CSN Login
Members Online: 11

You are here

Partial Pathology

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

I live too far away to get a full report in my hand for a few days BUT here is the news as reported this morning:

Clear Cell Renal Carcinoma; Negative Margins; Fully encapsulated.  No lymphs taken.  Awaiting word on staging!

Follow up every 3 months with a CT yearly til further notice!

 

I think I'll take it!

 

As I get more information, I'll post it!

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

Staging sounds like stage 1 or 2 (Guessing that since no lymph nodes were removed).

You didnt get any info on the grading?

The follow up scheme sounds a bit odd though, 3 months check with 12 month ct scan?

/G

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

I've called back for more information, but like you I would guess T1b; somewhere between 4 cm and 7 cm.  They said looking at the lymph nodes they decided not to take them.

They didn't ask me!  LOL

As far as the follow up- it is the VA.  I don't know the rationale!

Texas_wedge's picture
Texas_wedge
Posts: 2799
Joined: Nov 2011

Thank goodness you've taken the potion again and changed back into your old, handsome self!!

Pity that we've lost sight of your Wife, though  :(

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

I'll be putting more up.  She is veryeasy on the eye!

 

Thanks to all of you for your care and comfort!  Time to pay it forward!

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

...on a tumor is an odd thing. But as RCC's go a T1b is a good thing.

Crossing my fingers for you also getting a low grade.

/G

Ps. Im totally with Texas on the picture thing :-)

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

My picture with the beautiful woman sho shares my life, though heaven knows why!  Lucky I guess!

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013







Normal
0




false
false
false

EN-US
X-NONE
X-NONE

























DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="267">
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>


















UnhideWhenUsed="false" QFormat="true" Name="Title"/>

UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
UnhideWhenUsed="false" Name="Table Grid"/>

UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
UnhideWhenUsed="false" Name="Light Shading"/>
UnhideWhenUsed="false" Name="Light List"/>
UnhideWhenUsed="false" Name="Light Grid"/>
UnhideWhenUsed="false" Name="Medium Shading 1"/>
UnhideWhenUsed="false" Name="Medium Shading 2"/>
UnhideWhenUsed="false" Name="Medium List 1"/>
UnhideWhenUsed="false" Name="Medium List 2"/>
UnhideWhenUsed="false" Name="Medium Grid 1"/>
UnhideWhenUsed="false" Name="Medium Grid 2"/>
UnhideWhenUsed="false" Name="Medium Grid 3"/>
UnhideWhenUsed="false" Name="Dark List"/>
UnhideWhenUsed="false" Name="Colorful Shading"/>
UnhideWhenUsed="false" Name="Colorful List"/>
UnhideWhenUsed="false" Name="Colorful Grid"/>
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
UnhideWhenUsed="false" Name="Light List Accent 1"/>
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>

UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
UnhideWhenUsed="false" Name="Light List Accent 2"/>
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
UnhideWhenUsed="false" Name="Light List Accent 3"/>
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
UnhideWhenUsed="false" Name="Light List Accent 4"/>
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
UnhideWhenUsed="false" Name="Light List Accent 5"/>
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
UnhideWhenUsed="false" Name="Light List Accent 6"/>
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>



/* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

HISTOPATHOLOGICAL DIAGNOSIS:

      

       A. RADICAL NEPHRECTOMY:

          1. Specimen Laterality: Right. 

          2. Tumor Site: Lower pole. 

          3. Tumor Size:

             a. Greatest Dimension: 4.5 cm. 

             b. Additional Dimensions: 4.0 x 3.6 cm. 

          4. Tumor Focality: Unifocal. 

          5. Macroscopic Extent of Tumor: Limited to kidney. 

          6. Histologic Type: CLEAR CELL RENAL CELL CARCINOMA. 

          7. Sarcomatoid Features: Not identified. 

          8. Tumor Necrosis: Not identified. 

          9. Histologic Grade: G3: Nuclei very irregular, approx. 20 um;

      nucleoli large and prominent. 

         10. Microscopic Tumor Extension: Limited to kidney. 

         11. Margins: Uninvolved by invasive carcinoma. 

         12. Lymph-Vascular Invasion: Not identified. 

         13. Lymph Nodes:

             a. Number of lymph nodes examined: 0. 

             b. Number of lymph nodes involved: 0. 

         14. Pathologic Findings in Non-neoplastic Kidney:

             a. Significant pathologic alterations:

                1) Vascular disease (mild arterionephrosclerosis). 

         15. Pathologic Staging: pT1b, NX, MX. 

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

Lower pole, contained, clear margins. Focus on all the positive aspects and not the one negative one. Dont let that one down you now, when you have coped so seemingly positive with all of this. Okay?

Have a good and detailed walkthrough with an oncologist about all of it, and scrutinize a bit about your future control regimes given the grade. Thats the best advise I can give. That and sending positive thoughts in your direction (for what its worth).

/G

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Hi Michael, You received your results very quickly, your results pretty much match mine. I am not sure how they view a grade 3 in the States. However my surgeon has stressed that the tumour was fully encapsulated and the grade would be a concern if the margins were not clear. Galrim's comments have left me wondering.

 

Djinnie

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

Are you smiling? Nice reort. God bless you. It's the report we all wish we could have gotten.  Keep up with follow ups.

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

Its the report I wish I could share with all of you!  You guys were there when we didn't know what it would be.   You educated me, sustained me, cheered me up and kept me in the fight.

I have a lot of passing the peace on down to do.  I'm here for the long haul!

God bless each one of you!

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

Frankly, me too!  I'll take this report and run with it!

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Good for you!! I think it's a report to be welcomed with a big sigh of relief, congratulations Michael!

 

Djinnie  x

 

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

...no one worries without reason. My comment to Michael was that, as histologys go, he more or less couldnt have gotten a better outcome of it all. And that the fact that only one prognostic factor wasnt excellent shouldnt throw him off his feet :-)

But to answer more directly to your question regarding grading:

As a single prognostic factor, if you ignore all others, it is a heavy weighing factor.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471767/

Quoting from that:

"Tumor grade is an independent prognostic indicator for RCC. The Fuhrman nuclear grading system projects 5-year survival rates of 89%, 65%, and 46% for grades 1, 2, and 3 to 4, respectively, independent of T stage. Alternatively, in patients with T1 disease, 5-year cancer-specific survival rates have been reported to be 91%, 83%, 60%, and 0% for grades 1, 2, 3, and 4, respectively."

Additionally, if you look at a often used prognostic model (exists in several variants but is overall the same):

But, and I cant stress this enough: THE STATISTICAL MEDIAN ISNT KING!

Your individual situation and outlook is a combination of a lot of factors, relating only to you. So dont be alarmed or conclude anything regarding your own case based on the above. That information is based on overall statistics of thousands of cases, not you.

Talk to your oncologist about it if any doubts. Im not a doctor, no one in here is. Just providing and sharing information to digest, and then pursue if you think it makes sense.

As for how it affects the control regimes in various countries, I can only relate to my own country where grade 3/4 normally results in a higher control frequency, disregarding the stage.

/G 

 

 

 

 

 

 

 

 

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Hi Galrim,

Thank you for taking the trouble to post that detailed information, that is very helpful. I know that there is no hard and fast rule with this cancer. I was just interested in the differing interpretations, as my surgeon here in France felt the grade was not so significant. They are doing a regular 6 monthly check up though.

Thanks again.

 

Djinnie

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

Im just one of those horrible patients who annoy his doctors because he has read 1000+ pages on his own disease :-) Might as well put all those saved links and information to use in here, as long as people just remember to digest it and make their own opinion, and not take what I or anyone post as a final conclusion to anything regarding their own case.

/G

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Hi Galrim,

I appreciate you being on here, I glean more information from you than the Doctors. It gives us something to work with.

Thanks again

Djinnie

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

The graph would be useful information to have access to on this site.

Djinnie

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

Theres a lot of statistics out there regarding recurrence/mets, survival rates etc. None of them are false as such, but a lot are outdated, have limited statstical mass, poor data stratification etc.

Some are of course overall applicable since they are not very detailed, like the recurrence risk model I posted further up, but the problem with posting any of them here permanently is, simply put; Who should judge which ones are the best to post?

Also, having such data posted here un-commented, could mean that some members here take those statistics for immediately applicable to their own situation without asking around. I understand where your thought is coming from, but I think its better to post stuff like this "on request" and with comments and the possibility to debate it, like above.

/G

 

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

I see your point!

 

Djinnie

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

This is my second Dx with Cancer.  My first was a malignant Basal Cell skin cancer removed a year and half ago at the same facility.  I am no one's Eeyore when it comes to this certainly, but I am no Pollyanna either.  I recognize that the liklihood for me to have to deal with cancer in some form in the years I have remaining are fairly high. I realize that I will likely face cancer in some form as my life ending condition.  Okay!  Something has to do it!

Its okay!

I'm 66 years old, married to the love of my life with a great life behind me and as many years ahead of me to contribute back to my students, family  and society as I can squeeze out!  I want to give my 18 year old grand daughter away at her wedding, whenever that happens. Give me a 10 year survival rate and I'll dance at YOUR next wedding! LOL

The end of life does not scare me.  There is nothing on either side of that dividing line that I find especially horrifying or to be afraid of.

It is my goal to take what I have, however long it is, and do all the best I can with it.  All Cancer can do is end my life, it can't make me stop loving it!  It has no real power over me in that sense.

In this report, the glass is certainly far more than half full!  Its pretty close to the top!

 

Michael

Galrim's picture
Galrim
Posts: 305
Joined: Apr 2013

And an example of mental and spiritual attitude towards all of this to follow. Thanks!.

/G

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

Since my nephrectomy 2 years ago, I've also had a basal cell and melanoma removed. Sheesh. If I can make good news out of it, it is that my trial drug of MDX-1106 is also working on lung cancer, colon cancer, prostate, basal and melanomas. If it would only grow hair!

Also not overly afraid of the end. Happy I've reached my 60's. That has helped. I had always wondered about how it will end. Cardiac? liver failure? stroke, motor vehicle accident? Oh well, cancer it might be. But I will not lose any time worrying about it. No negative thoughts. What a waste of effort , energy and mental health. Way too much living to look forward to.

People always mention my good attitude. It is authentic. It was a concious decision I made when I was about 20. It always blows my mind when I hear people respond to,"How are you?" by saying ,"Not bad." I think to myself,"Gee, if only you felt worse, you might be happier." I have always and even will on my death dead respond with "Excellent!" or "Wonderful!" Always set the tone for "positive" thinking. Now after I'm asked how I am, and I answer, then ask them back how they are, They almost feel forced to say at least "Good." Then I say, "Good for US!" I always get a chuckle. It 's because in todays society, no one seems to expect 2 happy people to meet. Weird.

Life IS good. Stay positive.

MDCinSC's picture
MDCinSC
Posts: 574
Joined: Feb 2013

Let ME know!  A little lead in the pencil wouldn't bad either! 3:)

 

 

danbren2's picture
danbren2
Posts: 311
Joined: May 2013

I just recently became a part of this wonderous supportive family, and have you to thank for my first positive reply.  Your report sounds great (for a report about Cancer), it was alot like mine in July 2011.  I was not very tuned in on what was happening, ask for that CT scan to be given before the year is up.  Make sure they don't let your tests fall through the cracks.  You sound much more educated on the subject matter than I was.

I will hope and pray your staging will be a 1, and that all other tests will be positive ones for you!  God Bless!

Subscribe to Comments for "Partial Pathology"