One kidney

Hi Ian and welcome.

Mine wasn't exactly the same as yours, as I had two kidneys still and on 1st April had a robotic partial nephrectomy. My mass was discovered two years ago when scanning just before my hysterectomy for endometrial cancer, and it was 2.7cm at that stage. My urology consultant didn't want to do surgery at that time due to my hysterectomy, and by the time I had recovered from that, gone on my hols, had staffing problems at work, gone on more hols, came back to flooding and then had to deal with roof repair, water leaks repair and all my taps and drains being replaced, and my boiler sorted out - it ended up as a two-year active surveillance. Scans approx every six months and at each scan the mass didn't appear changed. (A Bosniak 4 from the start)

But I always had this hanging over me and whilst it wasn't changing, and I knew kidney cancer is slow-growing, I knew it might change at any time, a little or even a lot in between scans. So I bit the bullet and had the surgery finally. When it came out (T1a early-stage) it was actually 3.3cms. So I was very relieved I hadn't left it any longer.

If it's less than 5cm they probably won't be in a hurry to do surgery. However, as it's your only remaining kidney, the amount they need to remove could impact your kidney function if it should grow a lot in between forthcoming scans. My kidney function was >90 pre-surgery which is excellent for my age. Immediately post-surgery it had dropped to 75, which wasn't too bad all things considered.

It's not pleasant to contemplate surgery for it but the more kidney they can preserve, the better for you. 

Sometimes it seems they do a biopsy. My consultant didn't recommend that for me as it was 85-90% chance of being cancerous and he didn't want to risk disturbing it and preferred to just remove the lesion. If they are not quite sure what yours is, they may opt to do a biopsy. Do you know if it's a Bosniak 3 or 4, for example? Bosniak 3 has less chance of malignancy, despite looking "not normal". 

There's other things they can do instead of surgery, and it really depends on your consultant's view and on your own general health and age, whether they will choose to offer a less invasive procedure. Mine didn't want to give me those alternatives. 

Give yourself time to talk through all the options with your consultant. It sounds like they feel that this is still slow-growing enough to wait for a further scan at least, which indeed is reassuring. If it's taken from 2019 to get to the stage where it is now changing/growing, that isn't a bad sign at all!

Hi

Many thanks for the response. I have been through cancer before and this doesn't seem as bad. I'm also in pretty good health. Thanks again x

They have mentioned surgery, but only in general terms, I'll know more in July.

Hi

Me again. I had another chat with my CSN Team and it seems that the mass seems to grow 4mm every six months, so they're doing close monitoring. Apart from that the mass is stable and there are no signs of spreading. My bloods are stable have improved. Still might need an intervention in July, but it's a lot clearer.

That mostly seems quite positive - despite the growth in the lesion. I think I read somewhere that the mean growth is something like 2.4cms per year...which sounds a lot to me. Yours is well below that, which is good. 

Glad you are being closely monitored and that things look stable.

Thanks

Hi

New turn of events, the Senior CSN came back to me today. Nice conversation and she will be advocating surgery at the Royal Free asap  I'm not in danger, but she can't the point of prolonging things since the recent growth.

Frankly, I'm relieved and not really phased, at least something is happening. She us advocating cryotherapy, but it depends on the Royal Free.

That sounds a good move forward. She sounds very on the ball - indeed, as there has been recent growth, it's going to have to be seen to at some stage and the sooner you have this done, the less kidney function you will lose. That's how my consultant explained it to me. I was under active surveillance for two years and the lesion at each scan looked exactly the same and hadn't grown or changed. Which reassured him. However, I always knew I would have to have it done eventually, or I could have gone ten years and then ended up losing my whole kidney instead of just a small part of it. They weren't even sure with mine that it was suspicious but it had an upwards of 85% chance of being so. (It was, in the end)

When mine came out it was 6mm bigger than the scans had showed. Apparently the scans sometimes cannot see the full scope of it, due to the angles the scans are taken at. 

So I am glad you are going for this. Cryotherapy will preserve the function of your kidney as much as is possible, which is crucial for you. 

Hi

She's very good a doctorate from John Hopkins amongst the many qualifications in her armoury.

She very matter of fact in that her opinion it was likely to be cancerous (which I suspected) and there was no reason to wait.

I'm quite relieved as I don't have to through this in July and surgery has never bothered me; I've had two major ops in the last eight years, plus a few minor procedures. Two types of cancer and now third, so I'm quite experienced..

I'm on my second type of cancer! Only a few years ago, I didn't even realise it was possible to get more than one cancer!! (My parents each only had one)

I've been really fortunate in that both cancers have so far been early stage and no complications, no adjuvant therapy needed and a relatively smooth ride through the surgery. I say, so far, because I haven't yet had my 6-week follow up for the kidney cancer but I've had the histology already, and nothing scary at all there. 

I dreaded ever having to have surgery. I got to 62 before I had to - but I have to say, I feel I'm starting to get used to this. (Would rather not have had to - but, that's life!) 

Surprising how you start to adjust and live with it; for example, I only get anxious on results day. Now at one time, I'd start getting a week or so before. Obviously, I'd rather not have it, but what choice do we get?