Surgery Done 4/29!!!
Comments
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About those facts...Galrim said:Facts
Whether we like them or not.
Recurrence stats: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735023/
Prognostic factors: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471767/
Read and understand before throwing statements and starting arguments. Just a general recommendation...
/G
G,
I am certainly not looking to further upset anyone here - nor spark a fight. But I too am very fond of "facts". Except they are often totally contradictory.
For example, the link you suggested we consult for "recurrence stats" states this as its conclusion:
"In our experience, tumor size is significantly associated with synchronous metastases and asynchronous metastases following nephrectomy. Our results suggest that risk of metastatic disease for patients with tumors <3cm is negligible."
OK, that certainly seems straightforward enough. Except that particular study was published in 2009. Now here comes a paper that was published just a few weeks ago:
"Small Kidney Tumors Potentially Dangerous, Worth Treating"
"Even those renal cell carcinomas (RCCs) that are smaller than 4 cm may put patients at risk for aggressive cancer, according to a new study presented at the 28th Annual European Association of Urology Congress in Milan, Italy.
Sandra Steffens, MD, from the Hannover University Medical School in Germany, who presented the abstract, indicated that despite the fact that “many clinicians have regarded small renal cell cancer as having a benign biologic behavior,” smaller tumors may present with nodal or distant metastases.
This information differs from that of a study presented in February at the 2013 Genitourinary Cancers Symposium by Huang et al, which suggested that surveillance of patients with these small kidney tumors may be a safe alternative to surgery ... “These results have significant implications since the rate of patients diagnosed with small renal masses is increasing and nonoperative surveillance protocols are currently being used in patients with small renal tumor,” the researchers wrote in their abstract. “Our data confirm that small RCCs also have an aggressive potential and should be adequately treated.”
http://www.cancernetwork.com/rcc/content/article/10165/2138364
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pinkstar I know how you feel.pinkstar said:I refuse to argue. I will
I refuse to argue. I will continue to come to my own conclusions & remain positive regardless of you or anyone else. I can't believe that I am on CSN & having to defend myself. I have much better things to do as I would think you all would too. You don't have to agree with with me but you don't have the right to come after me either. I don't even experience this behavior on facebook & it is beyond me. So please....if you have nothing nice, positive or encouraging to say then DON'T BOTHER. No one needs it, considering we are all in this together.
pinkstar I know how you feel. I posted on here a few times and even though I was quoting my Dr's, every word I typed was nit picked. Sad really!
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I know that one, but...NanoSecond said:About those facts...
G,
I am certainly not looking to further upset anyone here - nor spark a fight. But I too am very fond of "facts". Except they are often totally contradictory.
For example, the link you suggested we consult for "recurrence stats" states this as its conclusion:
"In our experience, tumor size is significantly associated with synchronous metastases and asynchronous metastases following nephrectomy. Our results suggest that risk of metastatic disease for patients with tumors <3cm is negligible."
OK, that certainly seems straightforward enough. Except that particular study was published in 2009. Now here comes a paper that was published just a few weeks ago:
"Small Kidney Tumors Potentially Dangerous, Worth Treating"
"Even those renal cell carcinomas (RCCs) that are smaller than 4 cm may put patients at risk for aggressive cancer, according to a new study presented at the 28th Annual European Association of Urology Congress in Milan, Italy.
Sandra Steffens, MD, from the Hannover University Medical School in Germany, who presented the abstract, indicated that despite the fact that “many clinicians have regarded small renal cell cancer as having a benign biologic behavior,” smaller tumors may present with nodal or distant metastases.
This information differs from that of a study presented in February at the 2013 Genitourinary Cancers Symposium by Huang et al, which suggested that surveillance of patients with these small kidney tumors may be a safe alternative to surgery ... “These results have significant implications since the rate of patients diagnosed with small renal masses is increasing and nonoperative surveillance protocols are currently being used in patients with small renal tumor,” the researchers wrote in their abstract. “Our data confirm that small RCCs also have an aggressive potential and should be adequately treated.”
http://www.cancernetwork.com/rcc/content/article/10165/2138364
...look at the statistical mass and especially the approach and reasoning in the two surveys. Which is why I refer to the one I quote. Though its older it, is from a purely statistical viewpoint more reliable.
Quote: "Reasons for the recent discordant literature regarding tumor size and risk of metastases are not entirely clear. Klatte et al reported on 1,208 small renal mass patients (4cm or less) including 72 patients with metastases at presentation, noting that 6–7% of patients with tumors <2cm had metastatic disease.7 This is in stark contrast to our data, which includes 2,691 patients including 162 with metastatic disease at presentation and 1,227 patients with tumors <4cm, and the data reported by Kunkle et al,6 which includes 110 patients with metastatic disease at presentation matched with 250 controls, where not a single case of metastatic disease was observed in a patient with a tumor <2cm. It is plausible to conclude that the discordant results are in part related to unique referral patterns. While the report from Klatte et al included data from France, Italy, and Greece, the only center in the United States was UCLA which is a large referral center for metastatic RCC. We would suggest that the rare patient with metastatic disease and a very small renal tumor would be more likely to present to UCLA for an evaluation although the percentage of patients UCLA contributed to the combined database was not reported.7 Nevertheless, our data, where we used a relatively strict definition of metastases, supports the notion that as tumor size increases so does the risk of metastatic disease. This is supported by Kunkle et al where the definition of metastatic disease required biopsy confirmation.7 The results from Klatte et al, where M stage was assigned “according to 2002 definitions” although 56% had biopsy confirmation, remain intriguing and thus, further investigation is needed."
Anyway, my point was more of a general one; If throwing numbers and statements in here, please back them up somewhat, to the benefit of all. Then we can always discuss statistical mass validity afterwards :-)
/G
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Dear Pink,pinkstar said:I refuse to argue. I will
I refuse to argue. I will continue to come to my own conclusions & remain positive regardless of you or anyone else. I can't believe that I am on CSN & having to defend myself. I have much better things to do as I would think you all would too. You don't have to agree with with me but you don't have the right to come after me either. I don't even experience this behavior on facebook & it is beyond me. So please....if you have nothing nice, positive or encouraging to say then DON'T BOTHER. No one needs it, considering we are all in this together.
My comment wasnt directed to you personally, but towards the mentioned harsh tone in some posts. My point basically being, if anyone states something as a fact which has a relevance to others, when talking about something as critical as our disease, and especially if arguing, at least back it up with some kind of reference.
/G
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OKGalrim said:I know that one, but...
...look at the statistical mass and especially the approach and reasoning in the two surveys. Which is why I refer to the one I quote. Though its older it, is from a purely statistical viewpoint more reliable.
Quote: "Reasons for the recent discordant literature regarding tumor size and risk of metastases are not entirely clear. Klatte et al reported on 1,208 small renal mass patients (4cm or less) including 72 patients with metastases at presentation, noting that 6–7% of patients with tumors <2cm had metastatic disease.7 This is in stark contrast to our data, which includes 2,691 patients including 162 with metastatic disease at presentation and 1,227 patients with tumors <4cm, and the data reported by Kunkle et al,6 which includes 110 patients with metastatic disease at presentation matched with 250 controls, where not a single case of metastatic disease was observed in a patient with a tumor <2cm. It is plausible to conclude that the discordant results are in part related to unique referral patterns. While the report from Klatte et al included data from France, Italy, and Greece, the only center in the United States was UCLA which is a large referral center for metastatic RCC. We would suggest that the rare patient with metastatic disease and a very small renal tumor would be more likely to present to UCLA for an evaluation although the percentage of patients UCLA contributed to the combined database was not reported.7 Nevertheless, our data, where we used a relatively strict definition of metastases, supports the notion that as tumor size increases so does the risk of metastatic disease. This is supported by Kunkle et al where the definition of metastatic disease required biopsy confirmation.7 The results from Klatte et al, where M stage was assigned “according to 2002 definitions” although 56% had biopsy confirmation, remain intriguing and thus, further investigation is needed."
Anyway, my point was more of a general one; If throwing numbers and statements in here, please back them up somewhat, to the benefit of all. Then we can always discuss statistical mass validity afterwards :-)
/G
Agreed. Of course, you do know what they say... "There are lies, damn lies, and then there are statistics..."
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Jcosia, if thats...jcoscia said:pinkstar I know how you feel.
pinkstar I know how you feel. I posted on here a few times and even though I was quoting my Dr's, every word I typed was nit picked. Sad really!
...referring to the 0,2 percent thread, I recall it as you having read every stage 1 horror story in here and built a monster out of them, and I/we just tried to calm you down. Apologies if that came forward as nit pickimg, that was not the intention.
/G
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Small TumorsNanoSecond said:About those facts...
G,
I am certainly not looking to further upset anyone here - nor spark a fight. But I too am very fond of "facts". Except they are often totally contradictory.
For example, the link you suggested we consult for "recurrence stats" states this as its conclusion:
"In our experience, tumor size is significantly associated with synchronous metastases and asynchronous metastases following nephrectomy. Our results suggest that risk of metastatic disease for patients with tumors <3cm is negligible."
OK, that certainly seems straightforward enough. Except that particular study was published in 2009. Now here comes a paper that was published just a few weeks ago:
"Small Kidney Tumors Potentially Dangerous, Worth Treating"
"Even those renal cell carcinomas (RCCs) that are smaller than 4 cm may put patients at risk for aggressive cancer, according to a new study presented at the 28th Annual European Association of Urology Congress in Milan, Italy.
Sandra Steffens, MD, from the Hannover University Medical School in Germany, who presented the abstract, indicated that despite the fact that “many clinicians have regarded small renal cell cancer as having a benign biologic behavior,” smaller tumors may present with nodal or distant metastases.
This information differs from that of a study presented in February at the 2013 Genitourinary Cancers Symposium by Huang et al, which suggested that surveillance of patients with these small kidney tumors may be a safe alternative to surgery ... “These results have significant implications since the rate of patients diagnosed with small renal masses is increasing and nonoperative surveillance protocols are currently being used in patients with small renal tumor,” the researchers wrote in their abstract. “Our data confirm that small RCCs also have an aggressive potential and should be adequately treated.”
http://www.cancernetwork.com/rcc/content/article/10165/2138364
My own tumor was initially staged as 1, but turned into a Stage 3 once they did the pathology simply because of location. This experience led me to realize that it's important not only how large the tumor is, but where it is. I reailize it's hard to track this information, but it seems important since access to blood, adrenal or lymphatic system is one of the major ways it spreads. That's something these studies seem to gloss right over...
I thought when I was talking to my RCC docs and my uncle oncologist, that 5 year recurrence rates for even small tumors were in the 5-8% range. That's relatively small compared to a Stage 3 tumor like mine (40%), but I would hardly call 5-8% "negligible" or "rare". It's between 1 out of 20 and 1 out of 10.
Staying positive is great. But being following things closely and taking good care of yourself would still be prudent even with a small tumor in Stage 1. Long term survival is best in patients who stay on top of their health and advances in their disease's treatments. It's good to catch stuff as early as you can.
Disagreement doesn't mean we don't wish each other well. But we also want to make sure accurate information is being passed out. I know I got some inaccurate information from some of the healthcare workers I saw. We hope that by speaking up, the truth gets out so that we all can benefit from it. We can disagree and still support one another. We all share the same goal here and I think we all wish each other to be healed and well from this damn disease.
Todd
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Small tumourstodd121 said:Small Tumors
My own tumor was initially staged as 1, but turned into a Stage 3 once they did the pathology simply because of location. This experience led me to realize that it's important not only how large the tumor is, but where it is. I reailize it's hard to track this information, but it seems important since access to blood, adrenal or lymphatic system is one of the major ways it spreads. That's something these studies seem to gloss right over...
I thought when I was talking to my RCC docs and my uncle oncologist, that 5 year recurrence rates for even small tumors were in the 5-8% range. That's relatively small compared to a Stage 3 tumor like mine (40%), but I would hardly call 5-8% "negligible" or "rare". It's between 1 out of 20 and 1 out of 10.
Staying positive is great. But being following things closely and taking good care of yourself would still be prudent even with a small tumor in Stage 1. Long term survival is best in patients who stay on top of their health and advances in their disease's treatments. It's good to catch stuff as early as you can.
Disagreement doesn't mean we don't wish each other well. But we also want to make sure accurate information is being passed out. I know I got some inaccurate information from some of the healthcare workers I saw. We hope that by speaking up, the truth gets out so that we all can benefit from it. We can disagree and still support one another. We all share the same goal here and I think we all wish each other to be healed and well from this damn disease.
Todd
Very well put Todd I could not agree more:)
I know from personal experience how important it is to remain pro active. I had a small tumour removed in 2003, recently another tumour was discovered on the old site, it had probably started growing about 5 yrs after the removal of the first one. It has gone now for the last time hopefully, I will probably be a little more paranoid about my check ups in future.
Djinnie
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Totally agreetodd121 said:Small Tumors
My own tumor was initially staged as 1, but turned into a Stage 3 once they did the pathology simply because of location. This experience led me to realize that it's important not only how large the tumor is, but where it is. I reailize it's hard to track this information, but it seems important since access to blood, adrenal or lymphatic system is one of the major ways it spreads. That's something these studies seem to gloss right over...
I thought when I was talking to my RCC docs and my uncle oncologist, that 5 year recurrence rates for even small tumors were in the 5-8% range. That's relatively small compared to a Stage 3 tumor like mine (40%), but I would hardly call 5-8% "negligible" or "rare". It's between 1 out of 20 and 1 out of 10.
Staying positive is great. But being following things closely and taking good care of yourself would still be prudent even with a small tumor in Stage 1. Long term survival is best in patients who stay on top of their health and advances in their disease's treatments. It's good to catch stuff as early as you can.
Disagreement doesn't mean we don't wish each other well. But we also want to make sure accurate information is being passed out. I know I got some inaccurate information from some of the healthcare workers I saw. We hope that by speaking up, the truth gets out so that we all can benefit from it. We can disagree and still support one another. We all share the same goal here and I think we all wish each other to be healed and well from this damn disease.
Todd
I fully agree with you Todd. I have absolutely no doubt that we all wish each other well here. I also happen to think that polite disagreement is a very good thing too. It spurs us to focus more thought and attention on whatever the issue might be.
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Totally agreeNanoSecond said:Totally agree
I fully agree with you Todd. I have absolutely no doubt that we all wish each other well here. I also happen to think that polite disagreement is a very good thing too. It spurs us to focus more thought and attention on whatever the issue might be.
Todd's last paragraph was particularly appropriate, especially his firs two sentences:
"Disagreement doesn't mean we don't wish each other well. But we also want to make sure accurate information is being passed out."
That is the purpose and the value of forums like this
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AMEN to that pinkstar. Therepinkstar said:I refuse to argue. I will
I refuse to argue. I will continue to come to my own conclusions & remain positive regardless of you or anyone else. I can't believe that I am on CSN & having to defend myself. I have much better things to do as I would think you all would too. You don't have to agree with with me but you don't have the right to come after me either. I don't even experience this behavior on facebook & it is beyond me. So please....if you have nothing nice, positive or encouraging to say then DON'T BOTHER. No one needs it, considering we are all in this together.
AMEN to that pinkstar. There are a couple of people on here that would argue with themselves if there was no one else around hahahahaha
Eims x
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