Local oncologist recommended Keytruda every 6 weeks for a year. Second opinion oncologist at Duke Cancer Institute said Keytruda was not warranted with G1 tumor grade. He requested my pathology slides so he could have his pathologist evaluate them. The new pathology report lists my tumor as G2 (instead of G1), notes the tumor was necrotic (instead of that not being noted by the original pathologist), and the tumor extends into the pelvicalyceal (instead of perinephric tissue/renal sinus only). I don't know if that will change his recommendation. If it doesn't, I will have to decide which route to take, or to get a third opinion. If he changes his mind and also recommends Keytruda, it's a no-brainer to go that way.