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checkups for cancer patients
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checkups for cancer patients

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.



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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
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