Where is there an end of it? | Cancer


What are the odds?

I suppose it was during the ultrasound scan that I first realised something was really up. Here I was, having my bladder and kidneys scanned, as a result of two years, on and off, of what we Brits might term “waterworks problems”. We were chatting away (“Good drainage! — yes that looks fine” … small-talk like that) when the scanner reached my right kidney.

“Everything okay?” I enquire.

“Let me finish and then we can discuss it,” the sonographer replies. The tone had changed.

Now, I say this was my first realisation that something was wrong, but it’s not quite as simple as that. As a mild hypochondriac I often live with the strange internal doublethink of believing that every ache or pain betokens some dreadful illness, while simultaneously knowing that that’s silly and that I'm fine really. Now the balance had changed: the dark fears had become the reality; the self-reassurance the self-deception.

“Maybe some kind of cyst – it’s worth having it checked out. I’ll put something in a note to your GP.”

And so she did, as I find out on getting the ”I'm so sorry” call from my GP with the (not very meaningful) news that the scan had found a 27mm heterogeneous vascular lesion on my right kidney, and the (rather more meaningful) news that as a consequence I was being urgently referred to Addenbrooke’s with suspected cancer of the kidney.

More scans

“This is the worst bit,” said the consultant, “the waiting around not knowing.”

I doubted this: an early and painful death was potentially the worst bit I thought. In any case, it seems that in the World of Cancer “not knowing” is a constant. Or at least not knowing everything. You don’t how well you'll respond to various treatments, you don’t know what’s happening internally between scans, you don’t know what the limited resolving power of the of scanners can’t reveal. An ultrasound scan, it turns out, doesn’t give a very precise image of the organs, so I was now to have a CT scan during which a contrast agent would be injected into my body so that my organs “lit up” in the images produced.

Meanwhile, I’d been able to gather information about kidney cancer from the Web. In particular it seemed that:

  • The kind of sizes being talked about for my “mass” meant it was small in kidney cancer terms. In some cases the tumours grow football-sized before detection.
  • Kidney cancer doesn’t respond to the usual radiation-based treatments used for many other cancers. It is treated by surgery and (recently) by new immunotherapy drugs which can sometimes be successful in stimulating the immune system into attacking the cancer.
  • If a kidney has to be removed, people can usually get by fine with just one.

Quoth the server, 404

In addition to factual information available on the Web there is a range of forums and mailing lists dealing with kidney cancer, from furrow-browed ones detailing experiences and reviewing the latest research, to softer ones offering more purely emotional support (“I’ll pray for you on your cancer journey”). Needless to say I prefer the former. There are also lists of kidney cancer blogs (of which I suppose this is now one) which range from the reassuring (“I had kidney cancer n years ago and following surgery have had no recurrence”) to the embattled (“we were very disappointed to learn the scan showed there were now nodules on the lungs”) to the despairing, where a distraught spouse takes over to leave grief-stricken postings following the first blogger’s death. And there are those blogs which just get you a 404 – which could be good or bad …

So at yesterday’s meeting to review the CT scan result I already felt reasonably well-prepared for what might transpire and what the options might be. The key points were that:

  • The CT scan confirms a 3.3cm × 2.5cm mass on the lower pole of my right kidney. Its removal is recommended as it is highly likely to be cancerous.
  • The chances of any cancer having spread, given the size of the tumour, are very low. Removal of the tumour should effect a complete cure.
  • Other organs (in the thorax, pelvis & abdomen) were surveyed in the CT scan imagery: nothing was found. My left kidney is “pristine”.
  • The recommended procedure is an open partial nephrectomy, to happen just before or just after Xmas. This will probably entail 3-6 days in hospital and some weeks of recovery at home; no driving for 6 weeks.

So this is where I am. A fuller picture will emerge when the pathology is known for whatever is removed – but for now, the plan is that after some fairly hefty surgery I can expect the disease to be gone. Or, even better, that the slim chance comes good that the tumour is not cancerous – for as Woody Allen has observed, the most beautiful words in the English language are not “I love you” but “It's benign.”

Which is witty but not, I think, true.

Comments (12) -

  • Fernando Gebara Filho

    11/17/2011 2:04:39 AM |

    Alex, there are few words that have meaning at the moment and I hope I have chosen the correct ones: strenght, faith (whatever type you have, be it scientific or religious) and patience.
    I hope everything goes well and you have a quick and safe recovery.

    • Paul Cotton

      11/17/2011 5:58:50 AM |

      Cathy and I send our encouragement and hope you have a speedy recovery.

  • Jomar Silva

    11/17/2011 2:24:51 AM |


    I really hope that you hear the beautiful words on the end of the process: “It's benign.”

    Keep the faith and the things will end fine. I passed for something similar to that when I was 15, with a Brain tumor, and I know how hard is to live with the doubt. Faith, positive thinking and patience always help !



  • Jirka Kosek

    11/17/2011 2:25:00 AM |

    Hi Alex, I can imagine reading better news on your blog. I'm crossing fingers for you and your treatment. I hope that your body will shortly return 200 OK status code again.

  • Chris Rae

    11/17/2011 2:29:11 AM |

    My goodness - fairly puts things in perspective. I see Jirka stole my joke about kidneys and HTTP errors, so I'm stuck just wishing you the best.

  • Nathan

    11/17/2011 3:46:01 AM |

    Hope it all goes well Alex.  Best of luck with your recovery.

  • orcmid

    11/18/2011 11:03:21 AM |

    I'm a bit like you around symptoms, and of an age where there could be news like that.

    And it still throws me to learn that someone I admire is suddenly dealing with such an unwanted risk.

    My admiration is re-inforced by how you are reflective on such a worrisome personal experience.  

    All the best.  Thanks for sharing yourself and the challenge you face.  

  • Ian Easson

    11/19/2011 1:36:40 AM |

    My best wishes for a good outcome.


  • ctrambler

    11/21/2011 11:15:27 PM |

    Dear Alex,

    Very best of luck. Please keep us informed.

    Addenbrooke's patient care is good, but ward food, if you are NHS patient, is, well,... hospital food. Trust me, I had it when I had my eye surgery there. Not sure whether the spices are good for you, but their curry is edible, especially when compared to their English fare.

    Sorry but no cooked breakfast on offer. Only toasts and cornflakes. And if you only want either  they tend to compensate for the other by giving you double serving.

    Don't touch the sandwich if you can help it. They are, however, available 24 hours from the nursing stations.

    Having said that, don't try sneaking to BK in the concourse! Food are available 24 hours at the Concourse.

    I work at the hospital site (not for NHS or the concourse  caterer) so if I see you, I hope you don't mind I say hello.


  • Peter Junge

    11/23/2011 9:29:14 AM |

    Dear Alex,

    my deepest wished for a quick and a complete recovery. Keep the faith, especially in yourself!

    Kindest regards,

  • Alex

    11/25/2011 6:37:53 PM |

    Thanks everybody for your kind words and encouragement. If everything is as it seems I have a reasonably good chance of being back in showroom condition before too long.


    I have established there is a Costa in the hospital, so am relaxed about access to coffee and muffins if need be. Unfortunately I've been advised though that I won't want to be (or be capable of) eating much until a while after surgery, and that any movement around the hospital will probably be limited to shambling around near the bed. Besides, there just feels to me something wrong about the idea of visiting Burger King after just having had a chunk of kidney removed. Can't think why Wink

    It would be good to say hi if you're around.

  • Bridget

    12/12/2011 9:06:54 PM |

    Hi Alex

    Hope it goes well.  I had partial nephrectomy in July for a 4cm mass in my right kidney and am now doing ok.  The recovery is slower than you would think, which can be frustrating at times, but bit by bit you get there.

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