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Urology (Expert Forum)
checkups for cancer patients
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
checkups for cancer patients
by sued, Oct 10, 1999 12:00AM
My daughter had her left kidney removed when she was 12, her diagnosis was papillary renal cell carcinoma. She is now 14 and has had clear checkups for almost 2 years. In Jan. her Dr. wants to go to evey 6 months with just bloodwork and ultra sounds. I am concerned because it seems like a very long time between visits. She has only had 1 chest xray in the 2 years, cat scans and ultra sounds. Should I insist on every 4 months or is 2 years long enough and go to every 6 months. Her original lab reports said there was some lymp nodes involved. What do I look for as warning signs if we go to every 6 months? She only sees a pediatric urologist, should she be seeing another Dr.? Any information would be helpful and might make me feel a little more comfortable about deciding what to do. Thank you.
Doctor's Answer
by hfhs M.D.-AK, Oct 12, 1999 12:00AM
Dear Sue,
I waned to give you the latest study that we as urologists have seen. The reference is The Journal of Urology, vol 159, pages 1163-1167. This is a study out of MD Anderson, a large well respected cancer center. It looked at patients with different stages of renal cancer and recommends stage specific follow-up guidelines. Your daughter fortunately (not that she had cancer) had papillary renal cell carcinoma, a pathological diagnosis with better long-term survival.
If your daughter had a stage1 cancer confined to the kidney itself, I think your doctors recommendations are fine. At this point, she can be followed with an annual physical, chest x-ray and laboratory studies. If she is stage two, she can be followed with an annual physical, chest x-ray, and laboratory studies, but a ct scan should be done about 5 years after her surgery. From what you say she is being seen every six months which is fine after two years without evidence of disease.
However, you said her original path report had a lymph node. I don’t know if this was the final path or just a preliminary report. It makes a huge difference in follow-up and survival, if she has metastatic disease vs organ confined.
Overall, I think your urologist is giving you good information. Most likely your daughter didn’t have metastatic disease because she had surgery. In regards to seeing another doctor, unfortunately there are no warning signs. It is theoretically possible that blood in the urine or weight loss could occur with a recurrence. Other than that, you could be seen by your family physician.
The information provided in this forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personal physician.
Sincerely,
HFHS M.D.-AK
*keyword:Renal cancer
I waned to give you the latest study that we as urologists have seen. The reference is The Journal of Urology, vol 159, pages 1163-1167. This is a study out of MD Anderson, a large well respected cancer center. It looked at patients with different stages of renal cancer and recommends stage specific follow-up guidelines. Your daughter fortunately (not that she had cancer) had papillary renal cell carcinoma, a pathological diagnosis with better long-term survival.
If your daughter had a stage1 cancer confined to the kidney itself, I think your doctors recommendations are fine. At this point, she can be followed with an annual physical, chest x-ray and laboratory studies. If she is stage two, she can be followed with an annual physical, chest x-ray, and laboratory studies, but a ct scan should be done about 5 years after her surgery. From what you say she is being seen every six months which is fine after two years without evidence of disease.
However, you said her original path report had a lymph node. I don’t know if this was the final path or just a preliminary report. It makes a huge difference in follow-up and survival, if she has metastatic disease vs organ confined.
Overall, I think your urologist is giving you good information. Most likely your daughter didn’t have metastatic disease because she had surgery. In regards to seeing another doctor, unfortunately there are no warning signs. It is theoretically possible that blood in the urine or weight loss could occur with a recurrence. Other than that, you could be seen by your family physician.
The information provided in this forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personal physician.
Sincerely,
HFHS M.D.-AK
*keyword:Renal cancer
