RPLND - Retropertineal Lymph Node Dissection Surgery

what I know is that, if possible, surgery is the best way to treat mets (if possible); in your case and according to the doctor, it is possible.

surgery removes the mets and according to research, lowers or slows progression.

if you are uncomfortable, seek a second opinion from renal cancer expert in your area but do it quickly. I think the speed here is to make sure there is no further spread.

Sarah

Tbuck,

My thoughts are prayers go with you.  Sorry, I'm too new to offer any advice.  I'm still learning myself!  Second opinion sounds great though!

...of metastatic rcc is always an option that should be exhausted before moving onto systemic therapies. That said, the jury is still out on the specific value of rcc lymph node resection. A lot of articles out there on that subject, this one examplifies the overall debate quite well.

http://www.hindawi.com/journals/ijso/2011/816926/

/G

Tom,

  I had an RPLND in '08 and it bought me three years before the next met appeared, so for me it was worth it. The surgery was a biggie but I healed well and on schedule. Couldn't drive for a month. Docs got me up and walking the day after surgery, in the hospital halls. It was hard and painful and I didn't go far - a lap around the ward was a HUGE accomplishment! When I got home I had to force myself to stand and walk up and down the driveway each day. But each day it got a teeny bit easier. I can barely remember the particulars.....time heals allthings (well, , a lot of things). I had a mass near the aorta which they removed along with 30 non-cancerous lymph nodes  "to buy me time."

 You'll feel better about having it done once you get clarity on the situation. Good luck, Tom.

I am alive said:

I had the RPLND

Tom,

  I had an RPLND in '08 and it bought me three years before the next met appeared, so for me it was worth it. The surgery was a biggie but I healed well and on schedule. Couldn't drive for a month. Docs got me up and walking the day after surgery, in the hospital halls. It was hard and painful and I didn't go far - a lap around the ward was a HUGE accomplishment! When I got home I had to force myself to stand and walk up and down the driveway each day. But each day it got a teeny bit easier. I can barely remember the particulars.....time heals allthings (well, , a lot of things). I had a mass near the aorta which they removed along with 30 non-cancerous lymph nodes  "to buy me time."

 You'll feel better about having it done once you get clarity on the situation. Good luck, Tom.

Hey Tom,

I am thinking about you and wishing you a successful surgery with speedy recovery! Keep us posted!

Hugs,

Jojo

Tbuck1971 said:

Thank You again to each of you!

My second opinion was basically a duplication from the first suggested treatment plan.  My Dr. at Dana Farber in Boston advised that they suggest surgical removal of the lymph nodes, then review in 6 weeks to determine where we stand, new growth, treatment, etc.  I was pleased to hear that the medical teams at two different cancer centers were both on the same page.  At the end of my visit in Boston I advised my Doc I was working with folks at UNC Chapel Hill and that my surgery is planned for the 18th of July.  I told him who I was working with at UNC and he called him on the spot and spoke to him while I was in the room.  It was comforting to hear the Doctor tell me that he agreed.  They did have a differing opinion on which drug treatment might work the best with my situation if/when the cancer may return.  I guess I will have to cross that bridge when and if I come to it, fingers crossed and prayers welcomed!

 

I was also told by both to get genetic testing done ASAP!  My genetic counselor at UNC could not find a direct link between what I have and my family tree (no previous link to kidney cancer, rcc HLPRCC, etc.), so I was referred to a panel screening which tests for 25 different cancer related genes.  I was advised the genes do not cause cancer they just cause the body to not fight cancer mutations which can lead to cancer growth, etc.  I am not a rocket scientist, nor a genetics professional but that is what I understood from the counselor.  It will take 4 weeks to get my report and at that time may have a better idea of how to treat me if links are connected to what I have. 

 

So on the 18th I go to UNC for the RPLND, I was able to watch a video on this, robotic assisted, which is what they will use on me.  The video was on Youtube, wow, I wouldn't suggest doing that!  I am kind of freaked out.  My wife is interested in watching the video, I advised her not to.  So off to the beach on Saturday, back to work on Monday through Thursday, then the big day next Friday.  Again, prayers are very much welcomed!

 

God bless you all and thank you for being supportive and handing out the knowledge you all have!  I am so terribly sorry that we are all in this fight, but very much appreciate the time, energy and paricipation in these conversations that you all make!  Thank You!

 

Take care!

Tom

Go get'em Tom. Your targets are nicely aligned.

Tbuck1971 said:

Update

So sorry since my last update, I have been in recovery and not much following the CSN site. 

 

My surgery was supposed to be 3-5 hours and it turned out to be 7.5 hours, 37 staples and 10 days in the hospital (was supposed to be out by day 5).

 

Surgery was longer due to a mass extremely close to the Vena Cava.  Took 1.5 hours just to clear this group of/lymph nodes out. I lost a liter of blood and woke up in the operating room, I guess because the surgery went longer than expected??  First thing I heard was "he needs a blood transfusion".  I was in panic mode right out of the box.  However Dr said eveything was where it needed to be, every day I got better and better, but was so incredibly weak. I pulled out two IV's tossing and turning in the bed, got two shots every day in back of my right and or left arm.  Had blood drawn every 12 hours and had one vein in left hand so damaged that my pinky finger and ring finger on left hand is still partially numb but getting better, assume they got a nerve.   Total 11 lymph nodes removed 3 enlarged but 5 (including the three) with signs of cancer.  Dr claimed he picked me clean, no more tissue on right side of body and man I feel it.  My gut is like I boxed with Tyson and my stomach took all the beating.  One month yesterday was my surgery date July 18, I still cannot stand erect as I feel like I am tearing myself apart.  I try to sleep on my stomach to stretch myself out, but no good!  Good news is day 4 in hospital they pulled me from the pain meds, I was done with them, asked to get them away I could make it without them.  Good choice I assume I have not been in any pain since then that requires the heavy stuff. 

The next day, day 5 I was off pain meds, off drips, not hooked to anything, they asked me to eat and that is when all heck broke loose.  I began having projectile vomit and couldn't eat anything.  My belly was distended, after a ct scan they found I had way too much fluid in my abdomen.  A quick procedure to insert a drain tube and 4 liters later I felt like a new man, but for the next 4 days I couldn't eat without getting violently sick.  Day 9 Dr's walk in and tell me if I do not eat tomorrow I am getting tube down my nose for food, I was back on fluids (IV) again so that was ok, but they were really concerned about my not eating.  I lost 28 pounds in 10 days.  Day 9 I woke up demanded food (mostly sweets danish, sweets etc. which they found odd).  I killed them, and asked for more and more food.  By middle of the day my bowels were back going again.  That seemed to be the issue, the bowels were exposed to air too long and basically shut down.  Day 10 they pulled my 37 staples and they sent me packing. 

Day 5-9 I didnt sleep.  Watched Velocity TV for like 96 straight hours, it was AWESOME!  But I would have preferred to sleep.  The minute they came in and told me I was going to go home that my bowels were working good and I am now eating well, I almost passed out.  I was operating on adrenaline and seriously dropped back and almost past out.  I slept all the way home 2 hour drive, then slept for 36 of the next 48 hours, again with Velocity TV on!

Back to work on 8-12, follow up appoint on 8-11 and after discussion with my Dr he advised if I wanted to try work I could. I have been so incredibly tired, want to sleep all day, or at least 4-5 naps a day for 15 mins to 1 hour, but now I take nap as soon as I get home.  Wake up in time to go to sleep.  Weekends still taking many naps Sat and Sun.  I feel that I am getting stronger each day, but my digestion is still crazy and not always comfortable, but managable. 

 

What next - I have follow up appointments with Oncologist coming up soon and will need to follow a close regiment of CT scans and watching, drug therapies, etc as directed by Oncologist, additional surgeries if necessary.  I am optimistic but realistic.  My time away from work, recovering, etc has made one thing perfectly clear, I need a mid 1960's british convertible and many, many sunny days with the top down driving through central/western VA!

 

Thx and hope each of you find today better than yesterday but not as nice as tomorrow!

 

Take care!

Tom B.

You've been through a lot! I hope they got it all and that you're done for good with this crap.

Thanks for updating us.

Todd