had surgeon appt today

cindygodfrey2

My husband had his appointment with the urologic oncologist today. He has a baseball size tumor on his left kidney. The lymph nodes in the area are enlarged which doc said may or may not mean mets. The doctor will do scans of lungs, liver and blood test for bone to see if there are any additional lesions. If there are lesions then we will discuss chemo, if not they will proceed with the radical nephrectomy. He will attempt laprascopic but due to his obesity may have to perform an open.

Do any of you knowledgable people have any words of wisdom or advice for us? Thanks so much!

icemantoo

Hardball
cidnygodfrey2,

I hope that it is the size of a hardball rather than a softball. In any event I hope that there are no mets to complicate things. He is going to need the surgery once the tests are in and the other issues are addressed. A nephrectomy alone does cure Kidney Cancer in most cases where there are no mets.


The surgery is not fun. It hurts. The recovery is not fun. His age at 48 makes it easier than when I had it at age 59. He needs to get the weight down. Once the surgery is over you need to watch blood pressure very carefully as being overweight causes high blood pressure and hypertension. Hypertension causes Kidney disease and with one kidney you are more likely to have hypertension and kidney disease and if you already have it, it aggrevates it.

My surgeon is also a Urological Oncologist and most of them focus on Kidney and Prostate Cancer and nothing else. The one disagreement I had with my Doctor is that I asked for a referrral to a Nephrologist after I got Gout 8 years after surgery as Gout is Kidney related. He said I did not need it, but I could do so on my own. It turns out I have stage 3 Kidney Disease and it is now monitiored much more aggressively by a Nephrologist. Most of us survivors start at Stage 2 once we lose our Kidney or partial kidney.

Best wishes,

Icemantoo

MikeK703

icemantoo said:

Hardball
cidnygodfrey2,

I hope that it is the size of a hardball rather than a softball. In any event I hope that there are no mets to complicate things. He is going to need the surgery once the tests are in and the other issues are addressed. A nephrectomy alone does cure Kidney Cancer in most cases where there are no mets.


The surgery is not fun. It hurts. The recovery is not fun. His age at 48 makes it easier than when I had it at age 59. He needs to get the weight down. Once the surgery is over you need to watch blood pressure very carefully as being overweight causes high blood pressure and hypertension. Hypertension causes Kidney disease and with one kidney you are more likely to have hypertension and kidney disease and if you already have it, it aggrevates it.

My surgeon is also a Urological Oncologist and most of them focus on Kidney and Prostate Cancer and nothing else. The one disagreement I had with my Doctor is that I asked for a referrral to a Nephrologist after I got Gout 8 years after surgery as Gout is Kidney related. He said I did not need it, but I could do so on my own. It turns out I have stage 3 Kidney Disease and it is now monitiored much more aggressively by a Nephrologist. Most of us survivors start at Stage 2 once we lose our Kidney or partial kidney.

Best wishes,

Icemantoo

Chronic Kidney Disease Stages
Iceman,
You're in Stage 3 probably for the same reason I am -- your age. When they determine the GFR, which determines your stage, they take into consideration your creatinine level and age (as well as race). I'm 64 but a 30-year-old with the same creatinine level as mine would only be in Stage 2. So the young folks here who have had a radical nephrectomy may start in Stage 2, but we old farts usually start in a higher Stage. That's my understanding of it anyway.
Regards,
Mike

icemantoo

MikeK703 said:

Chronic Kidney Disease Stages
Iceman,
You're in Stage 3 probably for the same reason I am -- your age. When they determine the GFR, which determines your stage, they take into consideration your creatinine level and age (as well as race). I'm 64 but a 30-year-old with the same creatinine level as mine would only be in Stage 2. So the young folks here who have had a radical nephrectomy may start in Stage 2, but we old farts usually start in a higher Stage. That's my understanding of it anyway.
Regards,
Mike

CKD
MikeK703,

Thee reason I coose to raise the concern of Chronic Kidney Disease regarding Cindy's husband is that he is 48 which although younger than you and I, he is overweight which is consistent with high blood pressure and is an additional risk factor in Chronic Kidney disease, the other risk factors being age and having one kidney.

Icemantoo

Texas_wedge

icemantoo said:

CKD
MikeK703,

Thee reason I coose to raise the concern of Chronic Kidney Disease regarding Cindy's husband is that he is 48 which although younger than you and I, he is overweight which is consistent with high blood pressure and is an additional risk factor in Chronic Kidney disease, the other risk factors being age and having one kidney.

Icemantoo

Next steps
Cindy, what iceman and Mike have said is all correct. May I add a couple more thoughts?

It seems almost certain that he has RCC and you will soon know if he has any mets. If so (and, of course, like iceman I hope not) then they will be RCC as well, assuming that the liver tumour is the primary tumour. Chemo is ineffectual against RCC, as is radiotherapy but there are now quite a few new treatments.

If no mets then, as iceman said, surgery may well get the job done. His obesity (your Husband's, not iceman's!) and the size of tumour make open surgery probable and it will be less jolly than if the laparoscopic route were the way in - more painful after the op for a few days and a slower recovery.

What Mike says about creatinine levels, and age (and also estimated Glomerular Filtration Rate - 'eGFR') is correct as regards the classification of stage of CKD but it's consistent with iceman's advice that your Husband must get his weight down, whether or not he has a nephrectomy (but all the more so if he does have one) to protect against high blood pressure and additional kidney damage.

cindygodfrey2

Texas_wedge said:

Next steps
Cindy, what iceman and Mike have said is all correct. May I add a couple more thoughts?

It seems almost certain that he has RCC and you will soon know if he has any mets. If so (and, of course, like iceman I hope not) then they will be RCC as well, assuming that the liver tumour is the primary tumour. Chemo is ineffectual against RCC, as is radiotherapy but there are now quite a few new treatments.

If no mets then, as iceman said, surgery may well get the job done. His obesity (your Husband's, not iceman's!) and the size of tumour make open surgery probable and it will be less jolly than if the laparoscopic route were the way in - more painful after the op for a few days and a slower recovery.

What Mike says about creatinine levels, and age (and also estimated Glomerular Filtration Rate - 'eGFR') is correct as regards the classification of stage of CKD but it's consistent with iceman's advice that your Husband must get his weight down, whether or not he has a nephrectomy (but all the more so if he does have one) to protect against high blood pressure and additional kidney damage.

chemo
yes, that was my thought exactly! Of course i did not think about it then when i was in the office. I knew that if chemo was ineffective on the primary site, it would not be effective on any secondary site. Thanks for confirming and I do know that he will have a rough recovery post surgery.