Post surgery questions

adman

I had a Radical of my right kidney this past Tuesday.
- It was Stage-1, 6.2cm
- many MRI's, CT's, Bone Scans were done prior to surgery to determine whether there was ANY spreading. From what they could see, there was none.

Preliminary pathology, from what I was told by the dr, is a non-aggressive type. Not sure how long it takes to receive the final.
My next dr. appt is next week.

My questions.

1. What should I do, questions to ask, about the pathology?

2. Is a 2nd opinion an option?

3. What is the standard for storing my kidney, where does it go?

4. Are pictures of the kidney ( post extraction ) standard? Am I allowed copies of these?

5. How common/ uncommon is radiation, or other to treat the 'surrounding' areas that may have 'seeding' or spreading into fat areas or other?
-- How is a determination made about this?

Thanks in advance.

icemantoo

Questions
Adman,

1. Ask what each word means. Get a copy
2. Always an option, don't rush it until a serios question arises.
3. It is probably long gone
4 Maybe. If you ask.
5. Not unless it has spread.

Don't worry everything will be fine.

Icemantoo

adman

icemantoo said:

Questions
Adman,

1. Ask what each word means. Get a copy
2. Always an option, don't rush it until a serios question arises.
3. It is probably long gone
4 Maybe. If you ask.
5. Not unless it has spread.

Don't worry everything will be fine.

Icemantoo

Thanks, Buddy, much appreciated.

I really appreciate the follow up

garym

Post surgery...
adman,

With good reports from all of your other tests it seems likely that your pathology report will be good also, you should get the complete report at your next visit, make sure you get a copy and make sure the doc knows you would like a thorough explanation of it. Write things down before you go, its normal to be flooded by emotions on a good or bad report and get forgetful, and don't be afraid to ask for things to be repeated or more clearly explained. The pathologist will go through the tissue removed layer by layer to ascertain how well it was contained and what type it is. That said, it will probably be clear cell which is the most common, but type is very important going forward, stage is determined by size with 7.0cm as the start of stage 2 thus stage 1 for you, it will be graded from 1 to 4 with lower being best this is the measure of how well contained the cancer was and since no disease was detected on any other tests you should be in very good shape here. Ask about risk of recurrence and what the plan for follow-up tests and scans will be going forward. A second opinion is always an option, but based on what you know so far I doubt you'll need one. I don't know if they store or destroy the tissue once they are done with it, good question for the doc. You should be able to get copies of all records and photos, it may take more than one request however. Unless there is evidence of the spread of disease any post surgical treatment is unwarranted and unnecessary, the grade in your path report would be the determining factor.

Good luck and hang in there,

Gary

Texas_wedge

garym said:

Post surgery...
adman,

With good reports from all of your other tests it seems likely that your pathology report will be good also, you should get the complete report at your next visit, make sure you get a copy and make sure the doc knows you would like a thorough explanation of it. Write things down before you go, its normal to be flooded by emotions on a good or bad report and get forgetful, and don't be afraid to ask for things to be repeated or more clearly explained. The pathologist will go through the tissue removed layer by layer to ascertain how well it was contained and what type it is. That said, it will probably be clear cell which is the most common, but type is very important going forward, stage is determined by size with 7.0cm as the start of stage 2 thus stage 1 for you, it will be graded from 1 to 4 with lower being best this is the measure of how well contained the cancer was and since no disease was detected on any other tests you should be in very good shape here. Ask about risk of recurrence and what the plan for follow-up tests and scans will be going forward. A second opinion is always an option, but based on what you know so far I doubt you'll need one. I don't know if they store or destroy the tissue once they are done with it, good question for the doc. You should be able to get copies of all records and photos, it may take more than one request however. Unless there is evidence of the spread of disease any post surgical treatment is unwarranted and unnecessary, the grade in your path report would be the determining factor.

Good luck and hang in there,

Gary

What happens next
I'd like to echo what iceman and Gary have said, with a small tweak of one point of Gary's. It's stage that reflects the containment of the tumour and grade relates to the histology. Stage is far more important than grade for prognosis but it sounds as though you are both stage 1 and grade 1 so you have virtually nothing to worry about and will probably not need any more treatment of any kind.

As Gary has said, the odds are that the sub-type will be clear cell but the type won't really matter if the grade is 1. The likelihood of metastasis is assessed primarily by stage so it's no surprise that no spread has been detected and we all hope that you're now completely cured and can start forgetting about cancer - aside from occasional screening in the years ahead, just to be sure.

adman

Texas_wedge said:

What happens next
I'd like to echo what iceman and Gary have said, with a small tweak of one point of Gary's. It's stage that reflects the containment of the tumour and grade relates to the histology. Stage is far more important than grade for prognosis but it sounds as though you are both stage 1 and grade 1 so you have virtually nothing to worry about and will probably not need any more treatment of any kind.

As Gary has said, the odds are that the sub-type will be clear cell but the type won't really matter if the grade is 1. The likelihood of metastasis is assessed primarily by stage so it's no surprise that no spread has been detected and we all hope that you're now completely cured and can start forgetting about cancer - aside from occasional screening in the years ahead, just to be sure.

All feedback very much appreciated.....


I'm learning as I go here.
I look forward to supporting people as well. Thank you!!

garym

Texas_wedge said:

What happens next
I'd like to echo what iceman and Gary have said, with a small tweak of one point of Gary's. It's stage that reflects the containment of the tumour and grade relates to the histology. Stage is far more important than grade for prognosis but it sounds as though you are both stage 1 and grade 1 so you have virtually nothing to worry about and will probably not need any more treatment of any kind.

As Gary has said, the odds are that the sub-type will be clear cell but the type won't really matter if the grade is 1. The likelihood of metastasis is assessed primarily by stage so it's no surprise that no spread has been detected and we all hope that you're now completely cured and can start forgetting about cancer - aside from occasional screening in the years ahead, just to be sure.

DOH...
Good catch!!! Just making sure you're awake.

donna_lee

garym said:

DOH...
Good catch!!! Just making sure you're awake.

One more item
I pretty much agree with the guys on disposal of your souvenirs. Probably they took pix of the frozen slides for follow up studies later, and may even have cells in a preservative for future drug tests. Did you also sign any forms allowing for DNA studies to go along with your path samples. Since my surgery was done at a research and teaching hospital, it was part of the packet of papers to sign.
Oh, that mine had been Stage I- I'd be over the moon knowing what I do now. Much better than a IV.


All best wishes in returning to your "new Normal."
donna_lee

adman

donna_lee said:

One more item
I pretty much agree with the guys on disposal of your souvenirs. Probably they took pix of the frozen slides for follow up studies later, and may even have cells in a preservative for future drug tests. Did you also sign any forms allowing for DNA studies to go along with your path samples. Since my surgery was done at a research and teaching hospital, it was part of the packet of papers to sign.
Oh, that mine had been Stage I- I'd be over the moon knowing what I do now. Much better than a IV.


All best wishes in returning to your "new Normal."
donna_lee

Ha....

"Souvenirs"....in a club I didn't want membership in

Thank you.

adman

garym said:

Post surgery...
adman,

With good reports from all of your other tests it seems likely that your pathology report will be good also, you should get the complete report at your next visit, make sure you get a copy and make sure the doc knows you would like a thorough explanation of it. Write things down before you go, its normal to be flooded by emotions on a good or bad report and get forgetful, and don't be afraid to ask for things to be repeated or more clearly explained. The pathologist will go through the tissue removed layer by layer to ascertain how well it was contained and what type it is. That said, it will probably be clear cell which is the most common, but type is very important going forward, stage is determined by size with 7.0cm as the start of stage 2 thus stage 1 for you, it will be graded from 1 to 4 with lower being best this is the measure of how well contained the cancer was and since no disease was detected on any other tests you should be in very good shape here. Ask about risk of recurrence and what the plan for follow-up tests and scans will be going forward. A second opinion is always an option, but based on what you know so far I doubt you'll need one. I don't know if they store or destroy the tissue once they are done with it, good question for the doc. You should be able to get copies of all records and photos, it may take more than one request however. Unless there is evidence of the spread of disease any post surgical treatment is unwarranted and unnecessary, the grade in your path report would be the determining factor.

Good luck and hang in there,

Gary

Pathology

Stage 1 - tumor was measured ( post surgery ) at 5.0cm - how odd is it that the size changed from scans to actual? Pre- surgery was 6.2cm

Feurman Grade - 1 - All margins were clear

Clear Cell Type

The path report indicated that a sample WAS kept.



I am very lucky.

alice124

adman said:

Pathology

Stage 1 - tumor was measured ( post surgery ) at 5.0cm - how odd is it that the size changed from scans to actual? Pre- surgery was 6.2cm

Feurman Grade - 1 - All margins were clear

Clear Cell Type

The path report indicated that a sample WAS kept.



I am very lucky.

Good news
You are lucky. Congratulations. As far as the size difference between the scan and the actual surgery, I don't think it is anything to worry about. I don't think its unusual to have some variance between scan and actual tumor.