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Hodgkins Disease,thyroid Cancer,breast Cancer,skin Cancer,blood In Urine,renal Test,shadow.Cancer?

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Posted on Mon, 28 May 2012
Question: I am a 53 year old woman who is a 4 time cancer survivor. These cancers include Hodgkins Disease, Thyroid Cancer, Breast Cancer Stage II (both breasts had cancer) and more than enough skin cancers in my lifetime. Last year, during a routine physical there was a trace of blood in my urine. They sent the blood off to get cultured and it was negative for infection. Eight months later at my routine check-up, they repeated the urine test and I was showing moderate blood (+5). It was determined to have me visit a urologist. Urine cytology was negative, U/S of the renal showed a shadow on the left kidney and they immediately scheduled a contrast CT for further evaluation. I am also to have a cystography tomorrow.

My question. If the urine cytology came back negative, would that excludea cancer issue? What exactly does a "shadow" mean surrounding the kidney?

Thanks,
doctor
Answered by Dr. Robert Galamaga (12 hours later)
Hello and thanks for the query.

First of all WOW congratulations on being such a survivor, fighter and inspiration to all of us.

As far as your concern regarding the shadow near the kidney, this really means there was an irregularity in the density of the tissue which normally surrounds the kidney.

This could be something like some fatty tissue, a cyst or some kind of growth. This may be nothing at all but I think it is appropriate to followup with a CT scan to get a good look at all of the tissues in the area to rule out any significant abnormalities.

The cystography will give the physicians a good look at the inside of urinary tract and help to rule out any pathology from the kidney down to the end of the urethra. Again, I think this is appropriate for you to get it done.

Regarding the urine cytology, a negative study does not to 100% rule out cancer or a disease process within the kidney or bladder. It is a test which helps us sometimes diagnose things like cancer, however. The urologist did not find any malignant cells on the cytology which goes against cancer in your case as well.

I think the ultimate peace of mind will be obtained by getting the CT scan done. After that you can get a comprehensive work-up and evaluation done. Decisions can be made regarding further work-up if needed or you can finally get some reassurance that things look fine.

I know this must be causing you quite a bit of frustration and anxiety but I am confident that your physicians are doing everything they can to complete a comprehensive workup.

I thank you again for the query and I hope that you find my answer to be helpful and informative. Should you have additional concerns, I would be happy to address them.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Robert Galamaga (7 hours later)
Thank you for your response.

I got the preliminary dx u/s report and it states:

"Retroperitoneal US which noted a solid homeogeneous mass superior to the Left Kidney"

This is all the information I could obtain, so my understanding since this is a solid mass they are looking at a possible malignancy, as in tumor?
doctor
Answered by Dr. Robert Galamaga (14 hours later)
Hello again,

A tumor is certainly a consideration but it could be a cyst with solid component as well. This is why a CT scan is warranted. One step at a time they will get to the bottom of this. The CT will further describe the density of the area and whether it is connected to or separate from the kidney.

For the time being try not to worry and focus on maintaining adequate rest, good diet and exercise which regardless of the findings of the CT scan will help you maintain an optimal quality of life.

Thanks again for the query. If you have additional questions or if you'd like me to review the CT findings when they are available I would be happy to do so.

Sincerely,

Dr. Galamaga
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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Hodgkins Disease,thyroid Cancer,breast Cancer,skin Cancer,blood In Urine,renal Test,shadow.Cancer?

Hello and thanks for the query.

First of all WOW congratulations on being such a survivor, fighter and inspiration to all of us.

As far as your concern regarding the shadow near the kidney, this really means there was an irregularity in the density of the tissue which normally surrounds the kidney.

This could be something like some fatty tissue, a cyst or some kind of growth. This may be nothing at all but I think it is appropriate to followup with a CT scan to get a good look at all of the tissues in the area to rule out any significant abnormalities.

The cystography will give the physicians a good look at the inside of urinary tract and help to rule out any pathology from the kidney down to the end of the urethra. Again, I think this is appropriate for you to get it done.

Regarding the urine cytology, a negative study does not to 100% rule out cancer or a disease process within the kidney or bladder. It is a test which helps us sometimes diagnose things like cancer, however. The urologist did not find any malignant cells on the cytology which goes against cancer in your case as well.

I think the ultimate peace of mind will be obtained by getting the CT scan done. After that you can get a comprehensive work-up and evaluation done. Decisions can be made regarding further work-up if needed or you can finally get some reassurance that things look fine.

I know this must be causing you quite a bit of frustration and anxiety but I am confident that your physicians are doing everything they can to complete a comprehensive workup.

I thank you again for the query and I hope that you find my answer to be helpful and informative. Should you have additional concerns, I would be happy to address them.

Sincerely,

Dr. Galamaga