Where is there an end of it? | Pathology


Last of the Clexane
Last of the Clexane by alexbrn

Five weeks ago I left hospital after undergoing an open partial nephrectomy to remove a suspicious 3cm tumour from my right kidney. The experience was not as bad as I anticipated. Hospital itself was made bearable by an internet connection, and the tweets, chats and emails from well-wishers (thank you all – it makes a huge difference!). After three nights I was back home. After a week I was off pain-killers. After three weeks I found myself bounding up stairs two-at-a-time again — and now … I am almost back to normal, with only an occasional twinge to remind me of my wound.

Today I returned to Addenbrooke’s to discover the results of the histopathological analysis that had been performed on the tissue removed from my body. The findings were:

  • As suspected, the tumour was cancerous. The cancer is Renal Cell Carcinoma without any complicating sub-types. This is the most common type of kidney cancer.
  • The tumour is categorized as Stage 1 (on a scale of 1 – 4) – that is, small and completely contained within the kidney.
  • There is no evidence of spread to surrounding tissue.
  • The tumour’s Grade is II (on a scale of I – IV); where I is the least aggressive, and IV the most aggressive, cancer.

“How long have I got?”

I was slightly annoyed in the the run-up to my operation by a publicity exercise from Macmillan Cancer Support, whose publication of updated figures for median cancer survial times was accompanied by a widely-reported sound-bite from their chief executive:

“Finally we can answer the big question: ‘How long have I got?’”

Well, no. We can’t answer that question as everybody’s situation is distinct. If our lives were governed by probabilities I would not have cancer in the first place! A more scientific (and, maybe, more optimistic) approach to making sense of cancer statistics comes in Stephen Jay Gould’s excellent essay The Median Isn’t the Message. In my particular circumstances however the outlook is good: Cancer Research UK reports that for Stage 1 cases such as mine:

[w]ith a less aggressive cancer (grade 1 or 2 kidney cancer) about 94 out of every 100 people (94%) diagnosed live for at least 5 years after diagnosis.

So, especially given that the sample for these figures will contain a large proportion of elderly people, I will cheerfully take those odds.

Watchful waiting

So life returns, if not to normal, then at least to some semblance of it. My next medical appointment is a follow-up CT Scan in three months to check the result of the surgery and state of my organs. All being well, the follow-up regime may revert to a yearly ultrasound scan – since I am “young” it would be unwise to accumulate a large radiation dose from repeated CT scans for the rest of my life, which (I am told) I can now reasonably expect to last a long time …

Comments (9) -

  • Simon

    1/17/2012 11:56:54 PM |

    What a relief that is, especially for Sarah. On behalf of all of us who know and love you, I'd just like to say that it's good to know that you will continue to enrich our lives with your knowledge, wisdom and humour (your faith in the England cricket team being just one example of the latter)! Simon

  • Sarah

    1/18/2012 1:38:52 AM |

    I think this was the kind of appointment where a new camera/lens should be on the cards whatever the result!

  • Tug

    1/18/2012 2:01:41 AM |

    That's really excellent news for you and the family.

  • Gareth

    1/18/2012 8:15:15 AM |

    Trebles all round!


  • Alex

    1/18/2012 4:35:31 PM |

    Thanks everybody!

    @Simon - yes I must admit reading cricinfo when I got home from hospital rather took the edge of my good mood ...

    • Simon

      1/20/2012 8:33:45 PM |

      Still, your score is the best news: 44 not out ...

  • ctrambler

    1/21/2012 12:42:22 AM |

    Sorry for missing you in the hospital. I thought you were scheduled for the 29th!

    Glad to hear that you are feeling OK and not happy to hear that the tumor was not benign.

    Don't worry about the survival stats, I know I have another 20 years to annoy you. (You had been warned!)

    They couldn't be bothered to follow up the surgery with radiotherapy or chemotherapy. That tells me that they are very confident they got all out and, as we all suspected, a bit more to be safe. Hopefully not too much.

    Any chance of a picture of what they had taken out?

  • Murata

    1/23/2012 10:41:25 AM |

    You once said that every thing became easy after the BRM.   Even cancer appears to be unable to make you down.

  • Nurse Ed

    2/22/2012 3:07:28 AM |

    Love finding positive stories within the healthcare field. It makes being a nurse a much easier day to day job when there is a chance of getting good news from time to time.

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