Hi my name is Jonathan Wongso from Indonesia.

My father, Ekwandi Wongso Wong, 52 years old, diagnosed with a 8 cm Kidney Cancer on ther right Kidney on May 2018. He had the Right Kidney removed immediately and did a biopsy.

The Biopsy report stated that it was a "Clear Cell Renal Cell Carcinoma" WHO Grade 3, limited to Kidney, Pathological Stage pT2aNX, Resection margin Clear. We were informed that there was no spreading.
Surgery was done in Mount Elizabeth Hospital Singapore.

On 30 July 2018, We did a 3 months Checkup, CT Thorax found that there were 0,8cm pulmonary nodule at the right lung apex, near the right brachiocephalic vein, abutting against superior vena cava. It was discovered later that the nodule was there on 3 may, but the radiologist didn't notice that time.
And also 0,5cm nodule on the left lower lobe.
However, the urologist told us no need to see an oncologist and ask my dad to do another scan in 3 months time.

On 7 November 2018, we did another check UP.
My dad had a CT Thorax and Abdomen. The 0,8cm pulmonary nodule has grown larger to 1cm. There is another 1cm New nodules on the right apex. There were also a few small nodule less than 3mm on the right and left lungs.
We were told that my dad has a stage 4 kidney cancer, metastasis to lungs.

We consult to oncologist, we were told there are two option.
1. Targeted therapy (Sutent or Pazopanib)
2. Immunotherapy (Ipilimumab + Nivolumab)

The oncologist from National University Hospital Singapore told us Immunotherapy (combination of Ipilimumab + Nivolumab) has the best result compared to to targeted therapy.

I also heard about Dendritic cell combined with Natural Killer Cell Immunotherapy can be used to treat kidney cancer also.

I want to ask whether is there a "Second Opinion" or a "Better Alternative" to treat My Dad's Case?

I Really Hope to hearing from you guys soon.
Thank you so much