Kidney tumors in remaining kidney: What are our options?

Posted by daughterofpatient22 @daughterofpatient22, Jun 12 12:25pm

Hi Everyone,
My dad had a kidney removed in 1997 because they found (when testing for something unrelated) a large tumor in his kidney. In 2007 they found two lesions in his remaining kidney. His dr at the time said that if could try to go in and remove it but he would risk losing his only kidney then be on dialysis. We chose active surveillance. For 16 years there was very little to no movement in these lesions. Unfortunately, he went in for his annual sonogram last week and one of the two tumors doubled in size. It's about 5.1X2.7X6.2. We spoke with the surgeon who shares our concern. Dad is 82 and we are hoping he doesn't have to be in that tough situation of going into surgery, possibly losing his remaining kidney. I've been reading up on radiation and ways they could freeze a kidney tumor (cyroablation) but for some reason my dads doctor dismissed any option but surgery or waiting. I have no idea what caused such a growth after it being stable for 16 years and wondering if anyone has information on what could have caused this, how to avoid tumor growth, and cryoablation, or any other advice or information you can offer. My dad is very vibrant and active. Thank you.

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@daughterofpatient22

I'm glad to hear this! Would you mind sharing the size of the tumors? My dads are 6.2 and another is a bit smaller. I'm wondering if this would help. His surgeon doesn't seem to support radiation but wondering if we need to explore other options. Thank you.

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The scan shows solid lesion of 12 x 11 mm.

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@ronsale

The scan shows solid lesion of 12 x 11 mm.

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Thank you.

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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.

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@daughterofpatient22

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.

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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.

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@daughterofpatient22

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.

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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?

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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?

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