Second opinion?

askingforafriend

Hi all-

I received my pathology report a few days ago. 2.2cm clear cell carcinoma of the R kidney removed via partial nephrectomy. Grade 2 and pT3a. I was told on the report that the margins are not clear and that cells have spread to a segmental branch of the renal vein.

My doctor told me he feels very confident that they got everything during my surgery, and he says that no further treatment is needed at this time. I am basically just supposed to wait until my 6 month follow up scan to make sure that nothing comes back.

I am very new to all of this. My doctor is very experienced and I really do like him, but someone asked me if I was going to get a second opinion just in case. I hadn't even considered this. Did you guys get second opinions on your pathology reports/courses of treatment? I don't even know where to begin or if this is standard practice.

Any advice would be appreciated :)

Bay Area Guy

If you have both a surgeon and a urologic oncologist, you might want to check with the oncologist (assuming it was the surgeon that said everything was fine).

askingforafriend

https://csn.cancer.org/discussion/comment/1693411#Comment_1693411

I don’t have an oncologist. Just the urologist who performed my surgery.

eug91

First off, congrats on getting through your neph. Hopefully your healing is going well.

The six month wait before the follow-up scan is pretty standard. Especially in a case like yours where things look good and the doctor believes they got it all. But if you have any concerns, don't be afraid to bring them up to your doctor. He/she can further explain to you their thinking.

lobbyist0724

I did go for a 2nd opinion on the pathology. I would go for a second opinion if you are in doubt or if your doctor is not an RCC specialist. Also, it sounds like you do not have a copy of your pathology report, so it is good to get a copy so you know exactly what you are facing as well. But don't worry too much as it's a small tumor and low grade to start with. All the best!

askingforafriend

https://csn.cancer.org/discussion/comment/1693506#Comment_1693506

That is helpful to know. I didn’t know if docs did scans sooner than that or if 6 months just makes more sense to see if there has been any growth. Thank you for the advice!

askingforafriend

https://csn.cancer.org/discussion/comment/1693513#Comment_1693513

From all my reading it seems like second opinions are fairly standard. Is is what you’ve found?

misterace

If the pathology report is questionable, it may not hurt to get a second opinion from another pathologist to ease your mind. Every doctor specializes in different things. It sounds like your Urologist is just relying on the pathologists report - he likely won't necessarily be able to offer you any additional info.

lobbyist0724

I agree with misterace, it doesn't hurt another pair of eyes to take a look at your case. At the end of the day, it is something that affects our prognosis, and dictates our follow-up plan!

Also, I had an Ultrasound one month after my surgery, my doc said because I had a partial, he want to get a baseline of the surgery site for future comparison.

askingforafriend

Thanks for all the input! I’m calling a doctor Monday to schedule an appt for a second opinion. Hopefully he will agree with everything my primary doc said and it will give me some piece of mind.

Biner

Have you been offered adjuvant therapy? All the same, stage 3 involving the renal vein has a high risk of recurrence. It is usually advised to do a CT scan every 3 months at least for the first year. But of course, at the discretion of the doctor.

askingforafriend

https://csn.cancer.org/discussion/comment/1693872#Comment_1693872

I haven’t, but I am going for a second opinion this week!

AliceB1950

I had a CT three months after my nephrectomy, and mine was just stage 1. But it was grade 4, so my urologist said I'd be followed like it was a higher stage.

askingforafriend

Just to update- I went for my second opinion yesterday. My 2nd doc basically agreed with the 1st. He did say it was somewhat unusual to see vein involvement in a small tumor, but that it happens. He also said that doing a 3 month follow up scan for me wouldn’t make much sense bc I wouldn’t be fully healed and the scan could be inconclusive.

He did recommend doing a follow up MRI as opposed to a CT scan, bc if there is reoccurrence or spread to the renal vein, it will more likely show up on an MRI.

Im relieved but also hate that I just have to wait and see what the follow up scan shows. In the meantime though, I’m just going to try and take things day by day and enjoy my life!

Mmoses25

https://csn.cancer.org/discussion/comment/1693993#Comment_1693993

Take it one day at a time I’m stage 3 and going on 2 years I will pray for you but try and relax

askingforafriend

https://csn.cancer.org/discussion/comment/1694033#Comment_1694033

2 years NED? Congratulations!!