Doctor Q&A

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I am 65 years old and have had mild to moderate lower back pain and urinary difficulty for about a year. I had a CT scan at Queen's Hospital on July 2nd. On August 14th, the doctor informed me of a 2.6 cm tumor below my right kidney. Preliminary imaging suggests it may be renal cell carcinoma, but it hasn't spread to the lymph nodes or liver. I am currently scheduled for a follow-up appointment at the Urology Department of Queen's Hospital on September 26th. I am a stroke survivor with left hemiplegia, but I can get out of bed and manage basic daily life and walk with a cane. Am I a suitable candidate for surgical removal of the tumor? How is cancer diagnosed before surgery? Which private medical institutions in Hong Kong offer services for cancer cell diagnosis, tissue sampling, or surgical removal?

It appears the computer sketch from early July did not include the lungs. If it wasn't included, a separate computer sketch of the chest should be done, or a full-body positron emission tomography (PET) scan should be performed to accurately determine if there has been any spread. If there is minimal lung spread, staged resection may be possible.

Stroke recovery patients are not excluded from surgical treatment. Compared to the progression of the tumor and the development of various symptoms, the benefits of removing early-stage tumors far outweigh the surgical risks.

It's worth noting that risk factors for stroke, such as high blood pressure, diabetes, and high cholesterol, can all affect kidney function. If kidney function is too poor to allow for the removal of the entire kidney, then partial nephrectomy may be considered.

Besides imaging, image-guided needle biopsy can be used to extract tumor tissue for testing. If the tumor is confirmed to be malignant, then a partial or radical nephrectomy can be performed. I do not recommend removing the entire kidney based solely on imaging data, as there is a possibility the tumor is benign. If that is indeed the case, a healthy kidney would have been wasted.

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