New Kidney cancer diagnosis.....What now?

KatfromFlorida

My Cancer results are in...
Went to the doctor today for my post surgery consult and he handed me this:

Tumor Size: 6cm in greatest dimensions
Histologic pattern: Renal cell carcinoma
Histologic Grade: Moderately differentiated (Fuhrmans nuclear Grade II-III)
Renal Vein invasion: Not sampled
Perinephric Soft Tissue invasion: Not sampled
Invasion beyond Gerota's Fascia: Not sampled
Adrenal Gland present: No N/a

Margins: Specimen shows a thin rim of uninvolved capsular tissue focally, but if friable and fragments on handling precluding a definitive assessment of the margins, clinical correlation is required to determine the completeness of excission.
No lymph nodes received with specimen

TNM Staging: T1b, Nx, Mx which is Stage 1 grouping........

So it was bigger than I was told , still stage one but is it normal for them not to take out any lymph nodes to check ?
I dunno, it all makes me cry today anyways. I was advised that I don't need to see an oncologist at this point, just chest xrays and ct scans every 6 mths for the next 3 years so I guess I am very very happy about that...... Some of it just confuses me, especially the furhman grade .

Thanks guys
Kat

ams123

KatfromFlorida said:

My Cancer results are in...
Went to the doctor today for my post surgery consult and he handed me this:

Tumor Size: 6cm in greatest dimensions
Histologic pattern: Renal cell carcinoma
Histologic Grade: Moderately differentiated (Fuhrmans nuclear Grade II-III)
Renal Vein invasion: Not sampled
Perinephric Soft Tissue invasion: Not sampled
Invasion beyond Gerota's Fascia: Not sampled
Adrenal Gland present: No N/a

Margins: Specimen shows a thin rim of uninvolved capsular tissue focally, but if friable and fragments on handling precluding a definitive assessment of the margins, clinical correlation is required to determine the completeness of excission.
No lymph nodes received with specimen

TNM Staging: T1b, Nx, Mx which is Stage 1 grouping........

So it was bigger than I was told , still stage one but is it normal for them not to take out any lymph nodes to check ?
I dunno, it all makes me cry today anyways. I was advised that I don't need to see an oncologist at this point, just chest xrays and ct scans every 6 mths for the next 3 years so I guess I am very very happy about that...... Some of it just confuses me, especially the furhman grade .

Thanks guys
Kat

Hi Kat - Fuhrman grade refers to how the cells are in comparison to normal kidney cells. This is from wikipedia:

Grade I
Very little different from normal kidney cells. These cancers usually are slow to grow and spread and tend to have a good prognosis.
Grade II
Clear-cell renal carcinoma with nuclei that vary in size and are generally larger than in grade I tumors; nucleoli are slightly visible.
Grade III
Clear-cell renal carcinoma with cells that exhibit large nuclei with marked variability in size and shape; nucleoli are large.
Grade IV
Looks quite different from normal kidney cells and has a worse prognosis

Mine was Grade II, I don't think a mass would even show on a scan if it is Grade I.

My staging is PT1, PNX which is good - so is your staging. The PNX apparently means "Regional lymph nodes cannot be assessed histologically". Whatever that means.

I did not have any lymph nodes removed, but my pathology report says the margins are negative for carcinoma, which I think means no cancer cells have spread anywhere. Did your doctor explain to you the part about your margins, because I don't know what that means.

I was told by my urologist that I don't need an oncologist, but my primary care doc says I should have one. I am planning on finding one, because in case I ever have a recurrence I don't want to be scrambling to find a kidney cancer oncologist. If you do see an oncologist make sure he specializes in kidney cancer, because it is very different from other cancers. Luckily I live near Johns Hopkins and they have a big urology center and very specialized doctors.

I believe that the standard protocol for follow up is scans every 6 months, but my urologist says I should have the first one in 3 months. If you don't feel comfortable waiting 6 months perhaps you can talk to your doctor about doing it sooner, although waiting 6 months is perfectly normal.

You know what? I became very emotional last Friday, and it was after I saw my doctor for the results. And even though they were good results, I was still very emotional and it lasted a while, even now I am still somewhat emotional. Maybe the relief of it being over? Or the uncertainty because of unanswered questions?

Linda

KatfromFlorida

ams123 said:

Hi Kat - Fuhrman grade refers to how the cells are in comparison to normal kidney cells. This is from wikipedia:

Grade I
Very little different from normal kidney cells. These cancers usually are slow to grow and spread and tend to have a good prognosis.
Grade II
Clear-cell renal carcinoma with nuclei that vary in size and are generally larger than in grade I tumors; nucleoli are slightly visible.
Grade III
Clear-cell renal carcinoma with cells that exhibit large nuclei with marked variability in size and shape; nucleoli are large.
Grade IV
Looks quite different from normal kidney cells and has a worse prognosis

Mine was Grade II, I don't think a mass would even show on a scan if it is Grade I.

My staging is PT1, PNX which is good - so is your staging. The PNX apparently means "Regional lymph nodes cannot be assessed histologically". Whatever that means.

I did not have any lymph nodes removed, but my pathology report says the margins are negative for carcinoma, which I think means no cancer cells have spread anywhere. Did your doctor explain to you the part about your margins, because I don't know what that means.

I was told by my urologist that I don't need an oncologist, but my primary care doc says I should have one. I am planning on finding one, because in case I ever have a recurrence I don't want to be scrambling to find a kidney cancer oncologist. If you do see an oncologist make sure he specializes in kidney cancer, because it is very different from other cancers. Luckily I live near Johns Hopkins and they have a big urology center and very specialized doctors.

I believe that the standard protocol for follow up is scans every 6 months, but my urologist says I should have the first one in 3 months. If you don't feel comfortable waiting 6 months perhaps you can talk to your doctor about doing it sooner, although waiting 6 months is perfectly normal.

You know what? I became very emotional last Friday, and it was after I saw my doctor for the results. And even though they were good results, I was still very emotional and it lasted a while, even now I am still somewhat emotional. Maybe the relief of it being over? Or the uncertainty because of unanswered questions?

Linda

I don't know
Thank you so much Linda for the information. I think I have walked through this past month or so in kinda of a fog. Hurting physically now it gives you time to reflect on what just happened I guess. I was emotional all week and when I met with my doctor I too felt overwhelmed after I got the results.
Its easy to allow yourself to go down the dark road and I believe part of what we can learn from this is to learn to keep ourselves in the now. See today and be in today and not worry about what might happen down the line. It takes some practice and its not always easy I've been doing it. Especially at night, I find myself thinking about what if ? But...
as I have said before, its not anything I can control by worrying myself and my family sick and it takes so much time away from what is within my control.

My Best
Kat

abbeyw

your diagnosis
I just had a partial open removal of cancer from my left kidney. While I would have prefered to have not gone thru this they have pretty good results and there is a good clear area around the removal. If you have a good doctor they will leave you with good results. Life other wise is a gamble any way. This was my second cancer the first was colon cancer in 03. Surgery is what it is, follow you healthe care providers instruction and you will get thru it.

KatfromFlorida

abbeyw said:

your diagnosis
I just had a partial open removal of cancer from my left kidney. While I would have prefered to have not gone thru this they have pretty good results and there is a good clear area around the removal. If you have a good doctor they will leave you with good results. Life other wise is a gamble any way. This was my second cancer the first was colon cancer in 03. Surgery is what it is, follow you healthe care providers instruction and you will get thru it.

thank you abbey
I'm sorry to hear of your surgery. Hope your doing better everyday. Thanks so much for your kind words.... I am trying very hard to keep my head together and not worry about the what if's, its a day to day thing for me right now. Good moments and bad but just like everything else we just get through it.

My prayers to you

Thanks
Kat

KatfromFlorida

abbeyw said:

your diagnosis
I just had a partial open removal of cancer from my left kidney. While I would have prefered to have not gone thru this they have pretty good results and there is a good clear area around the removal. If you have a good doctor they will leave you with good results. Life other wise is a gamble any way. This was my second cancer the first was colon cancer in 03. Surgery is what it is, follow you healthe care providers instruction and you will get thru it.

thank you abbey
I'm sorry to hear of your surgery. Hope your doing better everyday. Thanks so much for your kind words.... I am trying very hard to keep my head together and not worry about the what if's, its a day to day thing for me right now. Good moments and bad but just like everything else we just get through it.

My prayers to you

Thanks
Kat

puppetman

I had the same as You
My Doc told Me the same thing as You, I had a 4cm tumer (cancer) on My right kidney, on May 4th 2011 I had 100% of My right kidney removed, I was in the hospital for 4 days, do what Your Doc tells You and You will be ok, I just had My first ct scan, and all is good, so do what Your Doc says and take things slow (cant do things fast anymore) and You will be fine, the only thing is no matter what I do, I get so tired around noon, if I dont take a nap, I fall asleep, but I will take being tired over having cancer any day, but most of all, put Your Fath and trust in God.

Another1bites back

garym said:

Battle scars
Welcome back Kat,

Surprised to hear from you so soon after, wow. You are officially a warrior with all the battle scars to prove it, wear them proudly!! Relax for a few weeks and let nature take its course, you'll be your ole-self before you know it.

Godspeed,

Gary

Lost in his pain!
My boyfriend was just told he has stage 2 or 3 kidney cancer and the tumor is 7 cm
the doctor is not much help all he says is " he needs to be patient" I think I way more worried than be is
everything I read says he has 3 years give or take ! Can that be true
KC

MikeK703

Another1bites back said:

Lost in his pain!
My boyfriend was just told he has stage 2 or 3 kidney cancer and the tumor is 7 cm
the doctor is not much help all he says is " he needs to be patient" I think I way more worried than be is
everything I read says he has 3 years give or take ! Can that be true
KC

Don't panic
KC,
Sorry to hear about your boyfriend. But don't panic over the size of the tumor. There are larger ones and folks survive those. There are considerations that the doctors won't know until the kidney is removed and the pathology report has been issued -- things like the type of renal cancer (e.g., clear cell, papillary), the Fuhrman grade, positive or negative findings in the local lymph node. (I'm assuming that the normal treatment for kidney cancer -- a partial or radical nephrectomy -- has been discussed). If the cancer has not spread elsewhere, the surgery will get it all. And we can function quite well on one kidney. So while it is understandable that you are worried about him, there is also reason for a positive outlook. Stay positive for both your sakes, but especially for his. He is facing a battle, no doubt. But you are his support. We are yours. Have him join us here and he'll be encouraged because of the good advice and positive attitudes of the survivors here. God bless and best wishes,
Mike

garym

puppetman said:

I had the same as You
My Doc told Me the same thing as You, I had a 4cm tumer (cancer) on My right kidney, on May 4th 2011 I had 100% of My right kidney removed, I was in the hospital for 4 days, do what Your Doc tells You and You will be ok, I just had My first ct scan, and all is good, so do what Your Doc says and take things slow (cant do things fast anymore) and You will be fine, the only thing is no matter what I do, I get so tired around noon, if I dont take a nap, I fall asleep, but I will take being tired over having cancer any day, but most of all, put Your Fath and trust in God.

Hope all is well...
Hey Kat,

Its been cold and wet here the last couple days, started me thinking about warmer climates like Florida and then naturally you. Haven't heard from you in awhile, hope everything is going fine. You are close to the 6 week post-op mark, for me that was about when I first felt near 100% physically but mentally it was still day to day. Its been almost two years for me now and it has gotten a lot easier to keep those inner demons at bay.

Hugs and prayers,

Gary

sabina57

Kidney Cancer
Kat,

I relate to your feelings of numbness, fear and other emotions that you are going through right now. I was diagnosed with uterine cancer on 10/11th. I'm still in shock. My husband was diagnosed with kidney cancer this past February. He had his kidney removed and has one healthy kidney left. Back then, he couldn't see any light at the end of the tunnel. Now, 8 months later, he is working 2 part time jobs and though still has some uncomfortableness at times, overall he is doing wonderful. Me on the other hand, I'm very much in the eye of this storm. Take one day at a time; one moment. I know its easier said then done. I believe together all of us will get through this. Know that you are not alone. Try not to let the fear of "what if" consume you. Just take it slow and allow the emotions to flow. I wish you well and will say a prayer for you. Just hang in there. The people here seem wonderful and this is only my second day here.

Best,
Sabina57

KatfromFlorida

garym said:

Hope all is well...
Hey Kat,

Its been cold and wet here the last couple days, started me thinking about warmer climates like Florida and then naturally you. Haven't heard from you in awhile, hope everything is going fine. You are close to the 6 week post-op mark, for me that was about when I first felt near 100% physically but mentally it was still day to day. Its been almost two years for me now and it has gotten a lot easier to keep those inner demons at bay.

Hugs and prayers,

Gary

All is well Gary
Dear Gary:

I am actually doing quite well thank you!!! Not yet back to work but have been keeping busy as my youngest daughter is planning her wedding next fall.....
It was a rough few weeks and I found that I needed to get myself some antidepressants to get back on the right track but overall I feel better than I have in a long time.
Still come here pretty regularly to read up on everyones progress and make sure all are included in my prayers. I am learning not to dwell on what I cannot control and am very thankful that the surgery is behind me.... Hope all is still well with you and your family

Many hugs and much love
Kat

KatfromFlorida

sabina57 said:

Kidney Cancer
Kat,

I relate to your feelings of numbness, fear and other emotions that you are going through right now. I was diagnosed with uterine cancer on 10/11th. I'm still in shock. My husband was diagnosed with kidney cancer this past February. He had his kidney removed and has one healthy kidney left. Back then, he couldn't see any light at the end of the tunnel. Now, 8 months later, he is working 2 part time jobs and though still has some uncomfortableness at times, overall he is doing wonderful. Me on the other hand, I'm very much in the eye of this storm. Take one day at a time; one moment. I know its easier said then done. I believe together all of us will get through this. Know that you are not alone. Try not to let the fear of "what if" consume you. Just take it slow and allow the emotions to flow. I wish you well and will say a prayer for you. Just hang in there. The people here seem wonderful and this is only my second day here.

Best,
Sabina57

So Sorry
Dear Sabina:

Thank you so much for your kind words and I am glad your spouse is doing so well after his fight. I myself had a hysterectomy many years ago so I know what is ahead for you in that area if that is what your doctor plans for you.... If you need to talk please feel free to put me on your friend list Actually, I think the hysterectomy surgery was much worse than the kidney surgery for me. I didn't really feel normal for almost a year after that but you will heal. I will pray that all turns out well for you and your family.
You will find much support and people to listen here... this place has been my life line and I love everyone.... so don't be afraid to vent or ask questions.... On pce again ..
thanks and you hang in there too....

Hugs and many prayers
Kat