Avoiding Unnecessary Treatment of the Small Renal Mass | Brian Shuch, MD | UCLAMDChat

Join UCLA urologist, Brian Shuch MD, for a conversation about novel imaging techniques and genomic profiling to detect and treat small renal masses. Dr. Shuch is Director of the UCLA Kidney Cancer Program and the Alvin & Carrie Meinhardt Endowed Chair in Kidney Cancer Research.
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[@user-uj3fp9lf8h]

I'm Korean, 58 old and lived in Seoul. I got dianosed as "Renal Carcinoma" with 4.0 cm, 3 years ago (Almosy no sympton). After I got the "Partial Nephrotomy" in Bundang Seoul Nation Uni. Hospital, My face turned to 10 years younger!! After surgery and the pathology result shows "Borderline malignancy right Kidney". The surgery cost with one week hospital bill was only eqivalnt to U$2,200.00 thanks to Korean National Insurance Policy. After that I go hospital for CT check with Kidney or Lung very year.

[@baphiri9703]

🙏🏾🙏🏾🙏🏾

[@BeckVMH]

Thank you for the detail and very reasonable approach and further research. Well explained for the lay person.

[@robinl3g436]

Watching this after the fact, but I just had a 1.6 cm renal mass destroyed by cryoablation. I'm 58 and was uncomfortable with just active surveillance. I actually had a local surgeon argue for radical nephrectomy. So glad I got a second opinion.

[@SisterPatGoad]

Can a 3.1 left renal tumor being too close to the main arteries be such that a radical nepharectomy should be done? Located at the renal pole. That is what 2 surgeons have said. ???

[@SisterPatGoad]

I am 68

[@bonitatorres5543]

That's exactly what Dr. Schuch is talking about! Unnecessary surgery!

[@seniortraderabacus6203]

@@SisterPatGoad Hi, I have a small mass near the renal pole too. Was wondering what you ultimately did.

[@prbgh5378]

@@seniortraderabacus6203could you decide about it? My husband has 2.5 cm near the pole, we found it accidentally and recommended partial nephrectomy, but it is not in good location and has risk of need to do radical. Not sure just monitor that or do surgery

[@kristafogle2803]

Watching this as I was just discharged from the hospital. I found out I had a Kidney mass in November 2021 due to a CT scan done for something else. Went round and round with urologist and radiologist with no help on what to do. On March 14, 2022 I went to ER in extreme pain. They did another CT scan and the mass had ruptured. They did a procedure to embolize the mass. Per my scans, the mass was 5cm in 11/2021. 6cm in 01/2022 and 7 cm in 03/2022. So either it grew rapidly or someone did not measure correctly. This was an angiomylipoma on my right kidney.

[@sharonarmstrong4578]

@Krista Fogle I have too just been diagnosed with a 22mm x 17mm mass on my right kidney at the lateral cortex. I am going for a further contast CT scan next week. Mine was found as yours, unrelated scan. I am not sure what the next process will be, but my anxiety in through the roof worrying about the outcome. I hope you are recovery ok, but what a nightmare you have been through.

[@Coco-og7zw]

@@sharonarmstrong4578 ... Hi Sharon. How did everything go for you? Like you and Krista, I was just diagnosed with mass (6cm) on my right kidney. My anxiety right now is at 100. Would love to know how your Drs proceeded.

[@Coco-og7zw]

Hi Krista. How are things going for you? Did you do surgery?

[@sharonarmstrong4578]

@@Coco-og7zw I am sorry to hear with your health issues. My urologist to going to keep an eye on my lesion. I have to have an ultra sound done in about a month to check to see if it has changed in size. Depending on the outcome this will determine what we decide to do. I hope you can get some help.

[@Coco-og7zw]

@@sharonarmstrong4578 ... Thank you Sharon. I'm going for a Pet Scan and MRI on Tuesday so my medical team is going to come up with a plan after they see the results of that.

[@eileenmacdougall8945]

Thank you Dr. Shuch. I was diagnosed with transitional kidney cancer July 8, 2019, after gross hematuria I think it's called. Anyway, the urologist did a cystoscopy and biopsied a mass and right away recommend my right kidney and right ureters out, plural as right side has two. Anyway thank you for such a clear presentation. Very informative.

[@ritastutler1470]

Did u have the surgery

[@hodalatif3334]

Thank you very much for your up to date information. I have been diagnosed with 1.3cm benign tumor in my left kidney and 8.00mm in the right kidney. The respectful doctors monitored it every 6months and they finally discharged me. They told me after the age of 40 the type of hormone involving this type of tumors will not be active in this stage. But, I sometimes I confuse muscle back pain with kidney pain in the cold of winter.

[@chenlong5923]

very good presentation. I learn a lot from it. thank you for sharing.

[@johnmcnamara1038]

Very informative and thought provoking. Just recently diagnosed with a small RCC. Thank you.

[@nitaharding5130]

How are you today?Have u had treatment?

[@cindyjones8284]

I had partial nephrectomy for 2 cm tumor. Said could watch it but I wanted it out. Good thing. It was small but a more aggressive form of cancer and y in the margins. It has been 4 years. No sign of recurrence.

[@Lawsonsworld17]

I am 34 and I have been undergoing ultrasounds the past year and now going to a ct scan. Should I ask for a biopsy or just ask for it out? It is 1.7cm. I’m just concerned because of my age. I will be monitoring it for so long.

[@EvansBrosRacing]

So , a biopsy is NOT covered by insurance , but the surgery to Remove the kidney is covered ? How on earth does that make any sense at all ? My brother was just told he has a 6.6 cm mass on his kidney , they found it from an MRI he had done for back pain . I am looking up info and found this video . We are waiting to get the CT scan to get a better look at it . They say there is also a mass on his aorta , and they think it is an aneurysm . He is 61 years old and also smokes . I have a feeling he will say no to any more scans or surgeries and will just take his chances .

[@rkvlogs8082]

How are now? God bless you🙏🙏🙏🙏🙏🙏

[@ritastutler1470]

I just got a mri of the lumbar spine. It showed hypo enhancement of the right kidney. I have to have a cat scan in three weeks. The thing is I had a simple cyst. Could it have changed..someone said I had a mass now. You helped my anxiety one hundred percent. Thank you very much❤❤❤

[@biaedwards4025]

Thank you for this candid educational chat.

[@noemifitzpatrick6039]

My mass is in upper near tubular vena cava & 4X3 cm. Was found by accident as UTI - gross HEMATURA. I opted for surgery of a SIMPLE NEPHRECTOMY with adrenal gland kept. My logic is: remove the mass with kidney. Cancer or not, had I left it through out the years- not knowing. The “bad boy” would have popped into the vena cava- & I’m blessed it was discovered by accident… ✨🙏🙏✨

[@mikeevans6589]

Thank you for your video. It is unfortunate that many questions here have been left neglected for replies.

[@dennislurvey3235]

I was told recently by a cardiologist that sometimes doctors do procedures JUST FOR THE MONEY!!

[@Sunkissedguy]

Thank you for this video. I was doing research because my dad recently had this. I appreciate this

[@kyleyoakum9383]

Greatly encouraging.

[@prbgh5378]

Thanks for your knowledge. Any update on this one after 5 years? New researches, tools, solutions for small mass?

[@lucille284]

Thank you for the info. Have one question. Why did you take out the 1.5 cm tumor?

[@elwafi2001]

This is life saver presentation, thank you very much! I have 2.5cm

[@prbgh5378]

What decision did you make? My husband has 2.5 cm solid mass on right kidney near the pole, we found it on unrelated scan and three Urologist recommended robotic partial nephrectomy, but as it is not in good location, has big risk of loosing the kidney. Not sure just monitor that or do surgery as all recommended us

[@alkhan4921]

Dr.Shuch sincerely appreciate your very detailed informative discussion about renal cancer. I was informed by my primary physician few days ago that a recent CT scan found 3.5cm Renal mass. I am lost found and surcharging in-depth information about why and how to seek appropriate diagnosis. Finding a facility and specialist is upmost difficult having the pandemic environment. In the event to have any type of procedures is mind bugling. I like to thank you and congratulate you for making me understand what to look for and to expect. I wish you were practicing In east coast, hoping my urologist who I have appointment on 17th of September will be as forward thinking physician as you.

[@yassmina6220]

Hi how are you? What did you do with the tumor?

[@alkhan4921]

@@yassmina6220 Hi Yassmina, Thanks for placing your question. So far I have consulted two very well known explained renal Sargent at Washington Hospital Center in DC. One of them has done numerous surgery and was recognized with honorable rewards. Which I never heard of. Also I have an appointment with one more urologist at John Hopkins Hospital in Baltimoe on the 11th November. I am searching for a sergeant has experience in laparoscopically to remove the cancer tumor as well has well bed side manners. I will choose the one has confidence to remove my specific type of growth with best track record in my area. Hope and pray the one will have patience like Dr.Such. Regards-Al

[@yassmina6220]

@@alkhan4921 Doctor have been watching my dads tumor. You find a doctor that doesn’t want just money and see you as a subject not human-been before you make a decision. Life never go back to normal after you cut out a piece of the kidney. Read about it inform yourself I read that not all tumors are cancers and doctors don’t know for sure until they take it out . Some rumors never cause any harms even if they stay.

[@sheilaconroy]

Have a biopsy.. rules it out. My husband did on his 2cm tumor and its cancer.. hes having a cryoblation in the morning

[@arymhansie]

All the best to you and your husband-hope all goes well!

[@yassmina6220]

Hi how is your husband?

[@mzaman1999]

What happened to him? Is he okay

[@hamed943]

Very good and informative.

[@4yt158]

Thank you! Very helpful as my renal ultrasound indicated a small mass of 2cm...

[@sharonarmstrong4578]

@Vamsi Parasa They have found a 22mm mass on my right kidney. I am quite worried about it. What did you end up doing?

[@mamush6305]

I was diagnosed with kidney mass 4 inches that said Last week and I can't even work and function very well since they told me that i have to do surgery to find out if this is Cancer or not and to remove that part or to remove the whole my left side kidney the way they told me i don't have hope to survive and live longer , im in this situation right now i couldn't find anyone to give me any hope 😭😭😭😭😭

[@rkvlogs8082]

How are you now? God bless you🙏🙏🙏🙏

[@BeckVMH]

Nancy, his name and medical facility is in the video description. There is an arrow to click to expose the description. Never mind... he’s Dr. Brian Shuch, UCLA.

[@EttevyD]

I have a 6 cm one on my right kidney. Doctors scary, they told me this could rupture 😢

[@TKFOO84]

I'm wondering cryoablation vs radiofrequency ablation which is better to treat benign kidney cancer with 3cm+?

[@debbriggs5811]

Is it considered RCC with any tumor? How do you know if its benign. Is a benign tumor staged? How do you know when to stage it and what stage it is? What is considered a "small" tumor. How do you know what type CA it is without a biopsy. Can you have 100% kidney function with a tumor present. How does a tumor affect kidney function. Is there a difference of concern or tx if a tumor is on the inside of a kidney vs a tumor on the outside of a kidney. At what point do you decide to remove it or try a treatment while observing it. Can tumors completely go away with tx. Do you continue observing the kidney even after a tumor is removed and how often and how long. Has there been success in curing kidney CA? What to do if it has metastasized. Once a tumor is removed, what are the chances of it returning. Would you want a tumor removed if you had one. Is it hereditary. Is there a test for a gene to kidney CA. If so, what test is it and how to get the test. My husband passed at 41 from kidney CA in 1995. He could not find anyone who took him seriously when he c/o back pain. They just told him he needed to do stretching exercises. By the time they did a scan it was too late. The Oncologist suggested the possibility of a trial tx but didnt move on it quickly and never had the chance to try one. He passed within months. Please tell me theres advancements made for tx and a cure. What suggestions do you have for those who find out they have a tumor and who to see in order to make the best decisions.Thank you.

[@stevecocran4899]

Thank you doctor

[@gatorgurl1598]

I have a hypervascular mass on left kidney. It’s 1.7 cm I also have CKD stage 3a

[@denise8216]

I had a RCC Cryotherapy 3 yrs ago it was found awhile bk but never mentioned was via CT for fatty liver. I was told after 3 yrs Zero reason to follow up is this true? I saw in another report CT showed another small spot on my other kidney. The Dr said original RCC was size of a half dollar. My Late sister passed of ovarian cancer and it returned over 4 yrs later ( so I had a Total hysterectomy and low and behold I got RCC!) So the Dr never tole me benign or not he just said I no longer have to follow up with it although another CT showed another spot on other kidney small 3 yrs ago that's how 1st 1 was. I'm a swf 60 yrs old and I feel I'm having kidney problems now vomiting etc. Please Respond 🙏. Tyou from Wilmington North Carolina 3/27/22

[@denise8216]

I have major gi issues too and copd

[@andys8702]

I have 4.1 cm tumor on my right kidney the MDt bored have said take the kidney out they said they can do a biopsy but I'm still very worried about tumor seeding spreading cancer cells I know the doctor above says this doesn't happen but some doctors say it does my doctor said theoretically yes so don't know what to do.

[@djamelsibachir1417]

Hi Andrew .how are you today? Did you take any action? Partial nephrectomy? Let me know Good luck

[@akliluyeshitlayoutube4576]

we need your advice, the doctor told us my wife has 2.7x2.6 cm kidney cancer, which seen by CT scan and he appointed us to carry out the removal of kidney after one days. please advice us and we need your help

[@skhochay]

second or third opinion

[@yassmina6220]

Hi what did you end up doing?

[@WWPlaysHoldem]

Is the clinical trial still ongoing in 2022? I have a 3.5CM cancer on my right kidney that was biopsied at UCI a couple of months ago. Waiting 6 months for a recheck as suggested by the Urologist who has since left UCI. I would join your clinical trial if still open.

[@Dakudi1945]

My sis recently had 8cm ×10cm retroperitoneal mass on left side of kidney removed by robotic surgery in india by a renowned onco surgeon.what prognosis do u see?? Histopathology report awaites.she has no symptoms except upper left lkmb DVT

[@rkvlogs8082]

From where you have done the surgery? Please tell me

[@krishnaDas-ce1df]

@daxashah

[@krishnaDas-ce1df]

Please mention the name of the doctor

[@sehnazkhan3365]

Kidney tumor on the upper pole of kidney which is 9mm in size. Can we go for ablation instead of laparoscopy or robotic laparoscopy or nephrectomy. It is asymptomatic tumor.

[@wayneash8868]

Im in this boat they want to do partial nefrectomy im 40 years old can i do active survalence

[@yassmina6220]

Wayne Ash hi what did you end up doing?

[@walterbuller9171]

What is your definition of a "small" renal tumor? What size in centimeters would that be? Thank you in advance.

[@sharonarmstrong4578]

Done seem to get any answers here from the presenter.

[@bobx1034]

no way he can answer all questions and trying to provide medical advice on KZbin could only lead to misunderstandings and legal problems. use gòogle 2cm and less typically considered a small tumor.

[@shujaatali2442]

If avioding یا necessory treatment please what remedy for kidney back pain

[@lindaglover580]

What a iliopsoas mass the tube from the kidney and bladder? How can that be treated?

[@gulsonronghang1852]

I'm from India and aging of 30 yrs male. In my recent ultrasound report i have been diagnosed with a renal mass increase of 2.61×2.72 cms present on my left kidney. My doctor asked me visit the urologist. Please kindly give me a better suggestion

[@metube1942]

Konsa treatment liya apne ab kayse hai ap

[@juanchy2317]

Doctor I have angiomyolipoma 8mm left kidney.is it's bad???

[@chiquitababy5]

What is the difference between a simple cyst and a hemorrhagic kidney cyst? Is a hemorrhagic cyst cause for concern?Thank you in advance.

[@branem.2254]

What is a small tumor ? What would 6cm ×5.5 cm tumor be considered? What do u suggest for this patient? Thank u

[@rweaver8140]

Exactly as you described for a CT scan for something else they found a 3.2 tumor on my kidney. It was not there or wasn't apparent in 9/16. So from then to now it is 3.2. They are saying it is malignant but hasn't spread. It it possible to tell both of these on a Ct scan with contrast?

[@yassmina6220]

R Weaver hi what did you do next?

[@rweaver8140]

yassmina Yassmina getting it removed and trying to figure out if there is anything I can do to keep it from spreading

[@yassmina6220]

R Weaver why can’t you wait for now and keep an eye on it???

[@Peggyznd]

Per most kidney cancer experts, this may have been so small NOT to be visible, or simply overlooked by the radiologist. To know if it is malignant, they must to a biopsy first. At present you cannot determine if a mass is malignant by CT scan with contrast. Again, a biopsy will be the only way to know. Too often a small mass is removed with this major surgery, but without knowing beforehand if it is a cancer, and that may not be the best for the patient. Ask for a review of the two CT scans by a kidney cancer expert and request a biopsy. With that you will have more information to make a good decision. I am a 16 year survivor of STage IV kidney cancer, a 10cm tumor with metastases in my lungs...no free of kidney cancer. In my case with that softball-sized tumor is very different than yours. I would have a biopsy if I were you.

[@rweaver8140]

Thanks. I already had it removed, about to be my first scan to make sure it hasn't come back. It was cancerous

[@xhappynonsense]

Im 28 and did a renal ultrasound last month that showed a small solid nodule of 0.4cm on my left kidney after feeling some pain in my left flank. I don’t have any other symptoms but recently started feeling a dull throbbing pain in the left mid back area. I don’t have any other symptoms, no blood in urine, no nausea or vomiting and my bowel movements are regular. I’ve been drinking more water lately. What are the chances of this being cancerous?

[@MicahHTX]

Same.problem

[@madmade6877]

Thats tiny

[@GabrielTheMagolorMain]

What ended up happening?

[@blitzchaserjzx100]

I've a 2cm one on left kidney no symptoms

[@mennamounir4342]

Can an itp patient do a surgery in kidneys??

[@stevelora1539]

If I had a 1.8 cm cyst, Id just have Ultrasound 6 to 12 months later. If its same or smaller then, then its probably nothing

[@ceciliamartin9409]

How can we get in touch with you Doctor?

[@yassmina6220]

Please answer me. My dad is 68 with 3.8 cm solid enhancing mass. Is surveillance a good option? How fast does renal cell carcinoma grow?

[@Peggyznd]

A tumor of that size 3.8cm is considered 'small', and appropriate surveillance might be a good option. Renal cell carcinoma is generally quite slow-growing, and may be 'indolent' or lazy as to growth history. The value of a biopsy is to understand if this is indeed RCC or is a mass that is NOT a tumor. If the doctor does not recommend it, seek another opinion. You must also be aware of the general health of your father, whether he has any symptoms that would interfere with surgery, and if possible, whether he can continue to be watched. Only a biopsy will give you enough information. Until that time a surveillance of 3-6 months is a good option.

[@kimb7543]

what if its a large mass. 9.8 ×6.8 ×5.4

[@yassmina6220]

KIM BALLARD what did you end up doing?

[@Rahul-rn8hs]

@@yassmina6220 do you also have Angiomyolipoma in kidney ?

[@sukritigrover124]

My father has 6.5 cm renal mass, 68 years age with no symptoms at all. Should we opt to remove the kidney ?

[@qazimuhammadusman5989]

What you did ?

[@sukritigrover124]

We got the kidney removed, later got to know the tumor was benign. its been 3 months now, he recovered mostly.

[@carlo344]

@@sukritigrover124what bengin type was it? All the best

[@nancyplawecki6564]

What is drs name? Hosp he practicesat?

[@bobcatwong811]

I just found out from a ct scan i have a partially exophytic heterogenous enhancing mass in the upper right pole .3.7 cm and is consistent with neoplasm .what advice would you give me ?

[@yassmina6220]

Bobcat Wong hi what did you end up doing?

[@nuckingfuts9527]

same

[@TKFOO84]

Hi Bobcat Wong, I just found out i have about 3cm cysts, wondering what did u do to get rid of it.

[@wadeadams9471]

The reason why you're finding a lot more tumors in people. It's because of the garbage food. Then garbage beverage drink. I have a 4 cm on my right kidney. I am 57 I blame it on the garbage food.

[@jeetdebnath2917]

🙏🙏

[@bristephens9642]

❤️🙏🏽❤️

[@Its__Mohit]

Sir i need to contact u

[@arymhansie]

@John Levison Oh my God, you have been through so much!!

[@Dakudi1945]

Her kidney is not involved

[@kristinajakakas9068]

71%?!?!

[@sandeeforeshee3567]

Sir, i feel you should understand something more….you seem to be missing one fact…PEOPLE are more important than things! Your probably a great doctor, dont get me wrong please. But health care cost is not something that should ever be a reason “to do harm”…your all different today than the doctors we used to have…every single person is different…how can you group together percentages of hearts and souls? Where is a basic moral compass here????

[@Clarkson350]

8 percent seems statically very low

[@chriseybrown5790]

Thanks doctor 💋