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26 y.o. w/ 2.5cm X 2.5cm Kidney tumor, May 6 scheduled Divinchi Partial nephrectomy

Posts: 2
Joined: Apr 2010

I am a 26 year old male. I was sent for a CT scan for stomach pains. They found I had a fatty liver, Enlarged Spleen, Hernia, Enlarged portal vein, and worst of all a 2.5cm X 2.5 cm Tumor on my right kidney. The urologist said he is 80% sure it is renal cell carcenoma. I am scheduled May 6, 2010 for a robotic partial nephrectomy with the divinchi robot. They keep telling me I will be fine as if i have a scrape on my knee. I understand thinking positive but I also want to be prepared for the worst. The urologist said after the surgery I will just go for tests every year and thats all.. Is that really it? Is there absolutely nothing to worry about?...I dont really like hearing about odds when it comes to this because from what i understand it is really rare for a 26yo to have this to begin with...I also have a fatty liver, enlarged spleen, enlarged portal vein and a hernia that they all found during that same CT scan... Can someone just be realistic and let me know if they experienced anything similar and what I should prepare for. Thanks!

HeartofSoul's picture
Posts: 730
Joined: Dec 2009

Get 2 opinions from 2 different med onc at 2 different med centers. Compare their diagnoses and treatment plans and if the med staff answers your questions to yuor satisfaction. find out what stage your cancer is & get TNM values (tumor size, node involvement, metastatis)

Stage I is an early stage of kidney cancer. The tumor measures up to 2 3/4 inches (7 centimeters). It is no bigger than a tennis ball. The cancer cells are found only in the kidney.

RCC cancer is one of ther most treable cancers in early stages and most often treated with surgery alone and close surveillance.

Get copy of pathology rpt after its available, either after a biopsy or after they have completed the Partial nephrectomy and make sure another cat scan is done after surgery. Your path report will tell you the type of cancer cells you have like RCC or another type of kidney cancer like renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects

Due to other issues that Dr found such as enlarged spleen, i would want a PET scan so verify there is no other suspicious growth (RULE OUT TUMORS of a malignant nature)

2. investigate why the portal vein is enlarged. is it from Portal Vein Hypertension?

The first thing to consider in the treatment of this condition is the underlying cause of the problem. If it is due to something correctable, then that problem needs to be treated.

For example, if there is a tumor then it may need to be removed. If there is an infection, it should be treated. If there is a blockage of the splenic vein, then the spleen may need to be removed. If there is a problem that is causing the formation of blood clots, then the person may need to be on blood thinners.

Treatment is aimed at reducing complications. If there is bleeding, then the bleeding can be controlled with medications and other procedures. If there is fluid build-up within the stomach, then the person will need to limit their salt intake and will need to take water pills to help increase urine output.

3. Why is your spleen enlarged
An enlarged spleen is not always a sign of a problem. When a spleen becomes enlarged, though, it often means it has been doing its job but has become overactive. For example, sometimes the spleen is overactive in removing and destroying blood cells. This is called hypersplenism. It can happen for many reasons, including problems with too many platelets and other disorders of the blood.

Causes of an Enlarged Spleen
An enlarged spleen can be caused by infections, cirrhosis and other liver diseases, blood diseases characterized by abnormal blood cells, problems with the lymph system, or other conditions.

Here are some common causes of an enlarged spleen:

Viral infections, such as mononucleosis
Parasitic infections, such as toxoplasmosis
Bacterial infections, such as endocarditis (an infection of your heart's valves)

Leukemia, a cancer in which white blood cells displace normal blood cells
Lymphoma, a cancer of lymph tissue, such as Hodgkin's disease
Other causes of an enlarged spleen include:

Inflammatory diseases such as sarcoidosis and rheumatoid arthritis
Trauma, such as an injury during contact sports
Cancer that has spread (metastasized) to the spleen
A cyst, a noncancerous fluid-filled sac
A large abscess, a pus-filled cavity usually caused by a bacterial infection
Infiltrative diseases such as Gaucher's disease, amyloidosis, or glycogen storage diseases

4. Have your fatty liver diagnosed and then find out what cause is, then treat

Your doctor may see something unusual in your blood test or notice that your liver is slightly enlarged during a routine checkup. These could be signs of a fatty liver. To make sure you don’t have another liver disease, your doctor may ask for more blood tests, an ultrasound, a CT scan or an MRI. If other diseases are ruled out, you may be diagnosed with NASH. The only way to know for sure is to get a liver biopsy. Your doctor will remove a sample of liver tissue with a needle and check it under a microscope.

Fatty liver may cause no damage, but sometimes the excess fat leads to inflammation of the liver. This condition, called steatohepatitis, does cause liver damage. Sometimes, inflammation from a fatty liver is linked to alcohol abuse; this is known as alcoholic steatohepatitis. Otherwise the condition is called nonalcoholic steatohepatitis, or NASH.

ask the doctor these questions before treatment begins:

What is the stage of the disease? Has the cancer spread? If so, where?
What are my treatment choices? Which do you recommend for me? Will I have more than one kind of treatment?
What are the expected benefits of each kind of treatment? Will it cure or control the disease?
What are the risks and possible side effects of each treatment? Will I be given anything to control side effects?
How long will treatment last?
Will I have to stay in the hospital?
What is the treatment likely to cost? Is this treatment covered by my insurance plan?
How will treatment affect my normal activities?
How often should I have checkups?
Would a clinical trial (research study) be appropriate for me?

icemantoo's picture
Posts: 3328
Joined: Jan 2010

As a kidney Cancer survivor of over 7 and 1/2 years let me address the Kidney Cancer. At 26 while a nepharatomy or partial nepharatomy is major surgery your recovery should be rather quick and you should be back to normal activities in a month or so. A 2.5 cm tumor is rather small as kidney tumors go. Most likely at that size the tumor has not spread. Surgery is a necessary evil in curing RCC and if the Cancer has not spread your life will be full and productive as far as any kidney cancer concerns. As for the other concerns these as well as the kidney cancer need to be addredded with your doctors.

Posts: 1
Joined: Apr 2010

I am 36 years old. I went to the hospital on march 5,2010 for appendicitis. While doing a ct to confirm the found a 3.6cm tumor on my right kidney. I had a radical nephrectomy on march 30. They remove my lower rib, entire right kidney, adrenal gland, and fatty tissue around the kidney. My incision is about 13 inches long. The day after surgery I was able to get up and walk down the hospital hall. I was in alot of pain but not more than I could handle. My surgery lasted 4 and half hours. Today I still have some mild pain but rarely have to take any pain meds. Yesterday I walked in my first relay for life walk. I walked a mile and a half and felt fine. I won't lie the first week and a half was terrible. I couldn't do anything without the help of my wife. But it gets better everyday. Your surgery should not be as bad because it will be laperoscip and alot less invasive. Not to mention a smaller incision.I Have to have ct scans for the next 5 years to check for recurancees, but other than that I fdon't feel any different. I will tell you, although it hurts try to get moving around as soon as possible, the surgery is a long one and you will have alot of gas. Trust me, the gas pains can be worse than the surgery itself. Moving around will help get the gas out of your body quicker. At such a young age you should recover pretty fast. Just remember not to rush your revovery,it can set you back further if you rush it. I will add you to my prayer list. I believe all the people I had praying for me definately helped. Good luck.


icemantoo's picture
Posts: 3328
Joined: Jan 2010

I recall on my discharge summary that the Surgeon wrote that I was discharged without pain. I do not know what he was on when he wrote that. Well it is not quite that easy, but the pain does go away.

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