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Big Decision Looming after scans

Posts: 48
Joined: Mar 2015

Yesterday Had CT of chest to monitor 2 small 5mm nodules suspicious for met. RCC after L nephrectomy 7 months ago. This time my kidney function was good so they did a contrast scan. Nods have increased by about 1.5 to 2mm in approx. 3 months. OK fair enough these nods are close together in the right lower lobe of the lung.....resection a real possibility I am thinking all should be straight forward. Went to see a lung surgeon this morning with the scans thinking the discussion will be about the nods. but he has noticed that the right HILAR lymph node is enlarged. He basically said that the small nodes are no problem ...small op. resection of the lung 2 weeks recovery but he was very focussed on this enlarged lymph node. Discussion points were as follows....biopsy of the lymph node a possibility but not guaranteed to supply a full proof result, could come back negative but still he would have a doubt in the back of his mind. RCC causes lymph nodes around the body to swell and react to proteins apparrently so it maybe that this enlargement is that....His inclination was to be aggressive get in there and removed the Lymph node and the 2 nodules but this would mean a major op....7 months after a major open left neph. surgery. It means I would lose half of my right lung at least and therefore a major change in my lifestyle....further discussions were to be had by him and my oncologist to talk about drug therapy and with respiratory doctors regard a the biopsy procedure...thisdiscussion will happen in 2 days time. So they will be getting their collective heads together to see what they feel is the best option. I have already had discussions with my Oncologist previously about the nodules(he wasnt aware of the lymph node) and he was in favour of chop them out quick.....so I cant see him changing his stance. So my question to you guys is...has anyone been in this situation....should I just get half my lung chopped off........should I take the biopsy option take the nodules out and watch the lymph node....get into the chemo/immuno to see if they kill the growths.......BIG DECISIONS AHEAD



Posts: 482
Joined: Dec 2013


sorry that yo didn't get the best news but it seems that you have a great team looking out for you.


Posts: 65
Joined: May 2015

A surgeon will base most of his solutions to your problems with surgery.  Doctors also have a pecking order.  And will respond to the answers proposed by the one with the biggest pecker.  What you have is quite small.  You have time to get a second opinion.

Instead of removing anything find someone to look at other solutions.  Cryloblation or Radio Frequency Ablation.  There is also the chemo/immuno route in an attempt to shrink bad stuff before anything else happens.  

There are no easy decisions.  Get as much information as you can.

Maybe for you what you are looking at is what needs to be done.  Be sure.

I wish you and yours the best.


Footstomper's picture
Posts: 1238
Joined: Dec 2014

I guess the question boils down, in part at least, to who do  you trust most?

sblairc's picture
Posts: 586
Joined: Feb 2014

It is a big discision. I am of the opinion, generallly,  that if a surgery can prolong/put off the need for medical treatment with targetted therapies, etc then do it. As we all know, those therapies work for a certain point before they don't. The longer you go before needing them, the better. 

There are many on here that have achieved long stretches of being cancer free from surgery alone.  And in that time, treatment evolved significantly. 


There is also the possibility of getting Immunotherapy "off label" and being treated with those amazing new drugs that could bring long term results. It's sort of the exact opposite of the opinion I just expressed, but I think with potential lymph node involvment this needs to be brought up. 


I wish you good thoughts while you think this over. We are here to help. 


Jojo61's picture
Posts: 1310
Joined: Oct 2013

I can't offer much advice, but it looks like you already got some good postings. I hope the right decision presnts itself to you.

All the best and please keep us posted!



Posts: 523
Joined: Nov 2013

Hi Tim.

I think you have time to consider ALL your options.  I would get myself to an expert in Renal Cancer at a major medical center and get their opinion.  It bothers me that your oncologist didn't know about the lymph node.  How can that be?  I wonder if the lymph node can be treated with radiation?  I thought that lymph nodes that are metastatic will light up with a CT/PET scan, and because of that, they aren't biopsied????   Maybe somebody else here knows whether you can treat a lymph node with radiation.

Im just throwing some thoughts out here.  I don't have experience with this.  My husband had one positive lymph node that was removed at the time of his nephrectomy.   He also has bone mets.  

Let us know what you find out.  Everybody here really wants to be helpful



sblairc's picture
Posts: 586
Joined: Feb 2014

It sounds like the node showed up on this scan due to the contrast being used (versus last time contrast NOT being used). 


brea588's picture
Posts: 240
Joined: Jul 2012

but you have a surgeon pulmonologist and oncologist getting their heads together so maybe they will have more answers for you soon.  But I truly believe in second opinions and that is what I would suggest to you.  Praying for you.

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