best places for robotic-assisted partial nephrectomy - dealing w 7cm kidney mass while pregnant

Best centers to perform robotic-assisted partial nephrectomy
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7cm solid kidney mass - 0.0%
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Kidney cancer while pregnant - 0.0%

 
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Angel79
New Member


Date Joined Apr 2015
Total Posts : 2
   Posted 4/13/2015 6:19 PM (GMT -7)   
Hi, I'm 35 yr old female 17week pregnant living in San Francisco Bay Area. During an abdomenal ultrasound, they incidentally located a 7cm exophytic mass on the upper pole of my right kidney. It is heterogenous with internal vascularity and hyper echogenic (possible indicator of macroscopic fat). I'm otherwise a very healthy person, physically active and in shape, with no family history of cancer. My blood and urine tests that my OBGYN ordered also came out normal. I did an MRI yesterday for further diagnosis.
 
I was refered to Stanford hospital where I'll meet with a urology oncologist tomorrow who'll review the MRI and possible options with me. I was initiallty positive trying to think that it's probably just a benign AML tumor (which is partially made of macroscopic fat with no calcification) but did some research online and I'm now freaked out as more than 80% of kidney tumor this size are malignant. What makes it extremely complicted (physically and emotionally) is my pregnancy. This is my first child and I was so looking forward to start planning for his arrival and preping the nursery until this news came out. :(  My OBGYN said 2nd trimester is the best time to do a suregry if needed. I'm considered an extremely positive and fearless type of person by people who know me but to tell the truth I feel like my world has come to an end. I'm so scared of meeting this Dr. tomorrow in case he'd be the bearer of the bad news (malignant tumor in need of immidiate surgery).
 
My question for you: if I have to udnergo a surgery to remove the tumor + part or all of my kidney, which center do you recommend in CA or nation wide for robotic-assisted surgery on kidneys? I would to go other states as long as I know I'd be treated by the best team. My OBGYN said she'd want me to get 2nd and 3rd opinions and evaluate the risks to the baby and myself if we decide to continue with observation or surgery. After Stanford, I'll be seeing a dr or more at UCSF. I'm also thinking of Cleveland Clinic as I realize they have number #1 Urology department with some top-notch surgeons who've pioneered special technics in robotic-assisted partial nephrectomy. I'd want to save as much kidney as possible so the more experienced the surgeon the better. I'm on a tight time constarint as I have only 4-6 more weeks left to undergo the surgery (if needed). Once I enter the 3rd trimester, no one will perform operation on me and if malignant it can spread into other areas by the time my baby is delivered.
 
Any lead would be highly appreciated.
 
 
 

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/13/2015 6:45 PM (GMT -7)   
I'm in your area (obvious with the name I guess) and I am going to a Stanford urological oncologist (Dr. Gill) for a 1.3cm mass on my right kidney. I've been seeing him for about a year and a half, as he is of a mind that we're better off to monitor this lesion for now. He's not certain it is malignant and he doesn't want unnecessarily reduce my kidney function if he doesn't have to.

That being said, I'd either stay with Stanford or, if for whatever reason you're uncomfortable there, I'd go to UCSF. UCSF has one of the best cancer groups in the world with Stanford not all that far behind. You might also want to ask about non-surgical procedures at Stanford. They have been using cryo-ablation techniques for some time now. They use small needles to go through the skin and into the kidney mask where they super-freeze the suspicious matter, thereby killing it. It may be a better option for you given your pregnancy.

As for UCSF, my brother-in-law used there cancer center when he was diagnosed with nasopharangeal (I can never remember how to spell that) cancer. It's a cancer that appears in the back of the nose and throat. It's inoperable, so he had three months of pretty much daily radiation therapy and once-a-month chemo. He's been in complete remission for over five years now.

So, again, either of those two hospitals are going to be very good for you.

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/13/2015 6:48 PM (GMT -7)   
One other point. Dr. Gill told me that cancers of this kind are usually very slow growing. But whoever you see at Stanford will be able to give you much more information about that.

Angel79
New Member


Date Joined Apr 2015
Total Posts : 2
   Posted 4/14/2015 5:29 PM (GMT -7)   
Thank you much Bay Area Guy. I didn't hear a good news today. My Dr. (not Dr. Gill) said it's highly recommended that we remove the tumor with entire kidney as the it's a large one and there's %90+ chance of being malignant. So partial nephrectomy would pose some risks. Considering some tumors grow fast due to pregnancy hormones, he didn't recommend waiting till the baby is delivered and I'm healed which will be ~6 months from now. I'm lucky it's still contained within one kidney and my other organs are clean with no sign of metastasis. I'm going to quickly send my test results to a few other wellknown doctors in the area and elsewhere and get their opinions before I opt in for the surgery in the next few weeks. It's such a shock that I'm going to lose a kidney while pregnant..... I need time to get used to it...

Bay Area Guy
Regular Member


Date Joined Jul 2010
Total Posts : 296
   Posted 4/14/2015 6:15 PM (GMT -7)   
I'm very sorry to hear that Angel. But, as you said in your earlier post, it was found incidentally, so as ungood as the news today is, there's something good that came out of all of this since it was found early enough that you can still get it taken care of.

Best wishes to you for a speedy resolution.

I'll be getting a CT scan on the 28th and seeing Dr. Gill on May 5th to see if my little friend has grown or otherwise changed.
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