Kidney tumors in remaining kidney: What are our options?

The scan shows solid lesion of 12 x 11 mm.

Thank you.

Your welcome.

Hi Everyone,
My dad has two tumors in his solitary kidney which did not change for 17 years. Unfortunately, his annual ultrasound in June showed that one of the tumors in the right, interpolar, anterior area doubled in size. The ultra sound showed it at 6.4 X 4.9 X 5.1 in June and now in September said that it was unchanged. However, the doctor ordered an MRI for the first time in a few years and the MRI now in September shows that it's actually 7.7 X 5.7. I don't know what the MRI would have showed in June because in comparing ultrasound to ultrasound June - September it says unchanged but the MRI is actually showing it larger. The surgeon who is old school and not quick to suggest surgery says that we got 17 years of quality life and if my dad is asymptomatic that at 83 years old he wants to just see him in 4 months. He said that if my dad was 52 or 62 he would suggest surgery. He said that he has a 96% success rate normally of just getting the tumor out and saving the kidney function but with my dad he feels it would be 90% but still feels that at 83 years old, even if he had a successful surgery, that he would risk being put on dialysis and his quality of life would go down. I was surprised he didn't make dialysis sound great at all and said 50% of people survive on it and that dialysis is worse that cancer itself sometimes. His lungs are clear and the cancer has not traveled. I have found this community to be so supportive and informative and I'm wondering what you think about the doctors plan. We thought we were looking at surgery 17 years ago and I was so nervous about my dads prognosis. I appreciate that the doctor wasn't quick to suggest surgery and put him at risk because we had 17 years but now I want to make sure we are making the best decision and also exploring all options. The doctor said that he will not lie to us and that when he saw this results in his inbox, he was not thrilled about them and he shares out apprehension. He also said that something seems to have ignited this tumor and he compared it to the storms in Florida. Again, I wasn't thrilled about this but he said it is probably clear cell carcinoma. I asked about cryotherapy, immunotherapy, radiation, etc. and the doctor said no that any of that would destroy the kidney function. He did share his screen and said that there is a lot of healthy kidney there. What are your thoughts? Does my dad have any other options in shrinking this tumor? Would he ever be eligible for a kidney transplant and to be put on a donor list? What are your thoughts on the surgeons plan? My dad feels good overall but his energy level isn't what it was a year ago and the doctor said it is probably both the kidney but also being 83. He is a vibrant 83 year old and for someone who has four older siblings in their late 80's and early 90's, I just want to make sure I am leaving no stone unturned and trying to make the best decision. By the way, his creatinine is 1.5 and his GFR is 46.
Thank you all in advance.

Being 82 myself and having been diagnosed with a malignant lesion in my left kidney in March of 2023 I can sympathize with you and your father. The urologist said that only a total nephrectomy of that kidney was the treatment. But I decided last year that because of my age I did not want to go through the long recovery from the surgery and the unknown problems that could result from the surgery and how the remaining kidney would function at my age. Instead I have decided on immunotherapy with Keytruda. I have had seven treatments with some side effects including severe skin rash; another eleven are planned. I also had to have five high dose radiation treatments to stop bleeding from the lesion; there has been no visible bleeding for last three months since the last radiation treatment. I can't really offer any advice, but I do understand how difficult it is to make the right decision especially when one is in his 80's. The only thing I can say is that for me my decision up to now has allowed me to do the things I want to do and not being burdened with a long recovery from surgery and unknown result; and how much longer would the surgery really give me as to a quality life. I have some days where I don't feel well, but others that are good where it's just great to be alive while I take my daily walk, breathing in the fresh air, feeling the sun on my face and listening to the birds singing. That's the way it has been for the year and half since my diagnosis when I chose my path. The future will take care of itself. I hope you make the decision that is best for you, and I hope that it helps to know that there are many of us in the situation and understand and support in fighting a terrible disease.

Hi @daughterofpatient22, I thought I would check in to see if you have learned more about the options available to your father. Have you been able to discuss treatment options and/or transplant with his cancer team? How is he doing? How are YOU doing?

My husband has renal carcinoma and had one kidney removed several years ago. The remaining kidney is now not functioning properly and they have stopped his blood pressure meds to try to help. Unfortunately, his blood pressure is really high now. Anyone experience anything like this?

@xnkpr1, you must be worried for your husband. Has anything helped with the kidney function of his remaining kidney?

He will be starting on Jardiance (actually a diabetes drug) to help. Fingers crossed that it will work.

Hi Colleen,

Thank you for checking in. His surgeon basically said that due to his age, he really doesn’t recommend surgery which would impact the function of his kidney. His creatinine number is 1.4. So, the function is good and they checked his lungs and do not see that it’s spread anywhere, but on the flipside the doctor said he’s not happy that it was stable for 17 years and now it could be growing like a “wildfire”… he showed us the scan, and did say that there is a “lot of healthy kidney here” and it is functioning. We met with the doctor back in October and he is scheduled for another scan in February and the nurse practitioner said he is being monitored as closely as we would monitor anyone. I got a second opinion, and the doctor looked at my dad’s results and thinks his surgeon is making the wisest choice but his eye doctor referred him to a different nephrologist, because he thinks we may have other options, I just don’t see what they could be. If the surgeon himself said he could go in and 90% remove the kidney tumor, he feels confident he could go in and just remove both tumors and have a successful surgery, but he said, even with a successful surgery, I guess the surgery alone would have a negative impact on the kidney function, which is already not great. Overall, my dad feels pretty well but recently, he’s been feeling kind of fatigue. Some of it could just be being 83 years old and he is pretty active.