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Kidney Cancer Concern
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Kidney Cancer Concern

Good Morning, Dr.,

Could Trace Blood in the Urine be from Kidney Cancer.

Could it be kidney cancer because I read that Trace Blood usually comes from the upper tract and not from the bladder, although this isn't a guarantee.

I am a N/S, 35 yold male and have had the following tests that started because of Trace Blood in my urine in 12-05:

12-05: GP, Trace Blood in Urine, everything else normal
1-06: CT SCAN with Contrast:  All Negative
1-06: URINE TEST: clean NO BLOOD, no protein, etc.
8-06: Cytology: Negative
8-06: URINE TEST: clean except for trace blood, no protein, etc.
9-06: KIDNEY FUNCTION TEST:  Very normal (.9 or.09 I think)
9-06: 2nd Opinion:  Urine Test Clean, moderate micro Hematuria,nothing else, protein normal, etc.
10-06: 1st Dr. URINE TEST: clean except for trace blood, no protein, etc.
11-06: CYSTOSCOPY: Negative for Cancer, found scar tissue in channel, removed and opened up.
12-06: URINE TEST: Negative for everyting (protein etc.) except for trace blood.  He wasn't able to see any under microscope, but the dipstick was positive.

My Urologist thinks it isn't anything serious (that the system is like a coffee filter and a few small blood cells sometimes get through), and said that is it very few blood cells so he said to come back in 6 months for a follow up.

He believes the CT Scan Rules out Kidney and Uter Cancer
He believes the Cystoscopy  Rules out Bladder Cancer

My concern is that the CT was done 10 months ago and that it may have not picked up a small kidney cancer and because this is a slow growing cancer, it may now be large enough to see.  

My Questions are as follows:

1. Would the CT Scan WITH contrast in January '06 show a cancerous lesion in the kidney at that time?
2. Is it possible that the CT Scan in January missed a very small cancer and it has now grown over the past 11 months and would now show up on the CT?
3. I have had no Kidney Cancer Sytmpoms other than the Trace Blood (no flank pain, no weight loss, no tiredness, etc.) for the past 12 months.  Generally speaking would I have had some other symptoms by now if I had the cancer for 12 months?
4. Would you suggest a 3rd opinion or going to a nephrologist for this and having another CT or is this Overkill?
5. Am I too young for Kidney Cancer?  
6.  Is it possible it could be something benign?  
7. Do people live their entire lives with trace blood in their urine?
8. Would the Kidney Function Test be Skewed if I had renal cancer?


It does make me feel better the urologist (and he has an excellent rep) says he thinks it is nothing, but I am the type of person that wants to know for sure.

I very much appreciate your help as I am frustrated that I cannot find a cause for this trace blood (I am not a runner or anything like that) and am worried that something is getting missed that I can stop.

Am I being too analytical?  Should I just let this go and let the Doctor take control?

Thanks for your help!
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To answer your questions:
1) A negative CT scan would indeed make kidney cancer less likely.

2) No test is 100%.  If there is concern about kidney cancer, an MRI can be considered.

3) Possibly.  It would depend on the size and location of any lesion.  This is less likely given the negative testing thus far.

4) I would stop testing at this point given the negative results thus far.

5) Kidney cancer is less likely to present in someone your age.

6) Periodic cystoscopy can be considered - since that can uncommonly miss bladder lesions.

7) Possible, if every test remains negative.

8) Not necessarily.  Small kidney cancers may not affect the creatinine, and subsequently, kidney function.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
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