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vickyj Asked September 2013

Is clear cell kidney cancer that has metastasized to the lung, small or non small cancer?

. 83 yo mother had a kidney removed 5 yrs ago due to clear cell kidney cancer. In 4-13 she suffered a bad fall. while in hospital getting xrays dr found several large masses in both lungs. Dr says no need for further testing as her body and health is too fragile for treatment . Called hospice and told us about 6 mos . It has now been 5 mos and other than extreme fatigue I am seeing no other symptoms. Is rcc that has mets to the lungs small or non small cancer ? It is very hard not to know what is going on.

vstefans Sep 2013
It has to be awfully hard given that she was independent just 5 months ago. I'm hoping they did not just assume she was too frail to do anything because she took a single fall, if that was not the case. I had to tell staff that my mom had been independent and not demented up to a few days before she fell at home...she had an MI and the confusion significantly cleared up...for a while. Once they knew that, they offered her heart surgery that might have prevented progression to untreatable disease less than 3 years later, but she declined it, saying "maybe later" and later never came. It turned out she never got back home in any event, though it was her dearest wish, but that's a longer story.

There are some surgical and medical options for clear cell renal cancer with lung metastases if you feel the idea was dismissed out of hand without them knowing your mother and/or without your mother learning more about them. I got into the literature by Googling pulmonary metastatic clear cell renal, and probably the two best articles I found were
www.cancer.gov/cancertopics/pdq/treatment/renalcell/HealthProfessional/page1/AllPages/Print
and There are even a few clinical tirals out there related to this situation as well.

But, at this point it may very well be that the answer might be the same as the first doctor's recommendation even if you review every scrap of literature and consider every single risk and benefit. Mom's wishes count, and if the leg pain is due to bone metastases as well, it would seem more likely that good hospice care is the best thing. No one can fault you for going either direction with this. We all have limited time and its more about what you make out of that time than how much of it. It has got to be a blessing for Mom you are at her side, and may God bless you both.

vickyj Sep 2013
* that feel was FAIL....

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vickyj Sep 2013
Thank You for the input. It is so darn hard not knowing what we are dealing with. Hospice has just got involved but they also have no answers. At times I feel like I am just watching her body feel so quickly but she still eats like a horse and all vitals are great. Lots of pain in her upper legs, gets worse at night. Hospice and Dr are not sure if it is cancer related . Everyone keeps telling me not to put her through more tests, mom keeps saying no tests , she is too tired , maybe tomorrow . So sad, 5 mos ago she was living on her own, walking her dog and now she can not get herself dressed.

lsmiami Sep 2013
There is a lot of good info on cancer in the web. Bottom line cancer sucks!
If she has extreme fatigue and is not a candidate for aggressive treatment, hospice may be the most humane option. chemo and radiation treatments are rough. God bless you both on this difficult journey

vstefans Sep 2013
Small cell and non-small cell refer to primary lung cancers, so that would be neither. I am not a cancer doc, but found this suggesting that this situation is compatible with longer survival, What I don't know is if just seeing masses on CXR is enough to confirm it's the metastatic clear cell renal cancer, or whether there is some chance it could be something else altogether, like a treatable infection. But you and your doc would have to make the call that any method of biopsy would be tolerable. I can see wanting to be more sure, and not wanting to just do nothing because of age - 83 isn't that old - but a lot of things go into that decision. Maybe just another chest x-ray would help be more certain?

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