Partial or Radical?

GiGi5

Hello, I am new here.

Six years ago I had a 5cm tumor and had a partial nephrectomy of the left kidney. My doctor said I have 2/3 kidney remaining.  Last week I had a CT scan for another issue, and a 1.7cm mass was discovered in my right kidney, "mid-kidney cortex lateral."  I have searched the internet for information if this would possibly be a partial or radical nephrectomy situation.  With only 2/3 of the left kidney remaining, I am scared.  I can't tell you how afraid I am.

I am waiting on a phone call to schedule an MRI to confirm size and location.   I don't know how long it will be before I will see my doctor to talk about this.  I appreciate any advice from anyone who may have experienced a similar situation.

Thank you.

icemantoo

No one right answer

This is an issue you will have to discuss with your surgepn. He will  lookl at your age, kidney function ans location of the sudpected tumor among othrt issues. Evtn after making a decision it can change afte rsurgery  begins.

The optimim would be a partial given your prior surgery. Lets hope so.

 

icemantoo

GiGi5

Thank you.  I've read your

Thank you.  I've read your story and you are an inspiration.  Congratulations on your successful journey!

Bay Area Guy

If there's concern about

If there's concern about surgery, ablation is a possible alternative.  I had a partial for a very small lesion, but my doc and I discussed the pros and cons of both surgery and ablation.  As I had no other mitigating conditions, surgery was the best course for me.  But it's something to discuss.

stub1969

variables

There are a lot of variables that go into an answer to your question--including and probably the most important is the skill of the surgeon.  Since your mass is small you have a little time to make sure your surgery is in the hands of an experienced surgeon.  Check their credentials through the hospital website, research articles, or just ask the doctor.  

Keep us updated.  

Stub

GiGi5

Thank you

Thank you all for your responses, all very good points and much appreciated.  MRI is today.  I am hopeful, still very scared, but hopeful.

GiGi5

Partial Neph Recovery

Just a quick follow up, I had a partial nephrectomy last week.  I know it's early yet, and recovery will be slow, but I do remember recovery from the left partial six years ago was easier.  I'll take age into account there.  I don't have my checkup until next week, but I just read my pathology report and it states 'MARGINS: Parenchymal resection margin is focally positive."  That sounds a little disheartening to me, I believe we all prefer to hear the word "negative".  But I guess I'll cross that bridge.

Late night thoughts here, sleeping all day/night has finally caught up to me and I'm awake and reflecting.  Six years ago when I got my first diagnosis, my brother-in-law also received a cancer diagnosis--Stage IV brain glioblastoma.  When asked how my recovery was going, I felt so aweful responding "good", as we watched him deteriorate.  We lost him 14 months later.  This second diagnosis for me has shaken me to the core, and I chose to keep it private.  I realize how lucky I am to have been diagnosed Stage 1 both times.  I have every reason to be thankful.  But I fight a mental battle, why was I so lucky and he was not?  NED milestones have been non-events for me because I feel it's disrespectful to my brother-in-law and his family.  That clock starts over again for me, and I know I will continue to keep it to myself.  I know I should be happy about a good prognosis and go on my merry way, but it's not that easy.  The mental struggle with cancer is difficult for me, and those old wounds have just been reopened.

eug91

congrats GiGi5

Great job getting through your neph. Well done! 

And yes, you are absolutely right that the mental battle is just as hard and stressful as the physical one. Survivor guilt is real - I'll probably forever wonder how/why I got so lucky while others didn't. 

This is some advice foxhd posted a few years back about feeling down that I like to re-read- 

"This is something that comes up regularly. No one ever wants to be diagnosed with cancer. Kidney cancer was always a death sentence. We deal with the anxiety, surgery and recovery. Tremendous emotional stress. But at some point, something has to give. I think everyone goes through some sort of breakdown. What did we do to deserve this? Was it my fault? Am I going to die anyway? Maybe we are just so damn thankful. But it gets to us. Depression. Crying. Sense of hopelessness. Let it out. It is bad energy. Don't think you are weak. We have all been there too.

You would be surprised to find out how many people seek counseling or require anti depressives at this point. If you need help keeping it together, talk to your doctor. It all comes with the territory. This is so much more than having a tooth pulled. You are doing great. It is just not quite over yet."

Here's to your continued healing! 

GiGi5

Thank You

I've done a lot of reading on this board, and one thing I've learned for sure is Foxhd had great wisdom.  Thanks for your response, I greatly appreciate it!

stub1969

Postive margins

Hi, GiGi

Just a quick note about your positive margins.  I, too, had microscopic positive margins on part of the resected tumor.  I'm five years out and still NED.  When I first read about it on the hospital portal, I freaked out.  Immediately, I called my doctor and after listening to my concerns, told me about medical studies that have been conducted where positive margins didn't necessarily represent high reoccurrence rates.   He also told me about the process they use when cutting the tumor out, which cauterizes as it cuts...essentially killing remaining cells near the edge of the tumor. I'll be honest, part of me did feel like he was covering his butt, so I did some research of my own and found some medical journals that supported what he was saying. 

I understand your fear and anxiety about this.  I just hope my response helps a little.

Stub

GiGi5

Helpful Info!

Hi Stub,

Thank you so much for that information!  My sister-in-law sent me this she found on google (after telling me not to google!): 

"A positive surgical margin does not necessarily mean that cancer remains in the renal remnant in most cases.  Therefore, radical nephrectomy or re-resection of the margin is overtreatment in many cases." 

I had my follow-up appointment Tuesday, and my doctor's comments on the pathology report pretty much mirrored this, he could have written it!  He said he is very comfortable and would be surprised if there were any developments. I never thought about asking about the procedure, and after reading your comments about cauterizing I am SO MUCH more comfortable--deep breathe and exhale!  I can't thank you enough for sharing!  Congratulations on your five years NED, and cheers to many more!

Today I am two weeks post-surgery and doing well!

GiGi