hear you're sore, have to ease into it. I'm 3-1/2 post op and it still routinely have flank pain! Not sure what the deal is with that & sometimes anxiety kicks in because of it. Eventually I get pissed at myself for my anxious thoughts about it & pull up my big girl pants & try to get on with celebrating life in the moment. Lately, the anxiety is getting the better of me & my GP told me last fall if it gets to be too much she will order my tests early to put my mind at ease. At least I have that in my back pocket. I'm trying my damndest (sp?) to hang in there though.  Some days are easier than others, for sure.

    Still keeping you in my prayers,

    Donna~

  • daisybud
    daisybud Member Posts: 541 Member
    hardo718 said:

    Hi Kim

    My follow-ups for partial neph, also Stage 1 are CT's with & without contrast & labs. I'm seen by a uro/onc doc. 

    If you were cleaning all day, I'm not surprised to hear you're sore, have to ease into it. I'm 3-1/2 post op and it still routinely have flank pain! Not sure what the deal is with that & sometimes anxiety kicks in because of it. Eventually I get pissed at myself for my anxious thoughts about it & pull up my big girl pants & try to get on with celebrating life in the moment. Lately, the anxiety is getting the better of me & my GP told me last fall if it gets to be too much she will order my tests early to put my mind at ease. At least I have that in my back pocket. I'm trying my damndest (sp?) to hang in there though.  Some days are easier than others, for sure.

    Still keeping you in my prayers,

    Donna~

    Hi Donna
    Are your CTS  and

    Hi Donna

    Are your CTS  and labs yearly?  Also do they Include your chest or do you get chest x-rays yearly?

    I totally get the anxiety!!  Gets the best of me too sometimes! 

    Kim

     

     

  • todd121
    todd121 Member Posts: 1,448 Member
    APny said:

    In case it helps, I was stage

    In case it helps, I was stage 1 also and my protocol is kidney scan and chest x-ray every six months. My surgeon is also an oncologist and an expert in RCC so I'm comfortable wtih that follow up.

    Urologic Oncologist

    Just chiming in to make sure we all have our terminology straight. Urologists are surgeons and not "oncologists". Even if they are a "urologic oncologist" they are actually a surgeon with special training in masses, but still are not what everyone calls an "oncologist".

    An "oncologist" in everyday language, actually refers to a "medical oncologist". These are NOT surgeons. They are internists. They almost always come from a background in internal medicine and maybe hematology. These are the docs that manage metastatic cancer (give chemo, refer us to surgeons like urologists and urologic oncologists, radiation oncologists, etc.).

    It's very rare for a surgeon to also be a medical oncologist.

    The terminology sucks. You're seeing a urologic oncologist and you think you're seeing an "oncologist". You are probably not seeing an oncologist.

    I think most medical oncologists would want to do a CT of chest, abdomen and pelvis with contrast if possible. The frequency for Stage 1 might be something like 6 months for the first 2 years, then yearly after that.

    I personally would never stop getting annual scans, even if I was Stage 1.

    My urologic oncologist wanted to do a chest X-ray and a CT of abdomen/pelvis at 6 months and 1 year, then yearly after that. I was Stage 3. This wasn't enough or frequent enough. I'm glad I found a medical oncologist with RCC experience who followed me more closely. Stuff doesn't show up on a chest Xray until it's pretty good size.

    Hope something I said is both correct and helpful. :) Lots of it is my own opinion speaking from my experience.

    Hugs,

    Todd

    P.S. Did you have a CT of your hip/femur with contrast? If it was a met, that or a nuclear bone scan should have shown something.

  • sblairc
    sblairc Member Posts: 585 Member
    If I was Stage 1, I'd probably stay with the surgeon

    Do you like your urologist? Is he doing a good job? We LOVED LOVED LOVED our urologist that did my husband's surgery. 

    But because my husband was Stage 3, we wanted a relationship with an oncologist in case it came back. I didn't really want to switch, but I did. He's a doctor of "Hematology/Oncology" like Todd stated.

    Otherwise, I would have been comfortable staying with my urologist. Even now, I feel like we are wasting the Oncologist's time going every 6 months to review scans about "not having cancer" but since that is who is now taken on the case, we go an meet him every 6 months. 

    So I guess my thought is it depends on the stage. 

    Also, a bladder is part of a CT scan. At least on my husbands anyway. 

  • daisybud
    daisybud Member Posts: 541 Member
    todd121 said:

    Urologic Oncologist

    Just chiming in to make sure we all have our terminology straight. Urologists are surgeons and not "oncologists". Even if they are a "urologic oncologist" they are actually a surgeon with special training in masses, but still are not what everyone calls an "oncologist".

    An "oncologist" in everyday language, actually refers to a "medical oncologist". These are NOT surgeons. They are internists. They almost always come from a background in internal medicine and maybe hematology. These are the docs that manage metastatic cancer (give chemo, refer us to surgeons like urologists and urologic oncologists, radiation oncologists, etc.).

    It's very rare for a surgeon to also be a medical oncologist.

    The terminology sucks. You're seeing a urologic oncologist and you think you're seeing an "oncologist". You are probably not seeing an oncologist.

    I think most medical oncologists would want to do a CT of chest, abdomen and pelvis with contrast if possible. The frequency for Stage 1 might be something like 6 months for the first 2 years, then yearly after that.

    I personally would never stop getting annual scans, even if I was Stage 1.

    My urologic oncologist wanted to do a chest X-ray and a CT of abdomen/pelvis at 6 months and 1 year, then yearly after that. I was Stage 3. This wasn't enough or frequent enough. I'm glad I found a medical oncologist with RCC experience who followed me more closely. Stuff doesn't show up on a chest Xray until it's pretty good size.

    Hope something I said is both correct and helpful. :) Lots of it is my own opinion speaking from my experience.

    Hugs,

    Todd

    P.S. Did you have a CT of your hip/femur with contrast? If it was a met, that or a nuclear bone scan should have shown something.

    Todd

    Thanks for the information! It was very helpful. My upcoming appointment is with a medical oncologist.I will still see the urologist for the nuclear renal scan with dieritic in June.

    I did not have a CT scan on femur. I had a full body nuclear bone scan and a regular x-ray on femur. They both came back negative thankfully.

    ;))

    Kim

     

  • todd121
    todd121 Member Posts: 1,448 Member
    daisybud said:

    Todd

    Thanks for the information! It was very helpful. My upcoming appointment is with a medical oncologist.I will still see the urologist for the nuclear renal scan with dieritic in June.

    I did not have a CT scan on femur. I had a full body nuclear bone scan and a regular x-ray on femur. They both came back negative thankfully.

    ;))

    Kim

     

    CT Scan

    Kim,

    I would be suprised if you didn't have a pelvic CT scan as part of your scans. Usually they at least do abdomen and pelvis. The pelvic CT will get your hip and the top part of your femur. Most bone mets in this part of the body occur in hip, hip join, or top of the femur. If it was a met, they should've seen something. And something would light up on the nuclear bone scan.

    You probably had a partial nephrectomy? Sorry I don't remember. The renal scan is to check how much work is being done by your kidneys relative to each other. It's like a CT but it's a moving/recording. I had one before they removed my kidney. They wanted to see what percentage of the work was done by which kidney, because my good kidney was smaller than my bad kidney. It might be that they can check for leaks in partials this way too? Ask your doc why they are doing the renal scan now after your surgery? I never had one after my surgery. But then I had a radical nephrectomy.

    If I had been Stage 1, yeah, hmmm. I can't say for sure I would've left my urologic oncologist. I liked him. I might've stayed. But I was Stage 3 and I worried that I needed to be followed more closely. Plus I wanted to do a clinical trial for an adjuvant study and that required me to change to the medical oncologist.

    Good luck to you! I hope it's all fine and it sounds like it probably is. I've had so many aches, pains and weird symptoms over the past 3 1/2 years that turned out to have nothing to do with mets. Still, I think it's a good idea to be viligant. Be calm. But be vigilant. :)

    Hugs,

    Todd

  • APny
    APny Member Posts: 1,995 Member
    sblairc said:

    If I was Stage 1, I'd probably stay with the surgeon

    Do you like your urologist? Is he doing a good job? We LOVED LOVED LOVED our urologist that did my husband's surgery. 

    But because my husband was Stage 3, we wanted a relationship with an oncologist in case it came back. I didn't really want to switch, but I did. He's a doctor of "Hematology/Oncology" like Todd stated.

    Otherwise, I would have been comfortable staying with my urologist. Even now, I feel like we are wasting the Oncologist's time going every 6 months to review scans about "not having cancer" but since that is who is now taken on the case, we go an meet him every 6 months. 

    So I guess my thought is it depends on the stage. 

    Also, a bladder is part of a CT scan. At least on my husbands anyway. 

    Yes, the terminology is very

    Yes, the terminology is very confusing. This is what I found. It's actually a very good website explaining various specializations and the difference between them. 

    There are mainly three types of Oncologists – Medical Oncologist which uses medicine for the treatment of cancer. Radiation Oncologists use radiation for the treatment of cancer. Surgical Oncologist treats cancer with surgery. It is important to mention that some urologists are known as Urologic Oncologists. They are actually surgeons who provide treatment of cancer of the urinary tract and male reproductive organs.”

    http://www.differencebetween.info/difference-between-oncologist-and-urologist

     

  • mrou50
    mrou50 Member Posts: 389 Member
    Cancer

    When it comes to cancer I leave that to my oncologist, as for my blood pressure (which until cancer was great) and my kidney I leave that to my nephrologist, and for the daily aches and pains that goes to my primary.  My team laid out the rules and I play by them.  I would not go to my baker to fix the engine on my car, and so when it comes to cancer I go to the oncologist a person trained in cancer.  Hang in there sending warm thoughts your way.

     

    Mark

  • lcsvb
    lcsvb Member Posts: 41 Member
    Almost 3 months post op and my back is still tight!

    Hey Kim, as you know our surgeries are super alike but I am a month ahead of you. I started seeing a chiropractor 3 weeks ago for chronic neck/upper back stiffness and it has started to lesson. My lower back also screams at me when I do a lot any given day. Our bodies just take a while to get over the atrophy from those first 6-8 weeks of caution. Did anyone else have aches and pains for months out from surgery in non-surgical areas?