Is kidney removal needed for RCC?

Leonard1905

My father was diagnosed with stage 4 kidney cancer 1 month ago. He has metastatic nodules in the lungs, but otherwise no symptoms except for choking caugh, when talking for more than 1-2 minutes. He is in relatively good physical shape (he is 71), aside from side effects from Sutent taken for 10 days now.

Physician thought his kidney does not need to be removed, since tumor is not large enough (3-4 inches large). From reading discussions on this network, I understand that ALL kidney cancer survivors HAD cancerous kidney removed as part of treatment. I am very concerned that leaving his kidney may prevent Sutent from fighting cancer off. I would appreciate a short feedback from you on whether or not your doctor recommended removal of the cancerous kidney, as pre-condition to successful treatment. Thank you for sharing your thoughts.

axelson

It is my understanding that removel of the kidney is the standard treatment. I would ask the physician if he/she is not recommending treatment because the cancer has spread beyond the kidney. I would suggest a very frank talk with the physician. By the way, I have heard that there are good results with Sutent.

demohgirl

My husband also was just diagnosed one month ago and put on sutent with out kidney removal ,they say his tumor is to large for a safe surgery. He has been on sutent for 12 days and was taken off had high fevers goes back on tomorrow, how is your father.

Unknown

A patient who has at least the part of the kidney removed that encloses the tumor has a smaller tumor burden. A 3-4 inch tumor (usually docs measure tumors in cm, and a 3-4 cm tumor would be quite a bit smaller) is actually quite large, and most docs would remove it before starting treatment. In the past, many doctors inexperienced in treating kidney cancer patients felt that death was inevitable and didn't want to subject the patient to surgery. Now, good treatments exist.

Make sure that your father is being seen by a doctor that has experience in treating metastatic kidney cancer. You can find one near your father by calling the Kidney Cancer Association at 800-850-9132. There is a kidney cancer specifi email support list; more information is at http://cancerguide.org/kofaq/ .

As an earlier reply said, sometimes with a very large tumor, the patient is treated systemically first to shrink the tumor and make surgery easier and more successful. If your father has a 3-4 cm tumor, standard treatment would be to remove it first if he were having immunilogical treatment later (such as interferon or interleukin-2). Targeted therapies such as Sutent are too new for studies to exist that tell if there is a survival advantage to removing the kidney. But if I had even a 3-4 cm solid kidney tumor, I'd want it out.

KCFighter

Get a 2nd opinion immediately! I agree with Trishpm that you need to make sure you see a urologist experienced in dealing with met. RCC. My understanding is that kidney removal is always done.

GregLW.

Hi Leonard,

I can only make one speculation and one suggestion:

1. I suggest a VERY frank discussion with your Father's medical team to establish WHY they are not operating - it could be that mets. are widespread or that your Doctor confuses inches with centimeters! Is your Fathers general health OK for radical surgery and recovery or is the doctor being kind.

2. The only other consideration is go get a second opinion and do it fast.

I hear Sutent is good but I had a nephrectomy in Sept. 2001 and currently have ongoing bladder cancer. I can see no earthly reason for carrying a 3-4inch time bomb around inside you UNLESS there are compelling medical reasons for so doing and if there are you deserve to know them.

Good luck - with the right care your Dad may well have several years of quality life left.

I hope all goes well.

Regards,
Greg L-W.

Unknown

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