Is 6 month CT scan correct protocol?

I would think 6 month protocol is fine for stage 1 after the first year. Given the aggressive nature of your RCC maybe for the first year you should keep to the every 3 months schedule. But yes, discuss this with your oncologist.

My husband had nephrectomy one year ago in Sept. He has had 1 ct scan since surgery and Dr wants to increase length of time already to once a year with chest X-ray in between. Ccrcc Stage 1b, grade 3, some necrosis.  At some point you have to weight the negatives of all the tests and learn to trust the Drs knowledge.  

Hello and I hope you all are doing well.

On Monday, it was confirmed via CT abdomen that I have a 2cm RCC in the interpoar region of left kidney fully contained with no abdominal evidence of metastis. But, also a .3 cm pulmonary nodule that showed incidently in the right middle lobe.  Follow up chest CT said no definite pulmonary metasticsis and suggested the nodule to be most likely just inflammation but ordered attention on follow up. Uroligist, surgeon, and GP all support the inflammation statement.  They all tell me I am lucky for finding this as I did; with symptons which turned out to not be associated with this.  Groin pain led me to coax my GP into a US Scrotum and US kidney.  The groin showed nothing but a trace hydrocele, but the kidney showed a hump leading to the CT abdomen.  The kidney is the problem for sure but the nodule is what is driving me crazy.  Anyway, I have 2 more opinions/consults remaining but my options appear to be partial lephrectomy, (either lap robotically or open excsision), or cryoablation via lap.  To this point there is no opinion in favor of full nephectromy since the tumor is small and in a good place away from stuff and easy to reach. I'm 58 / don't smoke / grandfather on my dad's side died of KC back in the 50's / my dad is 89 and just develpoed non small cell LC.  He smoked for 40 years; quitting for the last 30.

Thanks for listening. I would be happy to share more or answer any questions. Just writing this was helpful to me.

Bart1978 said:

newly diagnosed

Hello and I hope you all are doing well.

On Monday, it was confirmed via CT abdomen that I have a 2cm RCC in the interpoar region of left kidney fully contained with no abdominal evidence of metastis. But, also a .3 cm pulmonary nodule that showed incidently in the right middle lobe.  Follow up chest CT said no definite pulmonary metasticsis and suggested the nodule to be most likely just inflammation but ordered attention on follow up. Uroligist, surgeon, and GP all support the inflammation statement.  They all tell me I am lucky for finding this as I did; with symptons which turned out to not be associated with this.  Groin pain led me to coax my GP into a US Scrotum and US kidney.  The groin showed nothing but a trace hydrocele, but the kidney showed a hump leading to the CT abdomen.  The kidney is the problem for sure but the nodule is what is driving me crazy.  Anyway, I have 2 more opinions/consults remaining but my options appear to be partial lephrectomy, (either lap robotically or open excsision), or cryoablation via lap.  To this point there is no opinion in favor of full nephectromy since the tumor is small and in a good place away from stuff and easy to reach. I'm 58 / don't smoke / grandfather on my dad's side died of KC back in the 50's / my dad is 89 and just develpoed non small cell LC.  He smoked for 40 years; quitting for the last 30.

Thanks for listening. I would be happy to share more or answer any questions. Just writing this was helpful to me.

 

Bart,

Start a new forum post. Also double check the size of your lung nodule.Your  reported follow up on that suggests 3mm not 3 cm.

icemantoo

If your doc is a medical oncologist with lots of RCC experience, I'd trust him/her on the followups. If it's a regular oncologist (no or very little RCC experience) or if it's a urologist or a urologic oncologist, not so much. I don't know your doc. The protocols have been accused of being too lax and err on the side of missing some recurrence.

6 months isn't horrible.

I was Stage 3 and Grade 3 with 3 month followups the first year, 6 months the second year. Then I had a recurrence and tumor removal and I have been on 3 months followups ever since.

Are you getting chest/abdomen/pelvis CT with contrast? That's the best IMO. Some docs are stopping at 5 years. This I absolutely don't agree with. I have a few friends with recurrences much further out. I would rather catch things early while it may be operable.

You have a mixed case for recurrence risk. Stage 1 has a low risk, but then you have other features that drastically increase your risk. Can you find an RCC medical oncologist for their opinion? If your doc is one, then I'd trust him. Second opinion definitely would not hurt at all. Get one if you feel uncomfortable. Try to get one unrelated to the first one (not a friend, coworker, or mentor).

Todd

todd121 said:

Follow Ups

If your doc is a medical oncologist with lots of RCC experience, I'd trust him/her on the followups. If it's a regular oncologist (no or very little RCC experience) or if it's a urologist or a urologic oncologist, not so much. I don't know your doc. The protocols have been accused of being too lax and err on the side of missing some recurrence.

6 months isn't horrible.

I was Stage 3 and Grade 3 with 3 month followups the first year, 6 months the second year. Then I had a recurrence and tumor removal and I have been on 3 months followups ever since.

Are you getting chest/abdomen/pelvis CT with contrast? That's the best IMO. Some docs are stopping at 5 years. This I absolutely don't agree with. I have a few friends with recurrences much further out. I would rather catch things early while it may be operable.

You have a mixed case for recurrence risk. Stage 1 has a low risk, but then you have other features that drastically increase your risk. Can you find an RCC medical oncologist for their opinion? If your doc is one, then I'd trust him. Second opinion definitely would not hurt at all. Get one if you feel uncomfortable. Try to get one unrelated to the first one (not a friend, coworker, or mentor).

Todd