Renal Mass

Trease · October 2015

Hello

I've been reading this discussion board for a couple days now, and I am really just a bit lost and scared. Here's my story

I had a follow up CT on my lung from a nodule a year ago and the doctor called me the next morning to tell me that it's the same size as last year but incidentally we found your spleen enlarged can you go back tomorrow and have another CT on your spleen. I went back and then within the hour of having the scan the doctor called and said it's marginal and we will just watch it but incidentally we found a mass on your left kidney can you go back tomorrow. At this point I am more then scared so I had a with and without contrast scan. The next morning my doctor told me there was a lesion and because of where it is located they. Couldn't be positive about anything and she wanted me to have it biopsied within the week at the most 2 weeks. She referred me to a nephrologist and after a week of being nervous I went to see one only for them to tell me they don't do surgery and I needed to see a urologist. I can't believe doctor referred me to the wrong specialist! At this point I know I need to do a little research. My appointment, finally, to see the urologist is this afternoon.

I can't wait any longer. My scan report does not say cancer as so many of yours said and I have read several times that it should never be biopsied but determining the Basniak scale left alone watched or removed.

The scan report states it is an abnormally appearing partially cystic lesion on the left kidney with internal and external calcifications. There is a prominent thick wall with focal areas of nodularity with enhancement suspected. The lesion is 4.4 x 3.7 x 3.6.

I am having a really hard time concentrating on anything else. Does anyone have any wisdom they could share before my appointment?

Trease · October 2015

I neglected to add to my scan report:

There is mass like effect in the minor calyces in the mid pole region. I guess this is the part that concerns me the most.

sblairc · October 2015

Trease said:
I neglected to add to my scan report:

There is mass like effect in the minor calyces in the mid pole region. I guess this is the part that concerns me the most.

I think that statement just describes what you already said

That statement just describes the location. "Mid pole region" is location within the kidney and "minor calyces" is this:

"The minor calyces surround the apex of the renal pyramids. Urine formed in the kidney passes through a renal papilla at the apex into the minor calyx; two or three minor calyces converge to form a major calyx, through which urine passes before continuing through the renal pelvis into the ureter"

Don't panic, take a deep breath. I know it sounds cliche, but it works. I calmed myself to the point of almost falling asleep. If you see I posted here about my husband's scan results from yesterday. I know that the waiting is excruciating.

I also know that it's scary. Scary. We are here for you. Keep us posted.

Trease · October 2015

sblairc said:
I think that statement just describes what you already said
That statement just describes the location. "Mid pole region" is location within the kidney and "minor calyces" is this:

"The minor calyces surround the apex of the renal pyramids. Urine formed in the kidney passes through a renal papilla at the apex into the minor calyx; two or three minor calyces converge to form a major calyx, through which urine passes before continuing through the renal pelvis into the ureter"

Don't panic, take a deep breath. I know it sounds cliche, but it works. I calmed myself to the point of almost falling asleep. If you see I posted here about my husband's scan results from yesterday. I know that the waiting is excruciating.

I also know that it's scary. Scary. We are here for you. Keep us posted.

Thank you for responding so soon. I am trying to remain calm. I was resigned to the fact that I would need a partial nephrectomy on Monday and last night I went from maybe radical nephrectomy to its nothing because it doesn't say the C word and it does say cystic. Coincidentally I recently took a class on how to meditate but as you see my mind has not stopped, I'm working on that.

I did see your post and I'm glad you had "Ned" for dinner. I'm certain that means your husband's scan was cleared but what does Ned mean?

NewDay · October 2015

Trease said:
Thank you for responding so soon. I am trying to remain calm. I was resigned to the fact that I would need a partial nephrectomy on Monday and last night I went from maybe radical nephrectomy to its nothing because it doesn't say the C word and it does say cystic. Coincidentally I recently took a class on how to meditate but as you see my mind has not stopped, I'm working on that.

I did see your post and I'm glad you had "Ned" for dinner. I'm certain that means your husband's scan was cleared but what does Ned mean?

Hi Trease,

I know that this is a scary time. I'm glad you are here, but wish you didn't have need to be. If I were you, I would run, not walk, to another doctor. Even an average PCP would know that a nephrologist does not do surgery. You need someone who knows what they are doing when you may be dealing with cancer and when there are so many unknowns. If your cysts are not cancer, then it may be a type of kidney disease. If that is the case, you will need to be followed by a nephrologist. If surgery leaves you with diminshed kidney function, then you also may end up with a nephrologist, but first you need to see a urologist to determine if, and what, surgery you need. Kidney cysts are actually pretty common, but, unfortunately they cannot make a definitive diagnosis without removing the cyst. You will get different opinions about a biopsy. It had been thought that a biopsy could risk the possibility of causing the cancer to spread, but more recent studies say that is not the case. I think you will have to just follow the urologist's lead on that.

Find a urologist with a LOT of experience with nephrectomies so that you can be sure they make the right decision about doing a partial or radical.

If what is going on in your lungs and spleen are actually metastasis from a kidney tumor that would make you stage IV, which is serious business and would also require that you have an oncologist actually running the show, prefereably an RCC specialist.

I know that is a lot to take in and I hesitate to tell you all of that because it only makes you anxiety worse, but I just want to impress on you the importance of getting the right specialists involved. Don't panic, but don't take it lightly either. There are people who have been living many years with this disease.

Please let us know what happens and ask any questions you may have.

Kathy

Richgels1 · October 2015

Hi Trease,
The doctor today

Hi Trease,

The doctor today likely will make the call if they want to do a biopsy. If so, they will likely just talk to you about the biopsy procedure today and schedule it. You may not know anything today either. My guess is they will also draw some blood which will help with diagnosis. Good luck, hope it goes well. Scott

icemantoo · October 2015

Richgels1 said:
Hi Trease,
The doctor today
Hi Trease,

The doctor today likely will make the call if they want to do a biopsy. If so, they will likely just talk to you about the biopsy procedure today and schedule it. You may not know anything today either. My guess is they will also draw some blood which will help with diagnosis. Good luck, hope it goes well. Scott

LET US HOPE THEY GET TO THE BOTTOM OF THIS.

Trease,

Hopefully you will get some clarity today. The good thing is that if you have to become an involuntary member of our club that it was caught while still relatively small and the chances for a full and complete recovery are close to 100%.

Icemantoo

Footstomper · October 2015

Trease said:
Thank you for responding so soon. I am trying to remain calm. I was resigned to the fact that I would need a partial nephrectomy on Monday and last night I went from maybe radical nephrectomy to its nothing because it doesn't say the C word and it does say cystic. Coincidentally I recently took a class on how to meditate but as you see my mind has not stopped, I'm working on that.

I did see your post and I'm glad you had "Ned" for dinner. I'm certain that means your husband's scan was cleared but what does Ned mean?

Scared

We all are or were. Answers help a bit. I'm sure your urologist can assuage your fears and/or come up with a plan of action.

Trease · October 2015

icemantoo said:
LET US HOPE THEY GET TO THE BOTTOM OF THIS.
Trease,

Hopefully you will get some clarity today. The good thing is that if you have to become an involuntary member of our club that it was caught while still relatively small and the chances for a full and complete recovery are close to 100%.

Icemantoo

Answers

Thank you all for your comments

I seen the doctor earlier and I liked him a lot. I felt very calm discussing this with him even though I was ready to burst with nerves when he finally entered the room. We went over the scan and talked through the whole situation. He believes my friend is a class 3 in the Basniak scale and should come out. I will be having an ultrasound to verify the scale and veins I think he said. Then by my choice we will be doing the procedure as soon as possible. I can't stand to think of this staying any longer then necessary.

Jan4you · October 2015

Trease said:
Answers
Thank you all for your comments

I seen the doctor earlier and I liked him a lot. I felt very calm discussing this with him even though I was ready to burst with nerves when he finally entered the room. We went over the scan and talked through the whole situation. He believes my friend is a class 3 in the Basniak scale and should come out. I will be having an ultrasound to verify the scale and veins I think he said. Then by my choice we will be doing the procedure as soon as possible. I can't stand to think of this staying any longer then necessary.

{{{{ TREASE }}}}

Glad you

{{{{ TREASE }}}}

Glad you found us and are able to ask a lot of questions. I came here first and was so well prepared when I met with my Urologist/surgeon. So, it is nice to learn that you feel comfortable with your Urologist.

I just wonder who was the first doctor you are referring to in your initial post to us. Just not certain he knew what he was talking about without consultation with a specialist in this area. Unless he was the specialist, was he? It is my understanding that they do not do biopsies with suspected renal cancer, but I could be wrong. I was not told I needed a biopsy as the CT result was already suspicious for RC and so was the Urologist who showed me the difference between the margins of the suspected tumor and another cyst.

I learned a long time ago, to be an advocate of my health, but then I am much older with a lot of run away history with other disorders I have. So honestly, I was not afraid of the C word, but yes, took it very seriously. Again I am lucky, with Stage I, radical nephrectomy, due to where the tumor was lying.

I already had a robatic/laproscopic surgery, prior to my Renal cancer one. I knew it would be less invasive and better healing recovery.

I also used a lumbar velcro wrap to keep my abdomen muscles/ligaments supported while I healed. I also put dry ice inside the wrap over the incision areas to keep the pain down. This ice treatment allowed me to take less and less pain meds.

We'll be here for you through all this, if you like us to be.

Good luck with your surgery and recovery. I am sending healing vibes your way!

Gentle Hugs, Jan

Trease · October 2015

Jan4you said:
{{{{ TREASE }}}}

Glad you
{{{{ TREASE }}}}

Glad you found us and are able to ask a lot of questions. I came here first and was so well prepared when I met with my Urologist/surgeon. So, it is nice to learn that you feel comfortable with your Urologist.

I just wonder who was the first doctor you are referring to in your initial post to us. Just not certain he knew what he was talking about without consultation with a specialist in this area. Unless he was the specialist, was he? It is my understanding that they do not do biopsies with suspected renal cancer, but I could be wrong. I was not told I needed a biopsy as the CT result was already suspicious for RC and so was the Urologist who showed me the difference between the margins of the suspected tumor and another cyst.

I learned a long time ago, to be an advocate of my health, but then I am much older with a lot of run away history with other disorders I have. So honestly, I was not afraid of the C word, but yes, took it very seriously. Again I am lucky, with Stage I, radical nephrectomy, due to where the tumor was lying.

I already had a robatic/laproscopic surgery, prior to my Renal cancer one. I knew it would be less invasive and better healing recovery.

I also used a lumbar velcro wrap to keep my abdomen muscles/ligaments supported while I healed. I also put dry ice inside the wrap over the incision areas to keep the pain down. This ice treatment allowed me to take less and less pain meds.

We'll be here for you through all this, if you like us to be.

Good luck with your surgery and recovery. I am sending healing vibes your way!

Gentle Hugs, Jan

First doctor

Thank you Jan

The first doctor was my primary. The same doctor who referred me to a Nephrologist to do the biopsy. I have really lost faith in her. I understand this is not her area of expertise but she really should know which doctor to send me to.

I brought my sister with me for back up in case I didnt understand or couldn't think to ask questions. It's funny we heard 2 different things about it being cancerous. She heard 50% chance of cancer I hear 60 - 80% cancerous. I came home and Called my brother to let him know and he said after I told him "so no cancer then " lol. The important thing we both heard loud and clear was the surgery will remove the cancer. That's the important part.

I'm glad to have the experience and support I've found here. Thank you

APny · October 2015

Trease said:
First doctor
Thank you Jan

The first doctor was my primary. The same doctor who referred me to a Nephrologist to do the biopsy. I have really lost faith in her. I understand this is not her area of expertise but she really should know which doctor to send me to.

I brought my sister with me for back up in case I didnt understand or couldn't think to ask questions. It's funny we heard 2 different things about it being cancerous. She heard 50% chance of cancer I hear 60 - 80% cancerous. I came home and Called my brother to let him know and he said after I told him "so no cancer then " lol. The important thing we both heard loud and clear was the surgery will remove the cancer. That's the important part.

I'm glad to have the experience and support I've found here. Thank you

Hi Trease. I agree with you;

Hi Trease. I agree with you; it should come out as soon as possible. Like so many here, I did not have a biopsy either and it's not really recommended for kidney tumors from what I've read. Hope you find a good urologist, one who is knowledgeable and knows what he/she is doing. Depending on the location most likely you'll have a partial nephrectomy and even if you can't have it done laproscopically (with or without a robot) it's not as bad as it sounds. Mine was an open procedure and I was up walking that night and out of the hospital in two days. On the third day I was sitting at my computer doing work. My scar is barely over 4 inches and my recovery was amazing. I can't imagine how much easier a lap surgery would be so don't worry if it can't be done that way. Wishing you the best and keep us informed.

jason.2835 · October 2015

Biopsy?

Hi, Trease,

As others have echoed, biopsies on renal lesions are not standard practice and are usually not done. Depending on your situation, most urologists or oncologists will tell you to just get it out. If you can find a surgeon with laparoscopic or robotic experience, even better. My recovery was pretty easy, save for the fatigue. Pain was not a major problem; I had robotic nephrectomy at Jefferson in Philadelphia.

My question would be whether a biopsy is a good idea; the kidney is not in an area that is exactly easy to get to! My first inclination was "GET IT OUT OF ME ASAP."

Best of luck,

- Jay

Trease · October 2015

jason.2835 said:
Biopsy?
Hi, Trease,

As others have echoed, biopsies on renal lesions are not standard practice and are usually not done. Depending on your situation, most urologists or oncologists will tell you to just get it out. If you can find a surgeon with laparoscopic or robotic experience, even better. My recovery was pretty easy, save for the fatigue. Pain was not a major problem; I had robotic nephrectomy at Jefferson in Philadelphia.

My question would be whether a biopsy is a good idea; the kidney is not in an area that is exactly easy to get to! My first inclination was "GET IT OUT OF ME ASAP."

Best of luck,

- Jay

That is what my urologist

That is what my urologist told me today. Just keep in Mind this is the same doctor that sent me to a nephrologist that wants this biopsied.

I loved the doctor I seen today and yes I do want this out as soon as possible. The doctor does a lot of robotic partial nephrectomies. So I am confident in his abilities and I will be having the surgery at Karmanos Cancer Center. I am feeling a little more at ease with the situation as crazy as that sounds for just being told I likely have cancer. But I guess it's the answers and the plan that are making me feel more at ease. I hoping to get a good night's sleep tonight.

Thank you so very much for being here

icemantoo · October 2015

Trease said:
That is what my urologist
That is what my urologist told me today. Just keep in Mind this is the same doctor that sent me to a nephrologist that wants this biopsied.

I loved the doctor I seen today and yes I do want this out as soon as possible. The doctor does a lot of robotic partial nephrectomies. So I am confident in his abilities and I will be having the surgery at Karmanos Cancer Center. I am feeling a little more at ease with the situation as crazy as that sounds for just being told I likely have cancer. But I guess it's the answers and the plan that are making me feel more at ease. I hoping to get a good night's sleep tonight.

Thank you so very much for being here

Former neighbor

Treae,

Just moved from the Detroit area where Karmonos is located. We have been in South Florida for 3 weeks now. My surgery was at Beaumont Troy a lucky 13 years ago. You are in good hands.

Icemantoo

Richgels1 · October 2015

Trease said:
That is what my urologist
That is what my urologist told me today. Just keep in Mind this is the same doctor that sent me to a nephrologist that wants this biopsied.

I loved the doctor I seen today and yes I do want this out as soon as possible. The doctor does a lot of robotic partial nephrectomies. So I am confident in his abilities and I will be having the surgery at Karmanos Cancer Center. I am feeling a little more at ease with the situation as crazy as that sounds for just being told I likely have cancer. But I guess it's the answers and the plan that are making me feel more at ease. I hoping to get a good night's sleep tonight.

Thank you so very much for being here

Your News

Sorry to hear that news. I remember getting that news and it isn't easy. I hope you have loved ones to help you with support and it all goes well. The more research you do on your situation the better you will feel about it. Lots of info on-line. Scott

Allochka · October 2015

Richgels1 said:
Your News
Sorry to hear that news. I remember getting that news and it isn't easy. I hope you have loved ones to help you with support and it all goes well. The more research you do on your situation the better you will feel about it. Lots of info on-line. Scott

Hi Trease,
others are

Hi Trease,

others are absolutely correct - do not biopsy, listen to your urologist and get it out. And remember - even if cancer, it is relatively small, your prognosis should be very good.

And the rest of mentioned issues - your spleen is not actually enlarged, just marginal, lung nodule didn't grow, so most probably harmless. No need to worry about mets, which is great.

Keep us posted on your progress with this issue.

Trease · October 2015

Allochka said:
Hi Trease,
others are
Hi Trease,

others are absolutely correct - do not biopsy, listen to your urologist and get it out. And remember - even if cancer, it is relatively small, your prognosis should be very good.

And the rest of mentioned issues - your spleen is not actually enlarged, just marginal, lung nodule didn't grow, so most probably harmless. No need to worry about mets, which is great.

Keep us posted on your progress with this issue.

The kindness and generosity

The kindness and generosity in strangers is inspiring. Thank you all.

I am settling in to this situation but I'm still consumed with wanting to know everything. Does that slow down at some point?

I apologize for not being clear with my original post, I'm not concerned with the nodule on my lung. I'm an ex smoker so I'm assuming it's scar tissue. The spleen spooked me but when they said they just wanted to follow it I was ok.

And as far a support from family I do have support but somehow I spent my first evening with cancer alone . That concerns me but I'll get em in shape before the surgery. I think they just don't know I need them emotionally now. I'm the care giver in the family.

Iceman too I'm glad your in Florida with a name like that you belong there. Lol I'm hoping to move down to the gulf in the next 2 years. I really don't like the cold anymore.

Trease · October 2015

Allochka said:
Hi Trease,
others are
Hi Trease,

others are absolutely correct - do not biopsy, listen to your urologist and get it out. And remember - even if cancer, it is relatively small, your prognosis should be very good.

And the rest of mentioned issues - your spleen is not actually enlarged, just marginal, lung nodule didn't grow, so most probably harmless. No need to worry about mets, which is great.

Keep us posted on your progress with this issue.

By the way. What is Mets and

By the way. What is Mets and Ned

I'm seeing it a lot and assuming Mets may be a spread and Ned is no cancer. Wondering the abbreviations

APny · October 2015

Trease said:
By the way. What is Mets and
By the way. What is Mets and Ned

I'm seeing it a lot and assuming Mets may be a spread and Ned is no cancer. Wondering the abbreviations

Yes. Mets = metastases and

Yes. Mets = metastases and Ned = no (visible) evidence of disease

Trease · October 2015

APny said:
Yes. Mets = metastases and
Yes. Mets = metastases and Ned = no (visible) evidence of disease

Thank you

Thank you

Renal Mass

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