Left kidney cancer removed, now cancer in right

[bob1932]

2.4 cm and 2.1 cm mass in lower pole of right kidney, highly suspicious for neoplasm. Left kidney removed for RCC three years ago.
I have severe COPD (on continuous oxygen), and do not feel I can survive surgery, and definitely do not want to face dialysis. What are my alternatives?

[bob1932]

Thank you for that - your mom sounds like a wonderful person.
Very generous of you to share that.

[Limonada]

The same thing happened to my mom - she had a kidney removed due to RCC at age 48 and the doctors said she was in the clear.  A year later, at her annual follow up appointment, it was discovered that she had cancer in the remaining kidney as well.  She was also diagnosed as having pancreatic cancer at that point (a misdiagnosis) - and no chemo was given.  

I was living abroad at the time and don't know all of the details of this....Clearly, the doctors felt that her cancer was metastatic - in the end, I"m not sure where it ended up going.  She lived for 5 years post-initial diagnosis, was on many medications for pain, morphine eventually. Despite this, she had many good days in this time, including a vacation to Hawaii with my dad and numerous happy get-togethers with family and friends. Her strong and positive energy and spirit were - and still are - a source of inspiration for me.

I wish you all the best, Bob :-)

[bob1932]

Thanks for answering.
If I do nothing - no treatment,  what is the likely progression of this condition?
How do they know if these new tumor are metastatic or a new primary?

[Fernando Roque, MD]

Hi.  The first thing that should be done is to establish whether those right kidney masses are actually renal cell carcinoma (RCC) recurrence.  To do this, a biopsy of at least one of those masses has to be done.  If RCC is shown in the biopsy result, then your primary treatment option would be chemotherapy with one of the new "targeted" drugs like sorafenib or sunitinib.  Treatment at this point is not likely to be curative, but a modest improvement in survival can be expected with the use of these drugs.