Cancer is back :( Should i chose partial nephrectomy on the lone remaining kidney

JR83

Friends,

I am in a terrible state of mind. Three years before my right kidney was fully removed.

Pathology report after surgery showed stage 3 (pT3a)- renal cell carcinoma (clear cell) - 7.5 x 5 x 4.2 cm 

Oct 2020 - CT Chest and Abdomen - No evidences of cancer

Oct 2021 - 0.9 cm exophytic lesion on left kidney (CT scan without contrast)

Feb 2021 - 1.0 cm exophytic lesion on posterior lateral aspect of the upper pole of left kidney suspicious for a focal renal cell carncinoma (MRI scan)

Some doctors recommend wait and watch. Some doctors recommend immediate surgery to prevent more nephrons loss.

Have you anyone been in this situation? What happens after surgery? How bad the renal function can go for 1 cm tumor? Some say there is risk of going into haemo dialysis.

I am completely broken to realise that this evil cancer is back and now im getting closer to renal failure. (age -37). Kindly help me with your experience.

Thanks

eug91

JR83 - I'm so sorry. Not the news anyone wants to hear. This isn't the outcome you'd hoped for, so let yourself feel sad. These feelings are totally normal. Let it out.

But once the shock passes through, you can focus on dealing with this new one just like you did the previous one. You have reason for optimism - you caught this early. This is why we we schedule the follow-up scans and why we go through them - so in case something like this happens, you can catch it while it's tiny and improve your prognosis.

While I don't have experience with what you're going through, I did ask my doctor early on about a situation like yours with something developing in the other kidney. He warned me that it does occasionally happen, and I read an article about the amazing advances in partial nephrectomy-after-radical nephrectomy (I'm sorry - I tried looking for the story to share with you, but can't find it).

Talk to your doctor and see what his/her game plan is - wait and see, partial neph, adjuvant therapy, etc. You have options available to you. No one can say exactly what your renal function will be like afterwards, but whatever happens will be done with keeping an eye on preserving function.

If you haven't already, you might want to post at smartpatients.com - you might be able to find more perspectives on your situation.

One last bit of advice from the great FoxHD: "It is a shock to be diagnosed with cancer. There are no do-overs. But here you are. You have a good prognosis. So with more time you will be able to go on living. You'll be ok. That is how you do this. Otherwise you are only wasting time on the negative thoughts. But believe me, you will never stop thinking about cancer. If you are going to live or die, move forward. You have to learn that you are living with cancer. Not dying from cancer. It makes all the difference in the world. But takes practice."

We're with you. You've got this.

askingforafriend

So sorry to hear that you're going through this. I don't have any advice, but just want you to know that you're not alone.

JR83

https://csn.cancer.org/discussion/comment/1693908#Comment_1693908

Hi @eug91 ,

Thanks a lot for your words.

While reading your profile, I realized we both identified Cancer at same time. I noticed that you stopped after 2 CT scans and continued follow up with MRI. Was it recommended to you ? Was it without contrast or with/without contrast?

I had six CT scans all without contrast after my surgery and I am worried that whether this could have added to the risk of reoccurrence.

Thanks,

Jawahar

eug91

My doctor prefers to alternate CT and MRI to limit the radiation from too many CT scans. Yes, with contrast (I take a blood test weeks before my scans to confirm that my remaining kidney can handle the contrast).

This level of science is over my pay grade, but it seems to me more likely that the bigger risk factor for reoccurrence would be your previous history of RCC - rather than three years of CT scans. Regardless, mention it to your doctor if it concerns you, but be good to yourself and try not to beat yourself over figuring out what might have caused the reoccurrence. Most of the time it's genetics and bad luck.

Bryn1108

Hi,

I had left kidney removed 2016 due to renal cell carcinoma 9 cm.

Then in 2020 after radiation first I had my L5 vertebrae removed due to 4 cm RCC.

I also had Ablation procedure in my right kidney in October 2021, 2 cm. The scan looked great in Dec 2021. It was easy procedure. Hope the Lord guides you to the right decision.

JR83

Hi @Bryn1108 ,

Thanks for your comments. My urologist didnt give the Ablation option and is suggesting partial nephrectomy on the solitary kidney. Currently Creatine is 1.6 and egfr is 84 for me. Not sure whether i should go for ablation or partial nephrectomy for this 1 cm lesion. I have surgery setup at March 11th and I am not sure whom to consult for ablation over surgery.

1.Was your procedure cryo ablation or radiofrequency ablation?

2.What was you creatinine and egfr before and after ablation?

3.How did you get ablation as option instead of surgery - Did your urologist recommed that? Who will actullay do these ablation - is it your urologist surgeon or some other specailization?

Thanks

Bryn1108

Hi,

My doctors are at Mayo clinic Jacksonville fl.

They gave me the two options. I met with both Specialists and went with the non-surgical procedure. I have no regrets. It was the cryoablation.

Wish you the best.

AliceB1950

No suggestions, but sending you my best wishes on getting through this.

Allochka

Hello,

hee are some people with cancer returning several years later in another kidney. They are doing OK. Perhaps you could message them for more info? One of them is Medic, he posted recently about his second nephrectomy

Very sorry to hear about recurrence, but it is not the end!