My Transitional Cell Kidney Cancer: Diagnosis and Surgery

I started having sporadic episodes of  blood in the urine back in August 2009. The person on my physicians call-exchange alarmed me with "Sounds like bladder cancer." Not what you want to hear. I went to the ER, and had a CT scan that showed nothing really out of the ordinary. The diagnosis was probable kidney stones, though none were found. Due to some bacterial infection found, I was given antibiotics and sent home. All seemed to be well, so I carried on with life as usual.

A couple of months later another episode of blood in the urine, another visit to the ER, another CT scan. Same diagnosis: probable kidney stones, though again none found. This time my primary physician sent me to a Urologist, who did a cytoscopy, which revealed nothing abnormal in the bladder. The condition went away. However, one of the attending docs at the ER remarked about a "shadow" on the left kidney CT scan, which he had some suspicions about. He thought this could be a kidney stone stuck up in the kidney. He called my urologist with this concern, but my urologist seemed unimpressed with the evidence that this might be something serious, partly due to the fact I've never been a tobacco user and was still fairly young. Still seemed like maybe kidney stones, as I was presenting with some back and flank pain. I had passed some gross blood clots and such during urination, though maybe there might have been some small stones in there.

When another bout of gross blood in the urine occured in late July 2010, my urologist had seen enough and ordered a comprehensive CT scan with contrast. This time, the scan revealed a mass in the left kidney, which was diagnosed as probably being transitional cell carcinoma. I felt the blood drain from my face with the news. He recommended surgery as soon as possible to remove the left kidney and ureter. He said, "Don't be too anxious, we can fix this." A biopsy was ruled out as being to dangerous, due to risk of spreading the TCC, which he called a "nasty" cancer. 

Telling my wife of 27 and my 26 year old daughter was one of the harder things I have ever had to do. I remained optimistic and as upbeat as possible through this time and the surgery. My wife and daughter's support before hand and in the hospital was priceless.  

 August 31 was admitted to the hospital, and suddenly it all seemed very real. Don't think it had really sunk in until then. I don't even remember going to sleep. One moment they were wheeling me around on a bed, the next moment I'm waking up and seeing my family. The surgery was done laporoscopically by my urologist and his collegue, with just 2 small incisions, but a larger 6-inch incision in my belly was required to remove the ureter. No cancer was shown there on the scan, but since this cancer is notorious for spreading it was recommended they take this too for safety's sake. 

I was up walking laps in the hospital the following day, the pain was moderate but well controlled, and I went home 3 days later. The surgeons had done a good job, said the kidney had "come out cleanly", and they felt good about the surgery. I was feeling great, relieved that the surgery had gone well, no other evidence of cancer found outside the kidney, and it seemed to be contained in the inside part of the kidney capsule. 

My upbeat mood was attenuated somewhat when the pathology reported classified the tumor as a T3, high-grade, the doctor classified it as aggressive. About golf ball sized. The urologist set me up with a consult with oncologist due to the serious and rare nature of TCC. It became apparent then that my battle with the beast was not over, as I first thought. 




Mike Fitch Author