the scoop

"We are what we repeatedly do. Excellence, then, is not an act, but a habit." ~Aristotle

Wednesday, February 6, 2019

Is It Really Any Question?

I guess it’s a big decision, and I don’t want to be flippant about it ... but I keep coming back to this:

"If a kidney lesion is a solid mass, particularly one that picks up blood and thus 'enhances' on contrast CT, it is considered malignant until proven otherwise. In the era of CT scan however, masses are found at a much smaller size than ever before. [...] 


Most patients will wonder why a biopsy is not routinely performed to differentiate between benign and malignant renal masses, and this is currently a controversial area in urology. The classic thinking has been that nearly 90% of all enhancing renal masses are malignant. If a percutaneous biopsy is performed showing malignancy, it actually has not helped the management of a mass in that, as a default, surgery was to be performed anyway. If the biopsy is indeterminate, as it often is due to lack of providing a large amount of tissue for review to the pathologist, one must still act on the assumption that cancer is present. If the tissue is read as benign, unfortunately this test has only an approximate 85% sensitivity, and thus cancer could have been missed. In all situations, a biopsy is a separate procedure with risks such as tumor spillage, bowel injury, hemorrhage and needle site seeding with cancer. Some centers feel that a biopsy can help grade cancer as high or low grade, thus making it easy to offer some patients with renal masses conservative management, but this has not become the standard. Thus, the decision to proceed with treatment is typically based on statistical likelihood and not an actual biopsy."

And so, unless any different evidence presents itself, I shall say goodbye to a kidney and hello to a hopefully speedy recovery wherein I can avoid hearing the C word for at least ... could I have like 5 years? That'd be awesome.

NOTE: I am currently miserable. I have a stent in place from the previous scope procedure. It is a tube running from my kidney to bladder, which causes me to feel a CONSTANT need to void, and all the pangs and twinges and aching which accompany that feeling. I keep hydrated as instructed, which presents its own problems--I'll let you deduce.

My current best friend.
The stent comes out Monday. I'm literally counting the hours. I hope, at that time, to have a better idea of surgery date. Thank you, everyone, for the cards, posts, and fantastic anonymous gifts ... you make me laugh and I appreciate it so very much.

The kids are okay. Ezra is stoic, for him, but also a bit more huggy. Audrey is attentive and a bit more considerate, which is nice :) They seem to have gotten past the extreme fear of the sky falling, and God bless them for being self-sufficient while I hobble around in angry pain.

Only 106 hours to go.


1 comment:

  1. ช่วยตัวเอง ให้มีเงิน Slot Pg เรามาลองมาดูกันว่าถ้าอยากมีเงินเก็บมากขึ้นเพื่อสร้างความมั่นคงให้กับชีวิต ทุกคนล้วนคาดหวังให้ตัวเองสุขสบาย ลอง slot pg มีกิน มีเงินใช้จนถึงวันสุดท้าย ของชีวิต

    ReplyDelete