Radical Nephrectomy - I'm Trying To Stay Optimistic

Welcome Louis~Sorry for what you are going  through. However, you've come to the right place for information and support!

I wonder if you need a radical nephrectomy given the size of your tumor is uner 7cm. I believe you are in Stage I if there are no other issues surrounding that tumor. Mine was only 4cm but near a blood supply and could've bled out so the whole kidney had to be removed.

Does your urologist/surgeon do robatic surgery, laproscopic incisions, vs open which is a larger incision? If not,I would get a 2nd opinion and find out if you can get a surgeon who does robatic surgery and to find out if you need a radical removal of kidney or a partial. That is just my two cents.

I have had several abdominal surgeries and two were laproscopic/robatic. It is much less invasive and easier recovery. I also used a lumbar velcro wrap used for lower back issues, to wrap around my healing abdomen. It made a big difference trust me. I also put dry ice blocks over the larger of the small incisions to reduce the swelling and that really worked for me. I was able to be  off Opioids much sooner.

We'll help you  through this time if you want us too,  Louis.

Now find out if  you HAVE to have a radical vs a partial and robatic vs open incision.

Hugs, Jan

Louis,

Who ever  though in their wildest imagination they would be told they have Cancer and whoever heard of Kidney Cancer. Than the first thong the want to do is yank out your Kidney. That was me 14 years ago and a lot of other people on theis board. Mine was a few mm less than yours. At 5 cm you have a strong chance that the surgery will be a full and final cure. Scans will follow. As you can read from other posts Uncle Ned makes regular visits to Canada as well as the States. Fourteen years ago I temporarily postponed a visit to the San Juan Islands and BC to get nephed. Six weeks after being nephed I did make it back to the Seattle area as well as many times since.

Icemantoo

Louis,

My thoughts. If you are comfortable with your surgeon I would go ahead without a second opinion. Four months additional delay is too much where it is already 5 cm. If it were 1/2 that size or less I might consider a second opinion. Others may chime in with their thoughts.

We remain here for your recovery.

As for your doctor not liking the internet, I wish I would have had someone to  share my experiences with 14 years ago. What you do not want to read about on the internet are cases that are much more advanced than yours.

Icemantoo

Hi Louis, welcome to our club :-(

Waiting and worrying is the worst part of having cancer, and it never stops. Hopefully, you have discovered this site, and believe me, it will help you ease your mind. I had a radical neph in sept 2014 for a 9.5cm, at age 37, i think i can relate to how you must be feeling right now. Don't be afraid to ask questions here, to your Doc and to your nurses, and, as others already said, "try" not to google too much. There's so much information on the web that can drive you nuts, and the majority of it is out of date. 

I can tell you that living with one kidney is not a big deal, after 20 months, i can say i live a normal life and i have no side effects from losing the kidney. 

Good luck with surgery!!

Dave (Canadian too ;-) 

Louisp said:

Thank you Donna! I just

Thank you Donna! I just finished a follow-up with my urologist. Unfortunately, a partial is not an option for me because of the location of the tumour on the kidney. Additionally, there would be no way to connect the blood vessels so a partial doesn't seem to be an option at all. The maroon line in the attached picture indicates the border of the tumour. He also emphasized that the tumour is destroying my kidney and a radical nephrectomy would be required even if it's not cancerous.

The growth rate of the tumour is very slow. However, I'm not sure if I should get a second opinion if a radical nephrectomy is inevitable. This would also delay my surgery date by at least 4 months. 

The good news is that the tumour doesn't seem to be impacting my artery and the chance of spreading to the heart or other organs is nil. 

An area of concern is that he can't determine my margins until surgery. The report indicated that the tumour is on the edge of the kidney but there's a possibility that it could be growing into the fat. The urologist intends to remove some fat just in case. Because of this, he explained that an open surgery has a greater chance of removing all of the cancer, especially if it's worse than his current assessment.

Many of my other questions such as type and risk of recurrence cannot be determined until the pathology report (which gives me more anxiety).

He kept assuring me that I'll be fine and we'll just manage any challenges that may come up. He also lectured me about researching too much on the internet as I'm making the situation much worse than it needs to be.

Thank you all for your wonderful support! 

There should be no reason a second opinion should delay you by 4 months. Surgeons usually keep some openings for urgent situations and work you in within a few days to a week. You just need to reach the right person in the office and explain your situation. I'd try to see a urologic oncologist with experience in partial nephrectomies and laparascopic, robotic surgery. You should be able to leave your schedule with your current surgeon, and get the second opinion in parallel. You'll feel better if the other doc agrees. If the other doc has a major disagreement, you can always stop things to decide what to do. These tumors grow very slow.

In every case where I called to see a specialist when I had my tumor(s), I was worked in very quickly. I did have to go get copies of my scans and records and hand carry them, though. It was worth it.

If there's any way to save part of your kidney (without taking a risk with the margins), it'd be well worth it. As we age, our kidney function almost always declines.

That being said, I wasn't eligible for a partial. My tumor was right in the center of the kidney near the blood supply.

I'm not saying your surgeon is wrong. For myself, I just felt a lot better about my decisions when I had 2-3 opinions of highly qualified doctors. When I saw an oncologist, my first visit the oncologist was not correct. I ended up being much happier that I saw a couple of others.

If the doc you are seeing is highly qualified (I'd say he's a urologic oncologist with experience doing lots of partials and robotic laparascopy), then I'd be ok with what he says. However, if he's a regular urologist and has little or no experience doing partials or working with the robotic laparascopy, I'd take what he says with a grain of salt. He may be a little biased towards what he's capable of doing instead of what is best for you.

Hope it helps.

Best to you,

Todd