Cryotherapy for Renal Mass <2.5

kickkancer22

I changed doctors and during my new patient appt. the doctor was not pleased with some of my prior labs (eGFR and creatine). He ordered Renal Unltrasound where a renal mass was found. Next step was a CT Scan; they found a heterogeneously enhancing lesion in the posterior upper pole of the left kidney measuring 2.3x2.0x1.9cm. I met with my urologist yesterday to discuss the options: 1) actively monitor with scans, 2) cryotherapy, or 3)robotic partial nephrectomy. Active monitoring was recommended only for patients whose health does not warrant surgical procedures. Cryotherapy has a 95% success rate, and 98% success if a 2nd treatment is needed.

I have chosen to do cryotherapy and will most likely have treatment after the 1st of the year.

Anyone have similar situation?

Bay Area Guy

In late 2013, a lesion was detected on my right kidney that was measured at about half the size of yours. The urologic oncologist I was referred to at Stanford recommended active surveillance because of the small size. 2-1/2 years later, an ultrasound determined it had grown very slightly. We discussed ablation and the numbers he gave in 2016 were similar, whereas he said the numbers for the robotic were 99+%. He recommended the surgery since it would, for all intents and purposes, be curative. I went with that. The other consideration is that surgery removes the lesion intact so that a pathology report can better clarify the specific type of RCC it was, whereas ablation destroys the cells, meaning no pathology report.

kickkancer22

Thanks Bay Area Guy for your information . With ablation, the first thing the IR (Interventional Radiologist) will do is take a sample for pathology, and then they will do the ablation. I will have results from the lab within 3-5 days. If the 3 month CT scan shows additional growth, I can either do another ablation, or a robotic partial nephrectomy. Since they cannot cool down the kidney after the blood supply is cut-off during the partial neph., my urologist stated that there is always the possibility of damage to the kidney. I may have to go that path in the future, but I thought the least invasive treatment would be the best way to begin this journey. I feel confident with my Vanderbilt medical team, which is half the battle.

AliceB1950

One thing to keep in mind - there's a subtype of kidney cancer called "unclassified" which can be a mix of different subtypes. Unless the radiologist taking the sample is really lucky, the sample will only show the type in the specific spot that was nipped. It's not one of the common types, but it's what mine was. And there are other things that can show up in pathology that I don't know if they'd appear in a small biopsy sample, such as rhabdoid and sacramatoid (not sure of spelling on that) features, which would make the cancer an automatic grade 4. That's grade, not stage, so not terribly worrisome, but it can affect the frequency of follow-up scans. I hit the jackpot and got one of those in my pathology report, too. You might ask the surgeon about these possibilities. Good luck!