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Rookie Question

Tapman63's picture
Tapman63
Posts: 137
Joined: Dec 2017

A quick question about one (of many) things I don't understand:

 

According to the CT scan, my mass is <7cm.  The CT scan showed my other organs in the abdomen were "unremarkable" and to the best of my understanding the stuff around the kidney was all good and nothing showed up.  I'm assuming (hoping) that means nothing has spread.  I know it can't OFFICIALLY be called cancer until it's tested...but wouldn't this mean it's stage I if it tests positive for cancer?  Why do they have to wait until the removal to stage it?  Am I missing something where it may have actually done something that doesn't show up on the CT scan?

 

Just curious.

icemantoo's picture
icemantoo
Posts: 3351
Joined: Jan 2010

Tapman,

 

I could try and answer the questions, but you are seeing the Uro tomorrow and he can explain it a lot better. He will also probably order a chest CT (better) or chest xray to check your lungs if not already done.

 

 

Icemantoo

Abunai's picture
Abunai
Posts: 173
Joined: Oct 2016

It sounds like you've read up on the staging system and the meaning of each stage, or you've had it explained to you.

My guess is that if it hasn't been declared cancer yet, and further testing hasn't been completed, there's really no point of declaring a stage.

You are technically correct that if:

  • cancerous
  • <7cm
  • Not spread to lymph nodes
  • Not spread elswhere

is the definition of stage 1.

 

My urologist told me that I was stage 2 because of the size of my tumor when he remove my kidney.

However, he didn't do any further testing or scanning.

It was only after my wife wheeled me into his office, a week after my nephrectomy, in a wheelchair, because my legs had stopped working and I could empty my bladder, that he knew that it was more than stage 2.

There was even evidence in the CT scan I had prior to my nephrectomy that it had spread further. He, and the radiologist, had just not seen a tumor in my L5 spine, because they weren't looking for it. They were focusing on the kidney itself. It was a later, full-body, bone scan that showed additional tumors above and below the area visible in the abdominal CT scan.

Make sure that, after the surgery, you consult a Urologic Oncologist, and get a thourough set of scans and testing.

Only then can they give you a valid diagnosis and staging.

Reading over this, it sounds like I'm being scary and gloomy. What I'm hoping for is to just make sure that you are your own advocate and get the best people you can get to give you the most thourough information they can.

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

make an educated leap. Until an actual sample can be authenticated for cancer, it is only probable. Even if the odds are greater than 99 to one. This would be true of any suspected diagnosis in medicine. Even if everybody agrees.

stub1969's picture
stub1969
Posts: 917
Joined: Jul 2016

Hi, Tapman.  I'd encourage you to read posts by "Tango Xray".  Her story will explain your question about staging.  In summary, her tumor was smaller than 7 cm but it had broken out of the kidney.  Only through pathology were they able to determin this.  Her original stage 1 diagnosis moved to stage 3.  Like iceman said, you'll get a better explanation tomorrow.  Hope this helps.

Stub

Tapman63's picture
Tapman63
Posts: 137
Joined: Dec 2017

I guess this is where I'm getting lost a bit....I thought the CT scan could tell if the cancer had spread or left the kidney and you'd know this before surgery.   Tons of questions to ask the doctor today.....

kidneystoneblessing
Posts: 25
Joined: Aug 2017

I had the same issue.  On the scans I looked to be stage 1.  So NO spread to organs or bones. Then after they took it out, they found two small focal spots in the paranephric fat around the kidney of tumor adjacent to my 4 cm Tumor.   So as a result I went from t1a to t3a.  Also I have a rarer type translocation rcc.  So now I have to be watched even closer for reoccurrence since I have lymph invasion (these are like blood vessels except they carry your white blood cells).  So pathology is important.  This is called be upstaged.  

Tapman63's picture
Tapman63
Posts: 137
Joined: Dec 2017

Okay - I thought that since nothing showed in the lymph glands or in the organs on the CT scan I was in the clear as far as a higher staging goes.  That's exactly where I was confused.  So instead of feeling pretty confident I shoudl just go to cautiously optimistic.  

Abunai's picture
Abunai
Posts: 173
Joined: Oct 2016

Let us know the outcome.

We're all wishing for the best.

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

many small mets are taking up residence in other places. They are too immature to show up. Often they seem to be supppressed by the primary growth. After primary and or kidney are removed, follow up scans can show an explosion of secondary tumors. Like an invasion of dandelions in your yard. An express to stage 4. So keep up with those scans.

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