Radical nephrectomy - advise appreciated

skathleen

I am a 58 year women is excellent health.  Recently a contrast CAT scan found a 7.4 cm x 6.1 cm mass on the inferior pole of my left kidney.  Radiology report stated it was "highly suspicious for malignancy."  The urologist wants to do a radical nephrectomy (whole kidney - NOT laproscopic).  Surgery is scheduled a week from now.

CAT scan indicated liver, pancreas, spleen and right kidney look good.  Ultrasound showed lungs were clear.  Bone scan came back clean.  Bloodwork is great and I have no blood in my urine.  Lymph nodes are the uncertainity here. 

This is my question - does a radical nephrectomy seem appropriate?  I am assuming because of the size, the surgeon wants to remove all of the kidney.  He and I reviewed the CAT scan together and he indicated that he did have some concerns about the lymph nodes.  He says he doesn't want to do it laproscopically because he doesn't want any of the cells from the mass to possibly be released in my system.  This is something I am totally unfamiliar with.

Any thoughts or advice is greatly appreciated.  By the way, I named my renal mass "Amelia".  Much less scary than referring to it as a mass, tumor or cancer.  

icemantoo

Welcome

Skathleen,

 

 

Welcome to the club which no one in their rigiht mind would volunteer to join. A full neph appears appropriate given Amelia's size. This can be done either Laproscopically or open and the call is above my paygrade. Mine was a full neph. laproscopically 13 lucky years ago. My tumor was a little over  4.2 cm or so.  Some surgeons do only open because they were trained that way and others feel open is the better procedure. There is no one size fits all between Laproscopic and open and between a partial and a full neph. If you are not comfortable with the way your surgeon wants to do it, you may want to get a second opinion.

 

A neph. already. Lets get the surgery behind you.

 

 

Icemantoo

APny

icemantoo said:

Welcome

Skathleen,

 

 

Welcome to the club which no one in their rigiht mind would volunteer to join. A full neph appears appropriate given Amelia's size. This can be done either Laproscopically or open and the call is above my paygrade. Mine was a full neph. laproscopically 13 lucky years ago. My tumor was a little over  4.2 cm or so.  Some surgeons do only open because they were trained that way and others feel open is the better procedure. There is no one size fits all between Laproscopic and open and between a partial and a full neph. If you are not comfortable with the way your surgeon wants to do it, you may want to get a second opinion.

 

A neph. already. Lets get the surgery behind you.

 

 

Icemantoo

I'm so sorry you have to be

I'm so sorry you have to be here. I agree with Iceman; the size of Amelia is probably the reason for the radical vs. partial nephrectomy. And I think it may also be the reason why they're recommending open and not laparoscopic surgery. Wishing you the very best and a speedy recovery.

Jojo61

APny said:

I'm so sorry you have to be

I'm so sorry you have to be here. I agree with Iceman; the size of Amelia is probably the reason for the radical vs. partial nephrectomy. And I think it may also be the reason why they're recommending open and not laparoscopic surgery. Wishing you the very best and a speedy recovery.

Hello and welcome! Sorry to

Hello and welcome! Sorry to hear about your latest visitor, Amelia. They will get her out of there in no time, and you will be back to your old life!

I named my tumor Arnold - he was 13 cm and they managed to evict him laprascopically....amazing, isn't it? I am going for my scan November 12 to make sure that he hasn't returned. We all prefer to have NED visit us (No Evidence of Disease)we call him Uncle NED. So kick Amelia out and be ready for Uncle Ned's visit!!

We are here to help you through this.

Hugs

Jojo

 

skathleen

Jojo61 said:

Hello and welcome! Sorry to

Hello and welcome! Sorry to hear about your latest visitor, Amelia. They will get her out of there in no time, and you will be back to your old life!

I named my tumor Arnold - he was 13 cm and they managed to evict him laprascopically....amazing, isn't it? I am going for my scan November 12 to make sure that he hasn't returned. We all prefer to have NED visit us (No Evidence of Disease)we call him Uncle NED. So kick Amelia out and be ready for Uncle Ned's visit!!

We are here to help you through this.

Hugs

Jojo

 

NED!

Now I get it!  Thanks Jojo, I didn't know what Uncle Ned meant.

foxhd

skathleen said:

NED!

Now I get it!  Thanks Jojo, I didn't know what Uncle Ned meant.

Get it OUT!

That's all. You have nothing to worry about. Unless you try to do it yourself. Let the surgeon do his(her) thing. In a few months it will not matter which procedure they use. Think about the future.

artlady

Total nephrectomy

I also had a 13 cm kidney mass and had an open nephrectomy with removal of 6 lymph nodes(4 of which were positive), adrenal gland also removed, however, was disease free. This was done at MD Anderson this past June.  I am 65 and recovery was a bit slow for me, but I returned to teaching in August and doing well now.  I have a particularly aggressive malignancy due to the rhabdoid features and will return for follow up in December, God willing will be a negative report.  I am very grateful my surgeon performed the open and somewhat aggressive surgery.  Best wishes to you.  Stay strong.  You will do fine.

medic1971

sounds right

Due to its size, I suspect that a radical nephrectomy is right thing to do, but it never hurts to get a second opinion with a urologist who has a lot of experience with type of mass. 

I got my second opinion at MD Anderson.  One of the questions I had for my Dr was open vs laproscopic.  My Dr said there were pros and cons for both procedures, but in 6 months I won't remember or care how the surgery was done and that's pretty much what Foxhd said too.  

I am currently recovering from a robotic partial nephrectomy. 

 

Good luck!

 

 

Richgels1

Those Nodes

Hi Kathleen,

Wish you didn't have to be here but you have a great chance of being cured. As others here have said, the procedure they suggest sounds resonable. My one comment would be that you should be comfortable with what they are going to do about the surrounding nodes before the surgery. In my case (53 and healthy) they took my kidney out (10cm tumor) and then decided to leave the surrounding nodes in because they appeared to be fine. I had recurrance in the nodes 6 months later and I now wish they had taken the nodes out at the time. The doctor told me they were going to take the nodes out, which I believe is pretty standard practice, and then he didn't do it. If they had taken the nodes it's possible I would'nt have had the recurrence. So, my advice is have the surrounding nodes removed as a precaution. Possibly it would'nt have made a difference but I would have no regrets. Hopefully your scare won't be too bad and your recovery will go well. I know this is a scary thing so hopefully you have lots of support. You always have us here.

Scott

Jan4you

Richgels1 said:

Those Nodes

Hi Kathleen,

Wish you didn't have to be here but you have a great chance of being cured. As others here have said, the procedure they suggest sounds resonable. My one comment would be that you should be comfortable with what they are going to do about the surrounding nodes before the surgery. In my case (53 and healthy) they took my kidney out (10cm tumor) and then decided to leave the surrounding nodes in because they appeared to be fine. I had recurrance in the nodes 6 months later and I now wish they had taken the nodes out at the time. The doctor told me they were going to take the nodes out, which I believe is pretty standard practice, and then he didn't do it. If they had taken the nodes it's possible I would'nt have had the recurrence. So, my advice is have the surrounding nodes removed as a precaution. Possibly it would'nt have made a difference but I would have no regrets. Hopefully your scare won't be too bad and your recovery will go well. I know this is a scary thing so hopefully you have lots of support. You always have us here.

Scott

Well, Kathleen, I am glad you

Well, Kathleen, I am glad you found us! Ask ANY and as many questions you need to ok?

I had a radical nephrectomy due to his position near a blood supply. I really wanted laproscopic/robotic if at all possible.

The surgeon "bags" the kidney before taking it out so not to spread any cancer cells as I understand it.

If this were me, with the knowledge/information I gained on here, I would seek another opinion with a surgeon who does robotic surgery. I wonder if your present surgeon is not trained in robotic ?? Some have experience in laproscopic but NOT robotic. Hmm.. I watched the surgery online and saw how they bag it before removing it.

So yes, you can get robotic/laproscopic incisions and they make a slightly bigger incisions (about 3ish inches I think) as the other incisions for the robotic arms/instruments/camera are much smaller about 1 inch.

What do you think about getting a second opinion? It is a much easier post recovery in my opinion. I know, I have had two abdominal laproscopic surgeries.

Just my opinion.. it is your life~

Sending you healing hugs !! DM me (direct message) if you need to talk more.

Jan

ponzlaw

Just had partial Neph Lap 2 days ago.

I agree with many of the comments. Given the tumor size it appears appropriate. Get a second opinion. Are you located near a major cancer hospital, e.g. the Cleveland Clinic, Memorial Sloan in NYC? This is surgery that requires an expert. Many of these tumors are very treatable. I know of many cases where people have had similar sounding cases as yours and they are 5+ years out. My operation was for a partial which was done lap (tumor size 1.6 cm ) plus they took out appendix cause there was a small tumor/cyst at the tip. I was petrified but it was over before I knew it. Go to it!!!!You can do it.

ponzlaw

Richgels1 said:

Those Nodes

Hi Kathleen,

Wish you didn't have to be here but you have a great chance of being cured. As others here have said, the procedure they suggest sounds resonable. My one comment would be that you should be comfortable with what they are going to do about the surrounding nodes before the surgery. In my case (53 and healthy) they took my kidney out (10cm tumor) and then decided to leave the surrounding nodes in because they appeared to be fine. I had recurrance in the nodes 6 months later and I now wish they had taken the nodes out at the time. The doctor told me they were going to take the nodes out, which I believe is pretty standard practice, and then he didn't do it. If they had taken the nodes it's possible I would'nt have had the recurrence. So, my advice is have the surrounding nodes removed as a precaution. Possibly it would'nt have made a difference but I would have no regrets. Hopefully your scare won't be too bad and your recovery will go well. I know this is a scary thing so hopefully you have lots of support. You always have us here.

Scott

Nodes need to go

I totally agree about the nodes.