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39 with renal cancer?

TKDgal
Posts: 12
Joined: Aug 2016

A couple of months ago an ultrasound was done on my gallbladder and a 3.7 cm mass was found on my kidney. Last week I had a CT scan and was told it was a solid mass and most likely cancer. I've had past ultrasounds that were fine. I have seen two Urologists. One wants to schedule surgery and one wants to do a MRI followed by a biopsy. I feel so overwhelmed and drained. Any advice or words of encouragement for me? Right now I am trying to remember that this sucks but is manageable and I was lucky it was caught so early. 

foroughsh's picture
foroughsh
Posts: 775
Joined: Oct 2014

Kidney cancer usually doesn't need to be biopsied, it can be diagnosed by C.T scan with/without contrast. Doing biopsy is also a little dangerous as it might cause the cancerous cells to find their way out of kidney capsule and results metastasis. It's good to see an uro-oncologist  who has done many kidney cancer surgeries.

And yes, you are lucky. A 3.7 cm tumor is usually stage one which makes the survival rate more than 90℅ . That's a good cancer, isn't it?

Forough

 

iben
Posts: 7
Joined: Aug 2016

Hi there.i Got an ultrasound and My kidney wasent normal.they took a biopsi.its was 4 cm tumor.stage 1.i dident know about the rusk maybe metasticing later.and now i dont understand Why they room this biopsi.i thought i was normal presidure fore every kidney cancer patient.?i dont understand why they tolk the biopsi

icemantoo's picture
icemantoo
Posts: 3230
Joined: Jan 2010

TKDgal,

Welcome to the club which no one in their right mind would volunteer to join.

From my observations biopsy's are controversal and usually not done if it looks like Cancer on a CT. But I am not a doctor.  Tumors rarely spred smaller than 3 or 4 CM. Mine was 4,2 cm when they yanked it out 14 years ago and so far so good. Others will chime in with their thoughts. I would say that the surgery is painless, but I would be laughed off this forum.

 

 

Icemantoo

TKDgal
Posts: 12
Joined: Aug 2016

The doctor who wants to do the biopsy is older and more experienced with renal cancer. He says he always insists on doing a biopsy where he has removed a kidney that he didn't need to because the radiologist  said it was cancer and it looked like cancer. He doesn't believe doing a biopsy can spread cancer. My CT report said "solid mass should be assumed to be renal cell carcinoma until otherwise proven." 

Allochka's picture
Allochka
Posts: 874
Joined: Nov 2014

would it be really necessary to remove the whole kidney in your case? Perhaps partial surgery would be enough, so  even if not cancer (hopefully) - kidney still in place?

like other guys said, biopsy for kidney cancer is rather uncommon. If I were you, I'd say "cut it out"...

TKDgal
Posts: 12
Joined: Aug 2016

Both doctors agree that only part of my kidney should need to be removed. Where I am relatively young for RCC, they want to try to save as much as they safely can.

tiger09
Posts: 9
Joined: Aug 2016

Hi there! If it is any comfort, I am 29 with Stage IV RCC, so yes, it can and does happen to younger people like you and I.

I am sorry to hear this. Trust me when I say I know how scary it is. I would definitely do a partial neph if possible to preserve part of your kidney. Mine was too advanced to do a partial. I would also recommend a teaching hospital if you are able for the surgery. I went the next state over for my surgery because the surgeons where I live were not as comfortable doing the surgery because they don't see cases like mine very often, and I live in a large city.

Best of luck!!

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

like a common theme. The one where most doctors are unfamiliar with current RCC treatments. Biopsies aren't usually done as a scan is all that is needed. Biopsies can promote metastasies. Find more of a specialist in your area.

TKDgal
Posts: 12
Joined: Aug 2016

The one who wants to do a biopsy on my kidney is suppose to be the expert in the area. He's the one that treated my regular doctor's RCC. :/

hardo718's picture
hardo718
Posts: 853
Joined: Jan 2016

As others here have said, biopsy typically isn't the way to go.  Personally, when I heard the word cancer I just wanted it out....as soon as possible.

You have the information to make the best decision for you.  I would also advise you to make sure your doctor is a urologic / oncologist.  The good news is your growth is relatively small.

Keep us posted and best of luck.

Donna~

Allochka's picture
Allochka
Posts: 874
Joined: Nov 2014

If both docs says partial is possible - then just do a partial without biopsy. Thus you'll prevent possible spread, preserve the kidney and get the tumor out, no matter what it is.Post-surgery  Pathology will answer the question about tumor's nature. Sounds like win-win situation for me.

Just ask your doctor what benefit would biopsy bring him? He is not planning to remove your whole kidney, so why he has to know if tumor is benign or malugnant before cutting it out? The surgery will be the same anyway.

TKDgal
Posts: 12
Joined: Aug 2016

He said where there is a small chance it's benign and it is so small and I'm younger, we could take a watch and see approach to the tumor and not do any surgery. He has one patient that has had a tumor for 10 years that hasn't grown. He doesn't want me to lose part of my kidney unless I have to. The other surgeon says benign tumors are taken out at the 4 cm mark and I'm close enough that it mine as well come out, 

Teashea's picture
Teashea
Posts: 89
Joined: Feb 2016

If you can get a second opinion. I wish you the best.

icemantoo's picture
icemantoo
Posts: 3230
Joined: Jan 2010

TKDgal,

 

At 3.7 cm I would go with the second guy, but that is just my opinion.

 

Icemantoo

Bay Area Guy's picture
Bay Area Guy
Posts: 385
Joined: Jun 2016

Mine was 1.5cm when first discovered, and 1.8 when it was removed 2-1/2 years later.  I was advised against a biospy for the reasons given above.....not necessary and could lead to a possible spread of the disease.  I was fortunate enough to be referred to an excellent urological oncologist at Stanford University who helped explain what the best options were.  It's likely, that at the relatively small size your lesion is, that you would be able to have a partial nephrectomy.  If you can find a surgeon in your area that is an expert at robotic assisted laparoscopic partial nephrectomies, that would be the way to go.  But most important is that you find someone you're comfortable with and have confidence in.

Best wishes.  I think you'll find that there are quite a few people on this forum that have a lot of good information.

Kangaroorex
Posts: 45
Joined: Jul 2016

I had a biopsy on one of my tumors because the results from the CT, PET, US and bloodwork all came back inconclusive and my presentation was considered just odd.  but anything short of that would have just lead to diagnosis and removal. I am sort of surprised that they dont take the wait and see approach and see if the mass grows over time before doing anything more.

I would want to know more about what the doctor thinks a biopsy will do to improve your chances and your diagnosis.  there are a number of non-cancer related risks associate with a kidney biopsy that they usually dont mention until you are in preop (wait?!? you could deflate my lung?? and you didn't feel this was an important detail to mention? *from personal experience*)  

 

JoanneNH
Posts: 115
Joined: Sep 2013

"I've had past ultrasounds that were fine. "

Really doesn't mean anything now.

You could always have a second opinion on the CT scan.  I'd look into MD Anderson.  They can pretty much tell if it is cancer.

Allochka's picture
Allochka
Posts: 874
Joined: Nov 2014

Well, you could take a wait and see approach without a biopsy then. Just wait for 6 months (tumor of that size most likely won't spread, even if malignant), and then check if it has grown. Somehow this biopsy thing would make me uncomfortable due to possible spread.

my husband also has very tiny benign angiomiolipoma. So I've read about them and heard the same thing your second doc says - at 4 cm even benign vascular tumors have increased risk of rupture (and subsequent serious complications) and better be taken out. 

It is up to you to decide, but I'd better get this thing out of me if we are talking partial or get one more opinion ...

jason.2835
Posts: 337
Joined: Nov 2014

I was 35 at DX with a 2.8 cm tumor.  It definitely happens.  It's not fun.  But at over 3 cm (mine was also reported at 3.8 cm on the MRI but it ended up being 2.8 in path report, so it can change) I would want it out.  Just my opinion.

- jay

brea588's picture
brea588
Posts: 240
Joined: Jul 2012

For what its worth , I would find me another doctor period.  Neither of the both sound very good to me.  Get second opinions please!!!

todd121's picture
todd121
Posts: 1425
Joined: Dec 2012

If you can get another opinion, I would go for it. You didn't mention either doctor's specialty. Urologic oncologist is the best person to see for this decision. Mine was a top doc (head of the urology department at the university of california medical school) and he did not advise for a biopsy. However, mine was a bit larger at 6.8 cm. He said it needed to come out no matter what it was and so no reason to do a biopsy. Usually they do a CT scan with and without contrast. MRI is not usually what is done. I don't know why, but I can tell you that from the 3-4 different places I've been and they were really good cancer centers (City of Hope, UCI Medical School, Cedars Sinai, USC Medical School). All preferred a CT with/without contrast to make these decisions. So I'd try and get another opinion. If you can tell us where you are, people on here might make recommendations of where you might want to go. Another opinion never hurt anybody. Sometimes it takes 3-4 opinions before you see agreement among 1-2 doctors. If they explain their thinking, it might help you make a decision what to do. It's an important decision. There's no rush to make it.

Wishing you the best,

Todd

TKDgal
Posts: 12
Joined: Aug 2016

I am in Northwest Ohio so I could see about the Cleveland a Clinic. I know several people that had bad experiences there though. Michigan state would be the other option. 

Bay Area Guy's picture
Bay Area Guy
Posts: 385
Joined: Jun 2016

Ratings for Midwest hospitals as relates generally to cancer.  The article is from three years ago.

http://www.kansashealthcarecareers.com/top-10-cancer-treatment-hospitals-in-the-midwest/

 

 

Spivey88's picture
Spivey88
Posts: 43
Joined: Jun 2016

The biopsy is too dangerous.  Either way cancer or not, you want it out.  Don't r the biopsy.  Over 90% of the time, a solid mass is cancer.  Do a partial and get it out! 

medic1971's picture
medic1971
Posts: 190
Joined: Sep 2015

When you have about 20 minutes or so you should watch this video.  This is from a lecture given this year and the doctor presenting is a urologist at MD Anderson.   A video just like this one helped me to make decisions and this video gave me a lot of comfort.  It also addresses the biopsy question.

Evaluation and Management of the Small Renal Mass, Surena F. Matin, MD

https://www.youtube.com/watch?v=blUI-ZzcViE

TKDgal
Posts: 12
Joined: Aug 2016

Thanks for the link. I am really thinking I want this out now. 

lthhampton
Posts: 3
Joined: May 2016

When  I was first diagnosed my uncle who has been battleing different forms of cancer for many years highly suggested a biopsy. I brought the idea to my doctors (military) and they frankly said something similar to what other people here in discussion is saying- "it might spread." I made a well thought out decision to not biopsy due to having a scheduled surgery where part of the kidney was going to be removed anyway. I personally didn't want to waste anytime with a biopsy. I wanted to be relieved of a potentially fatal form of kidney cancer. At any rate, my surgery was July 22nd, my pathology report stated Multiocular Clear Cell Renal Cell Carcinoma which is malignant. So I'm glad I didn't wait for the biopsy. Just want to share...

Rob57's picture
Rob57
Posts: 25
Joined: Aug 2016

My urologist is a specialist in kidney surgery. All of the medical community that I spoke to had a very good opinion of him and his ability. Had an ultrasound that showed the initial evidence of the tumor and it was confirmed by CT scan a few days later. No talk of need for biopsy since he said that may cause the disease to spread. Mine was confiend to my left kidney at about 5.5 cm. My urologist said that he could do a partial or remove the whole thing. He suggested removing it as the safest course and I agreed. I also have the great benefit of having a friend who is a really good radiologist so I had him to rely on with my many questions. He was a great help to me. 10 days later it was gone. That was about 15 days from the initial diagnosis by my primary doctor who found it during an ultrasound in her office. Had lathroscopic surgery by robot. Four small holes and a 3 inch slit where the kidney came out. I was in the hospital less than a day and back at work about 3 weeks later. I don't mean to make it sound easy because it wasn't. This is major surgery and there are risks to that but in my case I felt it needed to be done and as quickly as possible. You need at least three weeks to recover from this type of surgery. I stayed on the couch for about 10 days because it was the most comfortable place.  No matter what time of day it was every two hours I got up and walked around my living room. 

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