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Pathology is in...... sort of.

LanceHeal's picture
LanceHeal
Posts: 57
Joined: Mar 2019

Just got some fantastic news!  Thanks to a bad signal, I missed the docs call with the pathology report from my partial neph last week but he did send an accompanying email message. 

 

He said the results are good.  There were not many details on the message as I’m sure he wants to go over them with me but he said the results are good. 

 

He did say that there did appear to be some spread into the renal sinus fat margin but he is confident from other parts of the pathology that they removed everything.  We were worried about this right after the surgery so much to the point that I was researching adjunctive therapy on my own.  With the results he feels confident he got it all and it won’t be needed for now. 

 

He is recommending abdomen CT and Chest X-ray in 6 mos.

 

The details like TNM and grade will come but the message is clear.  It was growing, they went in and got it and we kicked its A$$ for today!

Retcenturion's picture
Retcenturion
Posts: 240
Joined: Mar 2017

It sounds really good and now you can focus on your recovery. Listen to your body as it is recovering but small happy dance after phone call won't hurt. Speedy recovery to new you.

Manufred's picture
Manufred
Posts: 239
Joined: May 2017

That is the best result you can hope for at this stage - well done.

Best Wishes, Fred

stub1969's picture
stub1969
Posts: 798
Joined: Jul 2016

the pathology comes back as stage 3 with the minor extension of the tumor.  It is a relief your doctor expresses the confidence he has in the procedure.  Keep up with follow-up scans and take care of yourself.

Wishing you only the best!

Stub

icemantoo's picture
icemantoo
Posts: 3221
Joined: Jan 2010

Lance,

 

 

Only thing  I  might add is aski for a chest CT instead of xray. A Ct picks up nodules that an xray does not. even though small  nodules may just be harnmless space matter.

 

 

icemantoo

Dominick0711's picture
Dominick0711
Posts: 90
Joined: Jan 2019

Great news Lance! Now go celebrate with a few laps around the block! Walk as much as you can! It will make you feel bettter alot quicker!

en8236
Posts: 29
Joined: Dec 2017

stub1969's point on stage and icemantoo's point on CT over x-ray. Great that the doctor is confident. Follow up scans are important.

LanceHeal's picture
LanceHeal
Posts: 57
Joined: Mar 2019

Ok so the pathology is in.  

2.7 X 2.2 X 2 (smaller than the original radiologist note of 2.9)

Clear Cell RCC. pT3a, pNX, pM N/A ISUP Nucleolar Grade G3.

Margins on all 3 samples are clear. 

I knew about the Stage 3. It had advanced into the renal sinus. Margins were clear though. 

The higher grade surprised me and therein lies my question:

on the report, the “Final Diagnosis” says ISUP grade 2 but further down in the report, in The neoplasm section it says Histiogic Grade G3: Nucleoli conspicuous and eosinophilia at 100x Magnification. 

I assume it’s a typo and the final should be grade 3 Or am I missing something?

I ask because my Doc says to do the standard 6M scans but I am wondering if I am on the boarderline criteria for adjunctive therapy?  Not that I want to do that, I wonder if I should be considering it though.

I know I’m dealing with a well respected doc who sees way more cases of these a year than most docs and I do not want to step on toes  but am I now at the point where we bring an oncologist in as well?  For what it’s worth, my doc had a high confidence level and seems generally confident in the fact that there is nothing left in there.

Thoughts?

a_oaklee
Posts: 440
Joined: Nov 2013

You could just go for a consultation with an oncologist.  It doesnt mean you are giving up your current doctor.  

6 month scans are appropriate of chest abdomen and pelvis.

There is anatomical staging and the grade is cellular.   My husband is stage 4 grade 3 since 2012 and doing well.  So dont get too carried away.  

It would be good if your doctor explained what the path report means to you.

People over at smart patients say that adjuvant treatment doesnt work and the general consensus is not to take drugs until you really need them.

Congrats on your surgery.  Hope you recover quickly.

donna_lee's picture
donna_lee
Posts: 900
Joined: Feb 2009

Mine was stage 4 because it had Mets to other orgsna.

The Grade means the shape, size, and number of cancer sells in a given sample. After full path following surgery in 2006, my grade was moved from 2-3 to a 3-4.

And I'm still here.

Your test schedule seems appropriate.  After several years of CT's of Chest, abdomen and pelvis we went to a 6 month rotation of Chest x-ray with US of abd/pelvis.

Any way you read your results, they are pretty darn encouraging.

Hugs,

donna_lee

 

Manufred's picture
Manufred
Posts: 239
Joined: May 2017

You are entitled to know and understand exactly what the pathology is.  Keep asking questions until you are satisfied with the answers or until someone else clears up what looks like some ambiguity in the results.  Its your life.

But good generally so far, so consider it an exercise in learning, and enjoy the fact that they have cut it out.   Who knows what the future holds but whichever way it goes, there are now many options and many reasons to be positive about getting your life back.

Best Wishes, Fred 

Allochka's picture
Allochka
Posts: 871
Joined: Nov 2014

Hi,

Fred is right - you should keep asking questions until you fully understand your pathology. From full description it does seem that you are Grade 3, and that G2 thing could be a typo.

you are very-very lucky that you,ve insisted on taking the tumor out. It is very small, and true - tumors usually do not spread until they reach at least  3 cm and usually even much bigger. But rarely  there could be additional f@ctors like fat invasion, which could happen even with smallest tumors... So congratulations, you and your docs were right to cut i5 out asap. It saved your life!

Lexleigh3
Posts: 15
Joined: Apr 2019

It sounds like you had a great experience within a not so great situation.  It appears you are doing well!  I too see a CCF urologist, Dr Avallone. My tumor has grown in size (more than doubled in less than 5 mos to 1.3 x 1.2 x 1.2cm.  CT tomorrow and meet with the doc in two weeks.  I just posted on the discussion board Lexleigh3-Help) looking for some insight and since you are at the same hospital would you mind sharing?  Thank you and speedy recovery!!

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