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Urologist,Nephrologist, Oncologist???

Retcenturion's picture
Retcenturion
Posts: 240
Joined: Mar 2017

So we were invited to a large tailgate party yesterday. During the party my wife and I are introduced to an acquaintance of the host " who also had Kidney Cancer" This person is 3 years out from Partial Neph.  I explain I am 6 months full neph and schedule for 1st scans this week. They then ask what type. I'm alittle uncomfortable talking about it but explain CAT scan with/without Contrast. We then get lectured that after full Neph I shouldn't have contrast. I shouldn't be seeing a urologist. I should be seeing a Nephrologist and Oncologist just like they are. They advise me to call and cancell the contrast today.

Needless to say my wife was almost in tears by end of conversation. My wife was there when our Urologist said that I didn't need a Nephrologist or Oncologist at this point in my care. I have read some past posts on the argument for contrast with1 kidney. I tried to reassure my wife that the Dr sheduled the scan with contrast for a reason. I had bloodwork done last week and the Dr through Patient Portal said numbers were good for the scan.I am going to go through with the Scans this week as scheduled. I am hoping for posive results. And will talk again with the DR on Friday about the risks again of Contrast and radiation of the scan. Also I only had 1 Cat scan prior to surgery with the contrast so this is 6 months post op.

 I had the Scanziety in check till yesterday. Anybody have an experince like this?

icemantoo's picture
icemantoo
Posts: 3359
Joined: Jan 2010

Ret,

First the protocol for scans after kidney surgery require blood work showing your Bun and Creatine are at a certain level so that you will not have Kidney Damage. Sounds like this was done. Discuss the results with the Doctor. Second you are looking for nerative results from your scan (showing nothing bad) not positive results). Third as for seeing a Neprologist you should cosider it if you have low kidney function or other Kidney disease issues. There are opinions on both sides of this as well as seeing an Oncologist.

 

Icemantoo

ImNotDeadYet's picture
ImNotDeadYet
Posts: 244
Joined: Apr 2017

I've been told, by my oncologist and the radiology people, that CT contrast can make one kidney have to work overtime to process. Apparently, MRI contrast is different, so for my scans we usually do CT without contrast and MRI with contrast. If I recall correctly, we do CT for upper and MRI for lower.

donna_lee's picture
donna_lee
Posts: 1020
Joined: Feb 2009

can come from another cancer patient (or even the spouse) because no 2 cancer patients are the same.

The concern when there is only one remaining kidney and the w/wo dye is that "the" kidney has a more difficult time processing the dye out of your body.  The way to get around that is to have what is called pre and post infusion.  One liter of saline prior to the test, during which you also drink the 2 bottles of barium sulfate; then a liter after the test.  That ensures there is plenty of fluid in your body to process the dye and barium sulfate.  Generally they (radiologic dept) requires a CBC and CMP prior to the test.  This will tell them the eGFR or estimated glomular filtration rate and the creatinine (Crea) levels in your blood.  The eGFR goes down as we age and is also a reflection of the kidney's ability to process waste.  If you only have one kidney and are in early seventies like me, the normal eGFR can be 38-42, my normal.  I've always had contrast and have been doing this for over 11 years.

Have the CT and try to relax a bit.  Re your post appt. with the Urologist, there are questions you could ask:

-Has he had experience treating patients with kidney cancer. Also do you know what type, Stage, grade and size of tumor?

-Has he ordered pre and post infusion for other patients and is he aware of the benefits and need.

-How will he make the decision and what will he be looking for before referring you to an Oncologist.  He/she would be the logical choice.  A Neph. would be more likely only if there was subsequent kidney failure.

Then you need to know how far you would need to travel to see any one of these specialists.  Mine was D'xd as a result of a regular test during a physical, but was already stage IV (mets to the liver), and I was immediately referred to an Onc., who has planned and monitored my tests since 2006.

Re you new tailgate acquaintance.  Within my community, I know or am aware of at least 8-9 others who have or have had kidney cancer.  Each one has had different treatment.  Your "friend" needs to learn the wisdom of perhaps sharing his experience without telling others what they can and cannot do.  And I'll leave it at that.

If you want to learn more about my journey, click on my user name.  Meanwhile....

Hugs and Best Wishes on the upcoming test.

donna_lee

kiwi68's picture
kiwi68
Posts: 110
Joined: Oct 2017

Donna Lee.   It is with respect that I read your considered writings. You always have some great nuggets of information for going forward to the medical professionals and question asking. Thanks. 

marosa's picture
marosa
Posts: 333
Joined: Feb 2015

that not only you will benefit from Ret!  Good wishes for you.

Angie1496's picture
Angie1496
Posts: 154
Joined: Sep 2017

The answers you got covered what I have learned and read about contrast dye.  Hoping you and your wife can relax a little more now.  The people of this group are amazing!

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