We had an appointment with the Urology Department at Bath hospital today. We were not sure why but were glad of the opportunity to ask a few questions. We saw the consultant, Simon Evans, who had visited me when I was in Bath hospital originally, so it was good to deal with the same person and he answered my questions very clearly, as I summarise below.
Q: Why don’t you just crack on and whip out this dodgy kidney?
A: Because it is a 4 hour operation and your lung is not in a good enough state for you to be able to cope with that.
Q: Good reason! My discharge note references “8cm mass in the right kidney with nodules in the surrounding fat.” What is the significance of those nodules?
A: It could be spread, but it could also be enlarged blood vessels which sometimes happens. If you look here on the scan you can see your left kidney looks like a kidney, but the right kidney has a large round lump and around it are these other areas which could be nodules. If so they appear to be limited to the area of fat which naturally surrounds the kidney.
Q: Any further thoughts on whether this is likely to be two primaries or a secondary?
A: It is unlikely that a kidney tumour would be a secondary from the lung, but the reverse is possible and the fact that it is your right kidney and left lung is not an indicator either way.
Q: If you operate, what kind of procedure is it?
A: It depends on whether we do it as keyhole or conventional surgery. The size of your lump is borderline for keyhole but it may be the surgeon’s preferred option. It is generally a 4 hour operation with a 4 night stay.
Q: What is the waiting list like?
A: For non-urgent cases it is quite poor. However, you would be classified as an urgent case so we’d be talking weeks rather than months, once the decision is made.
Q: When will you make that call?
A: First we need the histology results from your lung biopsy. Then when the respiratory team have decided on their course of action we will work out a plan for your kidney to dock in with that, bearing in mind the point I made above about you being fit enough for any operation. Also, as I explained when we first met, we sometimes follow an operation with chemotherapy and sometimes the other way round. I will, therefore, see you again in about three weeks’ time when all the information has been collated.