my 86 y.o. father was just diagnosed with metastatic renal cell carcinoma, clear cell type by needle biopsy of lung. Kidney removed 7 years ago and lung nodule just found in yearly PE. Ruhman (?) grade 2. Pending apt with oncologist and surgeon. Options given were open chest surgery vs chemotherapy. What to do? He s is good health except for HTN and arthritis. Surgery scares me. Please provide your opinion if you can. Is this a slowly growing ca? Thank you
Hi, Thanks for writing in. Having a kidney removed 8 years back is rarely associated to cause a lung nodule after so long, However, any patient with history of cancer treatment in the past must be completely evaluated should they develop any lung nodule. The size and appearance of nodule is important. If it is less than one centimeter then it can still be observed. Proper diagnosis of nodule must be made after doing CT scan chest. As he is in good health and has no other signs of cancer, it will help to consult the oncologist and surgeon. It is better to do a CT PET scan to make sure that the nodule is a cancer. PET scan will pick up rapidly metabolizing or growing nodules as bright spot. If this feature is seen in the PET CT scan then the possibility of a cancer is confirmed. If the nodule is bigger then a biopsy can also be done to confirm with a pathological diagnosis. If cancer is present then chemotherapy and radiation can be started if he is not keeping fit for surgery. Please do not worry.