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Kidney Cancer
Old 04-04-2008, 10:18 AM   #1
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Kidney Cancer

A friend was diagnosed with kidney cancer this week. We are not certain how advanced, however the tumour on the kidney is 14 cm so our internet research indicates Stage III. However they are suspicious of spots on the lung but we won't know the outcome of the scan until Monday.

We are in total shock at the moment. Friend is only early 40s, very healthy. Thinking back he likely did have the symptoms for a while such as fatigue, lack of energy and hasn't looked well, however we think they were probably masked from the energy it took him to do his job.

Anyone have any experience with this disease and can give us an idea of what to expect? With regards to survival rates does anyone know if they include people who did not have good insurance/were unhealthy to start with? Survival rates at 5 years for Stage IV have ranged between 9-23% so we are hoping that our friend is that 1 in 10 who makes it. He is such a good person, has so much to offer that he deserves to make it through this. He is a person who likely would have been FIREd in a few years time, we are just hoping he does get to achieve that goal.
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Old 04-04-2008, 10:28 AM   #2
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I'm so sorry to hear about your friend.
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Old 04-04-2008, 10:32 AM   #3
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Danger, I'm very sorry to hear about your friend. As you have found, the survival rate for kidney cancer is not high. I will be praying that he is one of the lucky ones.....
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Old 04-04-2008, 11:24 AM   #4
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DangerMouse,
I am not involved at all in the medical field. Here are, from experience, some suggestions.

1. This doctor is a kidney specialist where most are prostate, bladder then kidney. He is excellent and very thorough and treats many very advanced cases.
Bradley C. Leibovich - Mayo Clinic

2. Second advice is to have your friend find out the "Grade" of his cancer. That is in many ways more important than the Stage. There are various grading systems but typical would be Fuhrman Nuclear Grade. Grade I is best, IV is a very aggressive cancer (in terms of growth).

Most kidney cancer will be Renal Cell Carcinoma and most common of those is the Clear Cell type.

Stage III will normally still be within Gerota's fascia and if so the biggest risk is involvement of the renal artery. EDIT: That is one way it can become metastatic to other organs such as the lungs. I will add, spots in the lungs can be from many other causes.


Questions he might want to ask:
1. Does the cancer appear contained by Gerota's fascia?
2. Does the cancer appear exophytic?
3. Are the Renal artery and vein involved?

The answers to those questions will give your friend a great deal of information regarding prognosis.

I would be glad to answer any questions, if I can.
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Old 04-04-2008, 01:20 PM   #5
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My sister-in-law has this. She is waiting for surgery. We are all very distressed by this. She was feeling bad for a month or so, went to MD who found that she was quite anemic. In the anemia workup they found this large tumor.

My job is to be upbeat with her, and support her. She can hardly talk to her husband about it as he is so distressed.

She is a very strong person, so I think she will do well. I hope your friend will also.

Ha
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Old 04-04-2008, 01:46 PM   #6
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I'm sorry to hear about your friend...

I have a relative with this condition (mid 50s). If I recall, prognosis is pretty good if cancer is contained to the kidney - they can just remove it and eliminate the cancer for something like 85% of cases. However, if it becomes metastatic prognosis is not so good (I believe it's pretty much automatically stage IV if it's metastatic). It seems to me the big question for your friend is whether the lungs are an issue or not - that will really shape the outlook.

It seems there aren't that many treatments for the metastatic form, and most seek to delay advancement of the disease rather than cure it. I think the only curative treatment is interlukin2, but many people elect not to do this since cure rate is <10% and it really hurts quality of life. There are other clinical trials combining drugs and/or using new 'vaccine' treatments which use the cancer cells to create a vaccine.

FWIW, my relative is doing ok (still has metastatic disease but is relatively stable) 3.5 years after kidney removal, 2.5 years after it was discovered to be metastatic.
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Old 04-04-2008, 04:21 PM   #7
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Sorry to hear about your friend. I hope it is confined to the kidney, and to one kidney so there is a possibility of removal and no metastasis.
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Old 04-04-2008, 04:38 PM   #8
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Sorry to hear about your friend .Hopefully it will only be in the kidney and no where else .
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Old 04-04-2008, 04:51 PM   #9
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Best wishes to you friend, and to you for your pain.

Renal cell cancer is one of the unpredictable ones, and does tend to strike a bit younger than many other types. On the other hand, it also sometimes responds dramatically to chemo even when metastases are widespread. In fact, I have seen cases where the "distant" metastases disappear when only the primary cancer is removed (there must be chemical influences that connect the two). True, at other times it can be relentless and progressive, but it's a very quirkly type of cancer.

If it were me, I'd get an opinion from both an oncologist and a urologic cancer surgeon. This is often done through major cancer centers - there are usually a couple in almost all metropolitan areas. Travel to distant centers is usually not necessary for state-of-the-art care unless either something unusual is present, or if futility warrants participation in an experimental protocol of some sort.

Best of luck. It's a shocker when it happens to someone you care about.
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Old 04-04-2008, 06:12 PM   #10
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Rich,
are there specific studies or examples that have conclusive proof that "distant" metastases completely disappeared because of the surgery removing the original cancer?

That's an amazing finding. Does it suggest a communication system between the parent cancer and it's offspring?
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Old 04-04-2008, 06:50 PM   #11
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Quote:
Originally Posted by Wilbury View Post
Rich,
are there specific studies or examples that have conclusive proof that "distant" metastases completely disappeared because of the surgery removing the original cancer?

That's an amazing finding. Does it suggest a communication system between the parent cancer and it's offspring?
Yes, it's well established, though rare, and documented in the literature. The theory is that there are "neurohumoral" dependencies; apparently the distant metastases rely on the presence of certain growth stimulators or growth enabling chemicals that only the mother-ship produces enough of.

On a more practical basis, it is also a disease where removing a solitary metastasis (usually to the lung) along with the primary tumor can be curative. So, while the 5 year prognosis of advanced disease remains poor (20-30% range), in individual cases there may be some room for realistic hope for a long term result.
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Old 04-04-2008, 09:14 PM   #12
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I would like to thank everyone for their words of wisdom.

It was confirmed today that it is stage IV. There are 7 spots on the lungs and possibly some on the brain, but the good news is that there is nothing on the other organs. I believe there is possibly going to be surgery performed next week. We do not know the grade.

Said friend has a very positive attitude, is talking about what survival and not death, and for some reason I do believe he is going to be the one that beats the odds and does survive. I am sure when we see him tomorrow there are going to be tears shed, however we are going to focus on a positive outcome and work out what we can do to help him and his spouse focus on the same.
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Old 04-05-2008, 10:42 AM   #13
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Dangermouse,
I hope this site helps you to support your friend. He will learn what stage the cancer is following surgery and the laboratory analysis of the tissue, etc.
Kidney and Ureter Cancer
This site helps understand many medical terms he will encounter in the clinical documentation.

Best to both of you.
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Old 04-05-2008, 07:21 PM   #14
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a few years ago DH had kidney cancer and had his left kidney removed

they just diagnosed him recently with multiple sclerosis

and through it all he stays ok
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