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Can I survive renal carcinoma w/out surgery age 74 (Stage 1) Help

1943
Posts: 2
Joined: Jun 2017

I am age 74 just received "90%" diagnosis of renal carcinoma in Type 1 renal masses.  No history of kidney function issues at all.  Discovered after I was diagnosed with Myasthenia and prescribed Mestinon which caused major abdominal pains.  CT Scan then MRI showed "Bilateral renal masses suspicious for renal cell carcinomas.  There is a large renal mass involving the inferior pole of the left kidney measuring 5 x 4.8 x 4 cm.  There is subtle i cm lesion in the anteromedial cortex of the right kidney.

Quit drinking in 1985 but took lithium for over 15 years and other psych med since.

Feel like being rushed into plural surgeries to remove both masses.  I am active now, and work as high level lconsultant.

Surgeries would likely put me out of health for close to year all told potentially, and likely end my consulting business.

I am insisting on second opinion , but all the opinions are likely to come from surgeons. 

Can anyone tell me why a watch and wait would not make sense here.  Oh no evidence of spread to veins or lungs etc.

 

Hope this is an appropriate post.  Everyone else seems to want to sell me a kidney or a surgery package.

 

God Bless You All.  My best friend is in VA Hospive San Diego now felled by throat cancer.  Pray for him to .

icemantoo's picture
icemantoo
Posts: 3317
Joined: Jan 2010

I was also born in 1943, but had the surgery 15 years ago.  Without surgery  at some point down the road it is likely to spread. With surgery their is always a risk because of your age. With watch and wait your chances for a sucessful surgery get harder as you get older. Get the second opinion and good luck with whatever choice you make.

 

 

Icemantoo

donna_lee's picture
donna_lee
Posts: 999
Joined: Feb 2009

And mine was D'xd 11 years ago.

It is a big conumdrum. i.e. surgery or not.  There is no magic 8 ball that can tell you how long the cancer has been growing in one or both kidneys.  I had no real option, as it had already gone to the liver.  Either surgery or die in 5-7 months.  I chose to live, and even though it had already spread and was found two additional times in single nodes, I still chose surgery...so it's been 8 years with ongoing tests and NED-No Evidence of Disease.

If you choose a watch and wait plan, the costs of the CT's, X-rays/untrasounds, blood work, and Dr. appt's could soon approach what it could cost for some of the surgery.  And you would still have cancer and/or reduced kidney function, with the cancer still multiplying.

Recovery from surgery takes about 6 weeks; and even then, you can function pretty well for a few hours a day.  Then fatigue will tell you to rest or nap.  I jumped back into the pool at 6 weeks and started walking a lot more and recovery was rapid from there on.

You have or have had other medical issues you've dealt with.  But I encourage you to not plan on dying from cancer.

Good luck in your decision making.

donna_lee

1943
Posts: 2
Joined: Jun 2017

I really appreciate your thoughts.  I had not realized that I was planning on dying from Cancer.  I almost killed myself with alcoholic till I got AA in 1985.  I honestly didnt recognize the self destructive side of my reasoning.  Have suffered from depression all my life.  This is forceing me to focus on why I live.

Jerry

Manufred's picture
Manufred
Posts: 241
Joined: May 2017

Jerry,

Surgery is a big decision, but quite survivable depending on your overall health and fitness and wil be effective in removing what they can see at present.  The big risk is metastasis.  They usually dont know wether or not that has happended until secondary tumours start showing up, typically some years later.  Today a lot of mets are responding to artificial antibody drugs like Opdivo or Keytruda which are nothing like old-style chemo.  They might even work for the primary, although I suspect very few clinicians would be prepared to risk leaving a large primary in place for the immune system to deal with.  Nevertheless, check it out.

Best of luck; Manufred

todd121's picture
todd121
Posts: 1449
Joined: Dec 2012

I think there are types of kidney cancer that they do the wait-and-watch. If you want an opinion apart from a surgeon, see a medical oncologist specializing in RCC. They have no bone in the surgery decision and they treat and study metastatic disease. I know that NIH has studied genetic kidney cancer and that certain types are very slow growing and that in patients with those types they don't do surgeries anymore. However, most of us don't have that type of kidney cancer.

See a medical oncologist that does research on RCC. If you need help finding one, post here and tell us where you are and we can help refer you to somebody.

In Los Angeles, Dr. Figlin at Cedars, Dr. Pal at City of Hope, Dr. Quinn at USC. There are others at UCLA, but I don't know them. These are just the ones I've interacted with. They all specialize in RCC and are medical oncologists.

Usually they recommend a partial nephrectomy if possible to spare kidney function, or a nephrectomy. I believe it's still the first choice, because it's been shown to reduce the likelihood of it coming back/recurring or prolong your disease-free recovery. In Stage I cases, it cures somewhere around 90-95%. However, you are potentially Stage 1, but you are near Stage 2 (the cutoff is 7 cm), and even Stage 1 can really be Stage 3 depending on where the cancer has invaded in the kidney. Chances of it spreading increase with Stage and with Grade (how abnormal the cancer is). Unfortunately, they can't tell you the stage or grade really for sure without removing it and having a pathologist examine it under a miscroscope.

Best of luck to you.

Todd

P.S. From imaging they cannot tell if it's cancer or not, what type, and definitely cannot accurately tell you the stage and grade. For that they need the thing sliced up under a miscroscope. Your Stage 1 diagnosis (if it's even cancer, as you mentioned, there's a 10% chance it's not) is a guess based on the imaging. Imaging is not very accurate. To tell the difference between Stage 1, 2 and 3 they need accurate measurement of the size on all sides, plus they need to see what kind of tissue it grew into. They can only do this accurately under a miscroscope.

tomt263
Posts: 11
Joined: Jan 2014

I had an 80% diagosis 6 years ago and turned out it was RCC.  So, I am glad that I decided to have surgery when it was Stage 1 and now doing just fine except for the ongoing medical anxiety from time to time.  You might want to find out what it means to you if the cancer spreads as I was told it is a real ugly way to go out.  Best of luck to you.

 

Bay Area Guy's picture
Bay Area Guy
Posts: 495
Joined: Jun 2016

You might want to talk to your doctors about the various ablation techniques that are becoming a little more mainstream these days.  Cryo-ablation (killing the tumor by freezing) and RF (radio-frequency) ablation (killing the tumor by cooking it) are being used in some cases where patients are not able to withstand surgery.  They have a slightly lower success rate (my doctor said it was about 90% whereas surgery had more of a 99% success rate for my 1.7cm lesion).  Because of my overall health (excellent other than the RCC) and the size of the lesion (as I said, 1.7cm), my doctor advised a robotic assisted partial that I had last year. At least at the time I looked into the ablation techniques, they were generally limited to lesions 4cm or smaller.  But given the way medical science is progressing, particularly in the cancer field, it might be worth a chat with your doctor.

In terms of the watch and wait, again, the size of the mass argues against doing that.  I was originally diagnosed in December, 2013 and, at the time, my little guy was estimated to be 1.5cm.  The urologist I was referred to at Stanford Hospital recommended watch and wait.  I was concerned about it potentially growing and spreading, but he told me that lesions that size typically grow very slowly.  He said that so long as it was under 4cm, it was considered Stage 1.  So I waited and it wasn't until April, 2017 that an ultrasound determined that the little bugger had grown to 1.7cm, so at that time, since there was positive growth, he recommended getting it out, which I did in June, 2017.

If you're in the Bay Area, the urologists at Stanford are all top notch.  I saw Dr. Gill and he was very thorough and a very kind, caring man.

Bay Area Guy's picture
Bay Area Guy
Posts: 495
Joined: Jun 2016

Just to add, surgery is still the gold standard of treatment.  I don't want anyone thinking I'm advocating getting the ablation.  I just put it out there as a possible alternative to discuss with your doctors.

smurfin57
Posts: 29
Joined: Sep 2009

Yeah Neprectomy is tough! So is dying I'm told. Here's a little exercise for you to do. Take a ruler that has Cm on it and draw your tumor size on a piece of paper. Then get a typical Kidney size from the internet and draw this on the same paper. When you see how big your tumor is you may change your mind. BTW waiting is BAD! The bigger your tumor gets, the prognosis worsens ALOT! I would probably get a PET scan to see if you have any cancer spread first. If you have cancer spread maybe you can keep your tumor. Gee what if you were healthy otherwise and lived to be 95? Take the shot at living longer, make sure you have some good Doctors and work with a recognized Cancer hospital!

love_of_my_life
Posts: 77
Joined: Jul 2012

I wouldn't mess around with this.  This cancer can be aggressive and it sounds like surgery is your best option.

My wife recovered pretty quickly from her kidney removal.

angec's picture
angec
Posts: 924
Joined: Mar 2012

Haven't seen any updated posts. Surgery or no surgery? My mom was diagnosed at age 79. She had robotic surgery and was home 5 days later after her kidney was removed. I hope you have given this serious thought. The longer you wait the chance it will spread. If you have it removed it can possibly be a cure. Either way, let us know how you are. We care. All the best to you.

jason.2835
Posts: 337
Joined: Nov 2014

1943,

Overall health is the biggest factor into how hard the surgery will be on your body.  It sounds like you are in pretty good health, so I would find a doctor who specializes in robotic or laparoscopic methods to remove the tumors.  Surgery sucks, but you could live another 20 years if you get the cancer out.

- Jay

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