Wait and see approach? Thoughts?

db8ne1

Hi, all.

I've been on the Colon Cancer board for Stage 3 Colorectal cancer diagnosed in December 2012.  Lots has happened since then but original CT showed a mass (1.5 cm) on left kidney back in 2012.  Follow-up CT six months ago (after completion of CRC surgery/chemo/stuff) showed slow growth to 1.75 cm.  Urologist wanted to "wait and see".  Just got results of latest CT in May and kidney mass has grown to 2.2 cm.  All reports indicate "RCC per CT/MRI".

Anyone else experienced this wait and see approach?  Is it ripe for the picking yet?

I have an appointment with urologist in June...

Your thoughts would be appreciated!

J

pamstayner

Ripe or not?

I had a good laugh on the ripe for the picking.  It is a good thing that it still on the smaller side... often only a partial will get the growth, and leave a lot of your kidney function left.  That is a good thing J. 

Smaller is better, and when your oncology appointment comes up you will find out so much more as far as a treatment plan.  There are lots of knowledgeable people on this site, so I will let them be a better guide for you. 

I am sorry that you have another battle to plan... but as you know from this forum, there are good people to support you here.

Pam

angec

Hello, sorry you had to

Hello, sorry you had to experience all of this! I hope you are recovering nicely from everything!  What is happening with the Colon cancer, is it gone now? Any mets anywhere?  Is there a chance the kidney mass can be from the colon?  I would not wait. Wait for what? For it to get bigger? These docs make me laugh (not really). My brother recently had two masses on his thyroid, one on each side. Instead of taking the whole thyroid, they removed half of it. It was cancer but the doctor says, let's wait on the other side and see what happens, how it grows! Does that make any sense at all? My brother decided against waiting, had the other side removed and it too was, ofcourse, cancerous. So, my opinion is to treat it now. It might be small enough now to freeze it.  Don't sit on it.. Go to an RCC specialist, Oncologist.  Please be sure to get a copy of all of your scan reports, path reports etc. Every test you take, even blood, get copies  of the reports.  Doctors leave out alot of important details. Hoping things turn out well for you.  Big hug!

icemantoo

angec said:

Hello, sorry you had to

Hello, sorry you had to experience all of this! I hope you are recovering nicely from everything!  What is happening with the Colon cancer, is it gone now? Any mets anywhere?  Is there a chance the kidney mass can be from the colon?  I would not wait. Wait for what? For it to get bigger? These docs make me laugh (not really). My brother recently had two masses on his thyroid, one on each side. Instead of taking the whole thyroid, they removed half of it. It was cancer but the doctor says, let's wait on the other side and see what happens, how it grows! Does that make any sense at all? My brother decided against waiting, had the other side removed and it too was, ofcourse, cancerous. So, my opinion is to treat it now. It might be small enough now to freeze it.  Don't sit on it.. Go to an RCC specialist, Oncologist.  Please be sure to get a copy of all of your scan reports, path reports etc. Every test you take, even blood, get copies  of the reports.  Doctors leave out alot of important details. Hoping things turn out well for you.  Big hug!

Watch and wait

j,

 

Watching and waiting is for little buggers under 2 cm where there is no evidence of growth, no liklihood of it being RCC or other issues sich as older age (over 65 ) or heart condition. Your does not fit in any of these reasons to watch and wait. A neph or partial neph should take care of it and it should be an easier experience than you went thru with Colon Cancer. Not fun, but it beats the alternative/ Mine was 12 years ago at age 59. Faye across the street is at about 18 years and she is in her young 80's.

 

 

Icemantoo

 

 

 

 

Srashedb

Disagree

wait and see? What is waiting for, exactly? It would have been wonderful if my husband had had his cancer diagnosed early. 

In many, if not most, renal cancer grows without symptoms and once there are symptoms, it may have metastasized.

from what I have learned, the size of the cancer may not be determinative of the seriousness. 

What does your gut tell you? Follow that.

Sarah

rainsandpours

Srashedb said:

Disagree

wait and see? What is waiting for, exactly? It would have been wonderful if my husband had had his cancer diagnosed early. 

In many, if not most, renal cancer grows without symptoms and once there are symptoms, it may have metastasized.

from what I have learned, the size of the cancer may not be determinative of the seriousness. 

What does your gut tell you? Follow that.

Sarah

Sorry about your colon cancer

Sorry about your colon cancer .  Unfortunately, having one cancer disposes you to more.  Vigilance is important.  As to the kidney mass...get it out.  Its grown quite a bit while you've been under active surveillance.  At the size it is now, you can have RFA (less than 3cm), or a partial.  Once it hits 4 cm, you would need a radical neph, and lose some kidney function.  RCC is nothing to play with.   I had a 7 month wait between detection of my kidney cancer and surgery, and was a nervous wreck the entire time.  I chose surgery over RFA though as it has better stats and less CT scans for followup. 

 

 

db8ne1

rainsandpours said:

Sorry about your colon cancer

Sorry about your colon cancer .  Unfortunately, having one cancer disposes you to more.  Vigilance is important.  As to the kidney mass...get it out.  Its grown quite a bit while you've been under active surveillance.  At the size it is now, you can have RFA (less than 3cm), or a partial.  Once it hits 4 cm, you would need a radical neph, and lose some kidney function.  RCC is nothing to play with.   I had a 7 month wait between detection of my kidney cancer and surgery, and was a nervous wreck the entire time.  I chose surgery over RFA though as it has better stats and less CT scans for followup. 

 

 

Thank you!

Thanks for all the good advice.

Unfortunately, I did see my onc after my CT and he's sending me back to the urologist.  (IMO, my onc is a tool.  Very nice man but not very informative or well prepared when I meet with him). Fortunately, I'm kind of a control freak and prepare for appointments beforehand.  So, I'd already read my CT scan results before meeting with him.  I knew he'd be sending me to see the urologist...

As for my colorectal cancer, I had 6 weeks of chemoradiation prior to surgery.  It eradicated the cancer and 1 involved lymph node.  Yay.  So, post surgery on 4/11/13, my path report came back clean.  Miraculous, really, given the size and stage. Then I had 5+ months of "clean up chemo" - FOLFOX.  Brutal chemo!  Never again.  I just had my 1 year follow-up colonoscopy and had 2 tiny polyps removed.  GI doc said I'm good for 2 more years. 

CT scan is also to follow a number of small but stable masses on my left lung.  Unfortunately, 2 more appeared this time, but they are too small to biopsy (measured in mm's). So, back I go in another 6 months for a recheck... I'm hoping they are not the result of my "wait and see" approach on the kidney mass!  THAT would really suck.

I have an appointment with the urologist on 6/3 to see if he thinks its time for surgery, I guess.  I don't know him well and have only seen him twice for short appointments.  His resume says he's chief of surgery at the hospital I use.  I do know that making an appointment with him always ends in a 3 week wait...I've done research on kidney cancer specialists, but can't seem to find anyone so specific in the area.  Any suggestion: greater Milwaukee area?

Well, off to work.  Thanks again for the input.  I'll keep you posted when I find out more!

J

 

aamdsi

Sorry

For all you've already have had to go through.  But I agree with the,"get it out", opinion.  Although it isn't fun (as you know) it will be taken care of.  And since it seems to have finally turned warmer, you can recoup outside in the sun.

wish could help with Dr.  I am across the Big Lake 8-(

Hope you have a great weekend.  I know easier said than done, but try to relax and not worry.

Laurie

db8ne1

aamdsi said:

Sorry

For all you've already have had to go through.  But I agree with the,"get it out", opinion.  Although it isn't fun (as you know) it will be taken care of.  And since it seems to have finally turned warmer, you can recoup outside in the sun.

wish could help with Dr.  I am across the Big Lake 8-(

Hope you have a great weekend.  I know easier said than done, but try to relax and not worry.

Laurie

Update: DaVinci Robotic Surgery Scheduled

Well, I saw my urologist and I he recommended a partial neph. (He does open neph's and says partials can often turn into full nephs...). I asked him what HE would do if he were me and he said "I'd go to Mayo".  I loved this guy's candor and honesty! Since that's not an option for me, he suggested a local major hospital in the area that does more kidney surgeries - (although he was happy to do it).

Fortunately, the second opinion urologist got me in pretty quick.  I took all of my scans and records and he went over numerous options from a full open neph, partial open neph, partial robotic neph, CT guided cryo ablation, or biopsy.  After much discussion, we decided on a partial robotic neph.  Of course, he's in demand with the DaVinci robot, so I'll have to wait until 7/8 for surgery, which is actually perfect for me.  I can enjoy a month of summer without having to work! :-)

I'm not worried - this should be a breeze compared to my colorectal cancer battle last year!

Thanks again for all of your info.

J

 

Karen0074

db8ne1 said:

Update: DaVinci Robotic Surgery Scheduled

Well, I saw my urologist and I he recommended a partial neph. (He does open neph's and says partials can often turn into full nephs...). I asked him what HE would do if he were me and he said "I'd go to Mayo".  I loved this guy's candor and honesty! Since that's not an option for me, he suggested a local major hospital in the area that does more kidney surgeries - (although he was happy to do it).

Fortunately, the second opinion urologist got me in pretty quick.  I took all of my scans and records and he went over numerous options from a full open neph, partial open neph, partial robotic neph, CT guided cryo ablation, or biopsy.  After much discussion, we decided on a partial robotic neph.  Of course, he's in demand with the DaVinci robot, so I'll have to wait until 7/8 for surgery, which is actually perfect for me.  I can enjoy a month of summer without having to work! :-)

I'm not worried - this should be a breeze compared to my colorectal cancer battle last year!

Thanks again for all of your info.

J

 

Oh my urologist offered me

Oh my urologist offered me the wait and see approach first. my response - hell no. Good luck with surgery, in hoping mine will be about the same time as yours.

 

Karen xx

GSRon

Karen0074 said:

Oh my urologist offered me

Oh my urologist offered me the wait and see approach first. my response - hell no. Good luck with surgery, in hoping mine will be about the same time as yours.

 

Karen xx

Yes J

You are all over it..~!  No more waiting... time to get it done..!  But I agree waiting until the other Cancer is handled and you fully recovered is the best choice.  OK, there are well over 200 different diseases called Cancer... so what works for one, does not for another.  Kidney Cancer is, well special.. (right).  Hopefully the surgery will be the end of it.  With a small tumor that is usually the case.  But, as this is not your first Cancer, I have no idea if that changes anything..  The lung "spots" could be anything when they are that small.. wait and see on those is what I would do.  The next scan should tell the tale.  If there is growth, then treatment is likely indicated, but... I would not be surprized if they want to biopsy to be sure what they are dealing with, as that would decide which treatment.  However, if you had a larger tumor and no other Cancer, usually there would be no need to biopsy.

And Pam.. welcome over here on the Kidney Forum..!  Hope all is going well for you..!!

Cheers..!

Ron

foxhd

GSRon said:

Yes J

You are all over it..~!  No more waiting... time to get it done..!  But I agree waiting until the other Cancer is handled and you fully recovered is the best choice.  OK, there are well over 200 different diseases called Cancer... so what works for one, does not for another.  Kidney Cancer is, well special.. (right).  Hopefully the surgery will be the end of it.  With a small tumor that is usually the case.  But, as this is not your first Cancer, I have no idea if that changes anything..  The lung "spots" could be anything when they are that small.. wait and see on those is what I would do.  The next scan should tell the tale.  If there is growth, then treatment is likely indicated, but... I would not be surprized if they want to biopsy to be sure what they are dealing with, as that would decide which treatment.  However, if you had a larger tumor and no other Cancer, usually there would be no need to biopsy.

And Pam.. welcome over here on the Kidney Forum..!  Hope all is going well for you..!!

Cheers..!

Ron

sounds like

you are in good hands. Good for you. Keep positive thinking.

Melliebean

db8ne1 said:

Update: DaVinci Robotic Surgery Scheduled

Well, I saw my urologist and I he recommended a partial neph. (He does open neph's and says partials can often turn into full nephs...). I asked him what HE would do if he were me and he said "I'd go to Mayo".  I loved this guy's candor and honesty! Since that's not an option for me, he suggested a local major hospital in the area that does more kidney surgeries - (although he was happy to do it).

Fortunately, the second opinion urologist got me in pretty quick.  I took all of my scans and records and he went over numerous options from a full open neph, partial open neph, partial robotic neph, CT guided cryo ablation, or biopsy.  After much discussion, we decided on a partial robotic neph.  Of course, he's in demand with the DaVinci robot, so I'll have to wait until 7/8 for surgery, which is actually perfect for me.  I can enjoy a month of summer without having to work! :-)

I'm not worried - this should be a breeze compared to my colorectal cancer battle last year!

Thanks again for all of your info.

J

 

Hi

Hello good luck with your surgery. There are a bunch of great people lending advice.  I'm like you and Karen waiting for surgery.  I hope everything goes well for you. Speedy recovery!

Galrim

Enjoy the summer and dont be to worried. Your tumor is very small and unless it has some major independant progonostic features youre in the >5% recurrence risk group :-)

/G