check ups

[mell31]

I was diagnosed with renal cell carcinoma november 2000 the toumor was 1.8 centimeters stage 1 and I had a partial nephorectomy, I was 30 years old.  I have been to all my check-ups and have been free of the cancer.  The doctors tell me they think I am cured but to make sure I get my check up annually now without the ct's, I am a bit worried that it might come back, and I dont want to wait until I have symptoms for them to do a catscan, I guess what I am asking is, should I trust what the doctors say and just go on with my life and get a urine test and blood test every year, or should I be concerned that it might come back. They are going off of this book that shows that in a 5 year study there has been zero reacurrence, but I study kidney cancer and they say a five year survival rate is 40% and some say 60% to 75%, the mayo clinic were I had my surgery says that I have a 97% chance of survival.  Which leads me to my next question.  What does the five year survival rate mean?  If your cancer does not come back in five years does that mean that your cured?  I can never understand what this means when you see a 10 year survival the percentage drops.  How can a doctor say they dont think that it would ever come back and go off a five year study  but you see a 10 year study and the percentage drops, does it have to do with age?  Does this mean in 10 years I will get cancer again? That does not mean you are cured.  I would really like to trust the doctors and go every year to get a check up, but at the same time I worry alot that I dont get a catscan so they will never know if it comes back unless I have symtoms, by then it could be to late, I just like the idea of catching it early.  please help me to understand.  thank you ray

[Kevin Pho, MD]

Five year survival rate is the percentage of patients with a disease that is alive after five years following a treatment.

It does not necessarily mean that after five years you are cured, since there is always a possibility that the cancer can return (unfortunately, nothing is ever 100%).

Regarding post-op screening of renal cell cancer - this should be discussed with your physicians.  Here is a study that discusses radiological follow-up or renal cell carcinomas post-op:

"The prognosis of patients after radical nephrectomy for renal cell carcinoma, smaller than 4 cm, is excellent and they do not need radiological follow-up. Patients with larger T1 tumors, 4-7 cm in diameter, or a higher stage should be followed with CT of the chest and abdomen done every 6 months for 5 years and then annually. Following partial nephrectomy of small renal tumors periodic renal ultrasonography should be done to rule out local recurrence in the operated kidney." (1)
http://www.arcweb.tzo.com/arc/arc.nsf/0/ed0d024d5d8e9ef6c8256c770055bcbc?OpenDocument

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.

Thanks,
Kevin, M.D.

[kevinmd]

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