I responded to Angel in the post "just diagnosed yesterday', where she had said she has a 3.3cm tumor that her doctor is 98% sure is cancerous. In my research for me, and then again for her, I found mostly this type of statement:
Removing a sample of kidney tissue (biopsy). In very selected cases, your doctor may recommend a procedure to remove a small sample of cells (biopsy) from a suspicious area of your kidney. Because surgery is usually the first line treatment for kidney cancer and a kidney biopsy carries the risk of a "false-negative," doctors usually forgo kidney biopsy. Kidney biopsy is typically reserved for cases that are most likely to be noncancerous or for people who can't undergo an operation.

Sorry, hit send by accident. That statement was from http://www.mayoclinic.com/health/kidney-cancer/DS00360/DSECTION=tests-and-diagnosis
It is also stated on UrologyChannel. com and many others. It was also said by my SeattleCancerCareAlliance which is one of the best cancer centers in the world. The reasoning is that there may be bleeding AND that some cancer cells could escape to the nearby organs and you'd never know it. Also about them perhaps missing the part of the cyst that IS cancerous and then coming back with a false negative.
I have a medical background so I when I got RCC I looked on the latest medical sites and found out that the kidney is enclosed inside a sac. An ultrasound can normally 'see' if the cyst is receiving blood. If it is - it is likely to be cancer. Cancer has to have blood in order to grow. A cyst does not. So provided you have a good doc and radiologist - that ultrasound is great! But they then also need a CT, MRI and bone scan to be done. The CT and MRI show more specifically where the 'tumor' is located inside that sac. The bone scan is important to be sure the cancer hasn't spread (metatisized). If it has spread, the normal treatment is immunology. (drugs). For tumors less than 4cm, usually a partial nephrectomy can be done. That is best because it prevents chance of chronic kidney disease, although people live with 1 kidney ok. Partial nephrectomy also gives you chance of having the surgery done in a less invasive way and I can tell you about that later if you wish.
I think the most important thing is to feel very confident in your surgeon, make sure he is aware of the latest treatments, surgical procedures AND latest methods of diagnosis. It's quite easy for them to find out!! Then I think they need to be of the type that explains thing thouroughly to you so you're cmfortable with all of it and can be comfortable with yourdecisions. Of course it's great if they're nice too..teehee. Think that's about all. If you have more questions please message me, I'll watch for them, in case. Stay strong and positive. Wishing you the best! ~Sandy~

Hi Sandy and friends, My doctor has ordered scans of my head, neck and abdomen and boneswhich I agree with but she also wants me to have a ct guided biopsy of one of the small nodules in my lungs. The radiologist believes he can get one even though the nodules are very small. Does anyone know if this is standard procedure? I have requested a referal to Seattle Cancer Alliance but my Group Health Dr said they would still want the results of the iopsy first. Any suggestions? All my scans are scheduled on the 28th of this month and I can't help but feel that I need to start treatment asap!

Hello pchandler- I'm sorry I don't know much about metatasis in kidney cancer or biopsy of the lung nodule. I'll try to look some things up, but no promises.
I would suggest you start a new topic so that the others who've gone thru or are going thru metatasized renal cancer can be sure to see your question and answer appropriately. Many people only read the original poster's question and answer it without reading the other posts. I'd hate to see your important question overlooked.
Hugzz ~Sandy~

pchandler - I'd also suggest you call SeattleCancerCareAlliance and ask to speak to the intake nurse for kidney cancer care. I did, and the nurse I spoke with was SUPER informative and wonderful. She'd be able to tell you if that biopsy is needed for referral to them. Their number is (800) 804-8824 Phone: (206) 288-SCCA (7222) and I got it from their site at http://www.seattlecca.org/diseases/kidney-cancer-overview.cfm
Cya in your own topic post. TTFN
~Sandy~

My Doctors didn't want to do biopsy due to me only having one kidney and there is a chance of uncontrolled bleeding caused by biopsy. They felt like it could cause me more harm than doing any good. They wanted to try other methods before biopsy, re: PET scan first. Of course PET scans do not show kidney cancer they were looking for cancer in another part of my body to do the biopsy on instead of the kidney. Thankfully no other cancer showed up. They were pretty sure it was cancer on the kidney so did laproscopic cryoablation, trying to save my only kidney as long as possible. Of course they did get tissue at that time to confirm their suspisions. Yes it was cancer, again.... MRI again in August.

Dear Angelpuss,

My husband has a long hisory with RCC which metatisized a year following his kidney removal. I recall the doctor wanting to biopsy the small tumor discovered on his lung so that they'd know if it was MRCC or lung cancer for which the treatment would be very different. The biopsy was inconclusive so my husband had surgery to remove the tumor...learning that it was MRCC.

Good luck to you.
Linda

Thanks, everyone for your input here. I guess, when it comes down to it, I'll be guided by my Urologist. He is up there with the latest and is very well thought of in medical circles. Will let you know what eventuates when I see him in November.
Angel

Hi Angel,
My urologist didn't want to do a biopsy on my kidney tumor. It was almost 6 cm and he was 98% (must be a magical number) sure that it was cancerous. He said that it was so big that he was afraid that he would miss the cancer in a biopsy if he only took a portion. He said that in the event it was noncancerous, it was probable that it would have turned cancerous in the future. I agreed to a radical nephrectomy. I had the option for a partial, but my urologist told me, that it would be less invasive, quicker recover and less pain with a radical than a partial. I know that this differs from what a previous post had said. He said that with a partial, they would have to do an open incision. They couldn't do a Lap with a partial, but they could with a radical. He also said that the cancer would be more likely to come back if they did only a partial. I was out of the hospital in a couple of days and back to teaching undergrads in a few weeks. I do 3-4 intense workouts per week. They didn't take my adrenal gland, but it is a possibility. They didn't tell me about that until I was being prepped for surgery. I almost jumped off the table. I am experiencing a lot of fatigue and I have gained a few pounds, but my kidney function is fine.

Good luck to you! You'll be in my prayers.

First on the biopsy question for kidney - in our experience and from two expert opinions, kidney biopsies are not SOP. The protocol with those likely to be cancerous, is remove the kidney. That's it.
As to lung biopsy - PLEASE be sure to get two opinions on that. We thought that a needle biopsy of the lung was a simple procedure. The risks were not delineated to us properly and the procedure went very poorly. My husband wound up with a collapsed lung and the location of the nodules made it impossible for the radiologist to obtain a decent sample. It was all for nothing.
He suffered with that needlessly. So be wary.
Good luck to you.

Hi Glors and the rest of my friends, I had to share my day with you all. I just got back from the Dr's in Seattle ( not Seattle cancer Alliance yet) and they decided against the lung biopsy. They completed all my scans except the bone scan which I will have Wednesday and he told me that there were no other "viable" spots to biopsy so he began the ct scan for the lung biopsy but after 30 mins of pictures he told me that none of the masses are big enough or have a clear enough access to for the risky procedure. He also shared the danger of lung collapse with me which I appreciated and I am glad that he acted on the side of caution. I do not know where we go from here but although he did not give me a lot of information about my scans ( probably waiting for oncologist) I am relieved that he told me he found no masses in my neck lymph nodes as I was concerned because they are swollen on one side. They all treated me with kindness and respect and one of the technicians even stayed in the room behind a shield and talked to me during scans. I was also told that the nodules in my lungs are the same size as they were last month so that was encouraging. I am exhausted from my day but I wanted to share with my ds family. I am in no rush to discover how much my rcc has spread but I do want to start treatment asap.

Hiya again Pchandler- I know you're exhausted and I bet it's mostly from the mental stresses of all this! I know I was! But ---- good news that the lung didn't get biopsied, good news of very small masses in your lungs and Great news about no spread to lymphs in neck! All is all a good day, I'd think.
I'd suspect the radiologist needs to read the scan now and by the time you get the bone scan (so happy you're getting it done btw) and get those results by probably Monday or so, you'll be all set for your appt with Seattle Cancer Care Alliance.
So for now, I'd suggest you rest as much as possible, eat well and relaaaaaax! Live your life as normally as possible and even spoil yourself some, cuz you're going thru a lot and deserve it!
Thanks for posting again. Was thinking of you and wondering.
Big hugzzz again ~Sandy~

Hi Sandy, Thank you for your encouraging words and I am trying to relax but it is tough because even though I feel that the world should stop now that I am experiencing this surprising the world around me has not changed at all:) Kids still being frustrating, bill collecters still calling, work and schoolwork still demanding ( what's wrong with them? Don't they get it? ) I am trying to be optimistic today but I guess the truth is that I will keep imagining the worst until all tests results are in and shared with me. I so appreciate your words! Thank you

Awww Pc - You sure brought back memories for me. I remember so much how at first, I kept thinking that people were somehow supposed to, I don't know, maybe gather around me, recognize me and my 'condition' more, and virtually just stop being so danged normal. It all seemed sort of surreal to me. teehee. Thing is tho that once I realized and accepted that there was nothing I could do but wait for the 'whatever is going to happen with me', I began to also realize that I truly appreciated that everyone was just being themselves and then I began to look at them all in a different light. I began to really love the things that typical kids do, or the dog did, or my hubby. Maybe it's a 'normal' reaction and process that we all go thru, I dunno. but from that, even 3 years later I still look at a lot of things with more 'fervor' I suppose it could be called. I still appreciate all the people, smells, skies, outdoors, etc more it seems than I had before my cancer. I also seem to really appreciate hugs and offer them more often. hahaha, but that's me.
It's such a scary time for you now. but luckily time will pass more quickly than you think and you'll soon be on the road to recovery. You seem like a strong woman and I'm betting that you WILL survive this mess and come out stronger! Hang in there, and if you want to just talk, message me or catch me online and PM me.
Stay strong! Huge hugzzzz ~Sandy~