The End of a Long Journey…

Unfortunately, I find myself writing this last blog.  Remember in my previous blog when I said that I thought there was a reason why I chose that video for my post?  Well, I know what the reason is.  My father-in-law, who I called Robert in this blog, passed away last Tuesday, October 20, 2009.  He had been fighting renal cell carcinoma for nine years.  This really came as a shock to us all. 

On Sunday, two days before he passed, my step-mother-in-law, Cathy, called Cole to have him meet her at the hospital because Robert was acting funny.  He was kind of delusional, which is something we were all used to as it was a sign of his urinary tract infections.  Cole quickly headed to the hospital, not thinking anything of it.  He even came home a few hours and confirmed that it was another UTI, but that his dad was talking strange.  Robert hadn’t walked in almost three years and he told Cole he was going to walk out of the hospital and go to work.  We all continued our day as usual.

Then, Cathy called Cole at 6:30 on Monday morning, just as he was getting ready for work.  Robert had severe bleeding in his brain and they were going to send him to a hospital in Trenton.  This was not something we were ready or expecting to hear. 

Cole, Cathy, and Claire (Cole’s sister) went to the hospital in Trenton.  Basically, the cancer that was on Robert’s forehead that we were told was not growing or pushing into the brain had eaten through his skull and caused the bleeding on his brain.  The bleeding was so severe they decided that surgery was not an option.  The only hope they had was if his brain would clot on its own.  We all had to sit back and “accept” that this was the end. 

Cathy had decided that she would keep him on the machines until Robert’s parents came in from Pittsburgh and then they would all say their goodbyes.  Robert held on through Monday night and on Tuesday morning, our son, Adam, decided to send his elephant up for his “pap-pap.”  He gave it a good squeeze before giving it to Cole.  When Cole and his family made it to the hospital, they set the elephant in the bed with Robert and that afternoon he passed. 

This is probably one of the hardest things I have ever experienced in my life and I can’t even imagine what my husband and his family are going through.  Our son is only three and we chose not to bring him to the viewing or funeral, but we did tell him where his pap-pap was. 

We said that pap-pap was in a place called Heaven and God was taking care of him.  We won’t be able to see him anymore, but whenever we want to talk to him we just have to look up at the sky and he’ll be there.  Our son is very sad and has said he misses his pap-pap.  It’s going to take time for this to really sink in. 

Robert’s birthday is this Saturday, October 31, 2009.  He would have been 54 years old.  Here is his obituary.  I chose not to change my families’ names this time.  This was taken from the McGuinness Funeral Home website.  http://mcgfuneral.com/.

“Richard S. Green of Glassboro, NJ., on October 20, 2009. Aged 53 years.

Legacy
For over 30 years, Rich was a Manager for Kmart in various locations in PA and NJ. Rich enjoyed collecting sports cards, golfing and spending time with his family. Bird watching in Cape May was another relaxing past time for Rich. Aiden, his grandson, was the apple of Rich’s eye and he loved spending time with him every chance he had. Rich will be sadly missed by all.

Family
Beloved husband of Cynthia (nee Szulewski )
Devoted father of Jason Bender, Christopher (Kirsten) Green, Caitlin Green. Loving son of Lois (nee Williams) and Chuck Allison and the late Carl Albert Green. Dear brother of Karen Finnegan, Dan Green and Kevin (Karen) Green. Adoring grandfather of Aiden, also survived by many loving aunts, uncles, nieces, nephews and friends. 

Donations may be made in memory of Rich to the National Kidney Foundation, 30 East 33rd St., New York, NY 10016 or www.kidney.org.”

***Just a side note- my husband brought up a few odd points while we were watching the video about Bob, the cancer survivor.  Cole told me that his dad was diagnosed with stage IV renal cell carcinoma at age 45 during a routine check-up.  He was a year younger than Bob was when he was diagnosed at 46.  We also thought it was strange that I chose to call my father-in-law Robert, even though his real name is Rich, and then I chose this You Tube video almost three weeks later about a renal cell cancer survivor named Bob.  I really did not even think about the coincidence when I was looking through the videos. 

Even if they never read my blog, I would like to thank Bob and his family for creating the video.  It was comforting to see that someone who was suffering from the same cancer as my father-in-law is doing well and has such a positive view on life.  I hope that Bob gets to enjoy many more years of health and happiness with his family. 

Thank you for taking the time to read my blogs!

A Survivor of Renal Cell Carcinoma

I have decided to include a video of people who have survived renal cell carcinoma.  The video I will show is a video about Bob (no, this is not my father-in-law).  I almost feel as if there is a reason I clicked on this video, but you’ll figure out why I think that in my last blog. 

Bob is a survivor of stage IV renal cell carcinoma.  He found out four years ago during a routine check-up at his doctor’s office.  He was 46 years old and was pretty healthy.  He had been complaining of stomach pains and the doctor ordered a CT scan.  That is when he was diagnosed with renal cell carcinoma. 

Three weeks later, a six inch tumor and his kidney were removed.  His recovery time was okay.  He “got back to normal” during the following months after his surgery.

Then, his wife approached him and told him that the doctors found another mass in his abdomen via another CT scan.  He underwent another surgery three weeks later.  Another six inch tumor was removed from his abdominal area.

Life got back to normal again, until his third set of scans were done.  Doctors found multiple masses in his liver, which is when Bob was diagnosed with stage IV renal cell carcinoma. 

After this third horrible occurance, bob chose to begin Interleukin-2 treatments.  When a person receives Interleukin-2 treatments, they are placed in the hospital for five days and are given fourteen doses of the medication.  Bob made it through twelve doses during his first treatment.

He said that the side effects were “brutal.”  He suffered the shakes, nausea, vomiting, diahrrea, and headaches that were worse than migranes.  His skin, eyes, and ears were peeling and he was bloated.  He gained almost twenty pounds from being bloated.  He said that the worst part of all was knowing that his family had to see him go through this. 

After the treatments, his doctors sent him for more scans.  His body was responding well to the Interleukin-2.  From August 2007 to June 2008, Bob had five Interleuking-2 treatments.  He was considered remissive and a responder to the Interleukin-2 treatments. 

Bob said that you need to believe that you can beat this cancer.  You need to have the desire to pull through.  He always made sure to have a roman soldier with him who he would visualize being injected into his body and fighting off the cancer.  He believes that you need to find something positive to help you conquer the cancer.

Bob’s video was comforting to watch.  Like I have said in an earlier blog, my father-in-law has been suffering with the cancer for nine years.  He obviously has something to believe in to have been able to hold on for this long. 

Gallner, A., & Gallner, R. (2009, March 19). How I Survived Stage IV Renal Cell Carcinoma Kidney
     Cancer [Web log message]. Retrieved from You Tube: http://www.ask.com/
     bar?q=stage+IV+renal+cell+carcinoma&page=1&qsrc=2417&dm=all&ab=7&title=YouTube+-+How+I+Survived+Stage
     +IV+Renal+Cell+Carcinoma+Kidney+Cancer&u=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DNjz37DZ0Q28&sg=Zh
     AKwTQMaMZM3eKXiJbwbjenzx5aiuit7q5o5WUeO28%3D&tsp=1256780613881

Support Group for Renal Cell Carcinoma

Through my research of kidney cancer, I came across a few sites that provided support groups for people with renal cell carcinoma. The first site that caught my eye was a site call The Daily Strength. This is a current site that has a blog for patients and family and friends of patients with renal cell carcinoma. Advice is also given by doctors on any topic that may come to mind.

Some of the discussions that I was able to see discussed a relieved patient’s end with the use of a certain medication. Another discussed a patient’s anxiety of being diagnosed six months prior with renal cell carcinoma and all of the tests that they are preparing for. There was also a blog written by the spouse of a cancer patient. I found this to be interesting because of the fact that the spouses need support, too.

There is a portion of the website that gives information on different types of treatment. Anyone can go into the page and click on any of the types of treatment to find more information. For example, I clicked on the link for dialysis. The definition for dialysis appeared, along with other discussions by different members of the website that gave their opinions and experiences with dialysis. This is also true for all of the other types of treatment that were available on the site.

Group members are able to create personal goals. The goals range from staying positive for loved ones to being supportive to getting in touch with their faith. Group members post their goals and give updates whenever they choose to. Other group members are able to post on their goals and give them words of encouragement and advice that may help them reach their goals. There is even a progress bar where the person can show how far along they are in meeting their goal.

I think this is a really great site for people with renal cell carcinoma to use because of all of the support and information it gives. There are also many links on the site for people to use to go to find more information on whatever the topic of interest may be. Some of these sites are even recommended or discussed by the members of the support group. I would suggest this site to anyone who has renal cell carcinoma or to any of the patients’ family or friends.

This site is also great for other topics. The site provides support for topics like: pregnancy, addictions, widows/widowers, other cancers, sleep disorders, behavior disorders, and relationships-just to name a few. If anyone is interested in looking further into the site the link is: www.dailystrength.org.

Renal Cell Carcinoma (Kidney Cancer) Support Group. (2009, October 25). Retrieved October 25, 2009, from http://www.dailystrength.org/c/Renal-Cell-Carcinoma-Kidney-Cancer/support-group.

Treatment of Renal Cell Carcinoma

If renal cell carcinoma is found only in the kidneys, then there is a 90 % chance of it being cured with surgery. If the cancer spreads outside of the kidney, then it needs to be treated with “adjunctive therapy and cytoreductive therapy.”

If the renal cell tumor is small, growing 4-5 mm a year, it is treated by partial nephrectomy. A partial nephrectomy is a procedure that is done to remove part of the kidney. These tumors are usually benign and needle biopsies are being done before surgery is suggested to test the severity of the tumor.

Surgery

Most of the time, removal of all or part of the kidney is recommended. This surgery could include removal of the adrenal gland, lymph nodes, and the surrounding tissues that have been affected by the tumor. If the tumor spreads to the renal vein, the inferior vena cava, or the right atrium those parts of the tumor can be removed, too. If mestasis occurs a cytoreductive nephrectomy can be done to increase the chance of survival of the patient.

Percutaneous therapies

Patients with localized tumors and who are not good candidates for surgery can have percutaneous therapies given by radiologists. During this procedure, a probe is pushed through the skin and into the tumor which is then destroyed with heat or cold. One of the issues with this type of procedure is that, unlike regular surgery, it is not known if the tumor is totally destroyed.

Medications

Cancer vaccines and Interleukin 2 are given to patients with renal cell carcinoma. Bevacizumab is used to help prolong progression of the cancer, but tests for effectiveness in stage three have not been conducted. Sunitinib, Sorafenib, and Temsirolimus are all used to interfere with tumor growth.

Chemotherapy

Chemotherapy can be used, but a cure is not likely unless the cancer has been surgically removed.

Cryoablation

Cryoablation is a procedure that is done to freeze the tumor which destroys it without having to undergo surgery. It can remove 95% of the tumor and is a better choice for patients who are not good candidates for regular surgery.

The results vary depending on the size of the tumor, where the tumor is, and if there has been a mestatic spread.

A person has a 90-95% chance of surviving for five years when the tumor is 4 cm or less. A person with a larger tumor has an 80-85% chance of survival. If a tumor spreads to the renal capsule, there is a 60% chance of survival. If the tumor spreads to the lymph nodes then there is a 5-15% chance of survival. If it spreads to other areas of the body, the chances of survival are 5%. All of this is based on a five year survival period.

If there is a recurrence of cancer, then the chances of survival are much less. Most of the time, renal cell carcinoma does not respond to chemotherapy or radiation. Immunotherapy has more of a promise than the other two methods.

Robert’s experiences

Robert went through many surgeries and medications while he had renal cell carcinoma. He had his kidney removed, which was where the cancer began. He then experimented with Interleukin 2. He had used it for quite some time. My husband said that the medication either works really well for some patients or doesn’t work at all for others. He said that Robert used more Interleukin 2 than most people did. He also said that while taking the Interleukin 2 it was like Robert had “the flu times ten.”

Robert had multiple back surgeries where vertebras were removed because the cancer had spread to them. His hip was replaced because cancer was also present there. He also underwent oral chemotherapy.

Kazim. (2008, December 21). Renal Cell Carcinoma. In Health and Fitness. Retrieved October 20, 2009, from http://healthforworld.blogspot.com/2008/12/renal-cell-carcinoma.html.

Symptoms and Prevention of Renal Cell Carcinoma

Risk Factors

Though there is no exact or definite answer on what causes renal cell carcinoma, there are many factors that contribute to the cancer.  Here are some of the factors:

• Smoking cigarettes is said to double a person’s chances of having renal cell carcinoma and contributes to about one third of all of the other types of renal cell carcinoma.  The more a person smokes, the better (or worse) the chances are of that person having renal cell carcinoma. 
• Obesity, especially in women, is a factor of renal cell carcinoma.  The more a person’s weight increases, the higher the chances of having the cancer.
• Exposure to petroleum products, heavy metals, solvents, coke-oven emissions, or asbestos.
• If a person had/has cystic kidney disease that is associated with chronic renal insufficiency.
• Cystic changes in the kidney and renal dialysis.
• Tuberous sclerosis
• Von Hippel-Lindau (VHL) disease
• Hereditary renal cancer
• Associated malignancy, like lymphoma

Signs and Symptoms

In the beginning stages of renal cell carcinoma, it is hard to notice any symptoms, if there are any at all.  Most of the time, the signs appear when the tumor begins to grow and presses on other organs or spreads to other parts of the body.  As with any other illness, the signs and symptoms vary depending on the person.  Most of the time, the tumor is not found unless a person has an image test done (CT scans) for something else. 

Some of the symptoms of renal cell carcinoma are:

• Hematuria, which is blood in the urine
• Pain in the side or back that will not go away
• Noticeable lump in the side or back
• Weightloss
• Fatigue
• Loss of appetite
• Fever
• Night sweats
• Malaise or feeling “blah”
• Anemia
• If the cancer has spread to the bones, it can cause a dull and achy pain in the bones.
• If the cancer releases hormones, also known as cytokines, there could be many other symptoms:
  • High blood pressure
  • Hypercalcimia, which is a high level of calcium in the blood
  • Polycythemia
  • Liver disorders
  • Muscle weakness
  • Neuropathy; which is numbness, tingling, or pain in one or more areas
  • Amyloidosis, which is the abnormal protein disposition through the body

A person should call their doctor if they have any of the above symptoms or any of the symptoms that follow:

• Blood in urine
• Pain in the side that will not go away
• A lump in the side or the belly
• Unexplained fevers
• Weight loss
• Night sweats

Prevention

In order to prevent renal cell carcinoma and any other form of cancer or illness, a person should not smoke, should exercise, and eat a healthy diet.

*All of this information was taken from the website emedicine health.  Here is the link:

Sachdeva, K., & Curti, B. (2005, October 31). Renal Cell Cancer. In emedicinehealth. Retrieved
     October 11, 2009, from http://www.emedicinehealth.com/renal_cell_cancer/article_em.htm.

What is Renal Cell Carcinoma?

Renal cell carcinoma is a form of cancer found in the kidneys and is the most common form of kidney cancer. Renal cell carcinoma is also known as renal cell cancer or renal cell adenocarcinoma. It can be found in one or both of the kidneys and is hard to get rid of once it has mastasized. The cancer is normally found in ultrasounds for things other than checking for the cancer.

There are many subtypes of renal cell carcinoma:

Clear cell carcinoma- This is the most common form of renal cell carcinoma and 8 out of 10 people with the cancer have this type. When you look at this cancer under a microscope, the cells seem pale or clear.

Papillary renal cell carcinoma- This is the second most common form of renal cell carcinoma and about 10 to 15% of people with cancer have this type. This cancer looks like it has finger projections on the tumor. Doctors call this cancer chromophilic because the tumors take in some dyes of the surrounding tissues that make the tumors look pink.

Chromophobe renal cell carcinoma- About 5 % of the people with renal cell carcinoma have this type of cancer. These cancer cells look a lot like the clear cell carcinoma cancer cells, but the chromophobe renal cells are larger and have more distinctive characteristics.

Collecting duct renal cell carcinoma- This is a rare type of renal cell carcinoma and the cells can form irregular tubes.
Unclassified renal cell carcinoma- There are times when the cancer cells are not labeled because there are too many cells to determine which category they may fit in. These types of cell groups are then called unclassified renal cell carcinoma.

*The above information was taken from the American Cancer Society. Here is the link:

What is Kidney Cancer (Adult)-Renal Cell Carcinoma. (2009, May 14). American Cancer Society. Retrieved October 8, 2009, from http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_kidney_cancer_22.asp.

Renal cell carcinoma has five stages. The stages, which are also known as clinicopathologic stages, tell a person and doctors the developmental phase of the. The stages are different depending on the size of the tumor, the location of the cancer, and the “extent” of the cancer.

Stage one of renal cell carcinoma is when the cancer is only in the kidney and the tumor is about 7 centimeters.

Stage two of renal cell carcinoma is when the cancer is found in the kidney and fatty tissue around the kidney and the tumor is larger than 7 centimeters.

Stage three of renal cell carcinoma has three different pieces:
-The cancer is only in the kidney, but the cancer cells get into the lymph system and invade a lymph node.
-The cancer spreads to the adrenal gland, fat tissue, and fibrous tissue and the cancer cells invade a lymph node.
-The cancer spreads to the main blood vessel, which is the renal vein, that carries clean blood from the kidney or to the main blood vessel that carries clean blood from the lower part of the body to the heart.

Stage four of renal cell carcinoma also has three different pieces:
-The cancer spreads beyond the fibrous tissue.
-The cancer cells are found in lymph nodes.
-The cancer spreads to adjacent organs like the pancreas, bowel, or lungs.

My father-in-law, Robert, was diagnosed in stage four of renal cell carcinoma and is still in this stage.

Stage five of renal cell carcinoma is when the cancer relapses after it has been treated.

*This information was taken from Omnimedicalsearch.com. Here is the link:

Morrow, A. (2009, May 4). Renal Cell Carcinoma. In Omnimedicalsearch.com. Retrieved October 10, 2009, from http://www.omnimedicalsearch.com/conditions-diseases/renal-cell-carcinoma-stages.html.

Allow Me to Introduce Myself

Hello everyone! My name is Kirsten. I am a senior at Rowan University; I’m a dual major in Elementary Education and Writing Arts. I have created this blog for an assignment for one of my courses and to begin looking into renal cell carcinoma. This topic is close to my heart because my father-in-law has been suffering with it for eight years. Here is our story so far…

A little over five years ago I met my father-in-law, Robert*. Before I met Robert, my husband, Cole* informed me that his dad was paralyzed from the waist down and gave me no explanation as to why. When I met Robert, he seemed fine. He was able to move around using a walker and was able to work his full-time job as a manager at a local K-Mart.

After a few months, I asked Cole why his dad was paralyzed. He told me his dad had renal cell carcinoma and that he had to have surgeries to remove the cancer. It started in his kidney, which was removed, and then it spread to his spine and other parts of his body. When the doctors tried to remove the cancer from his spine, they paralyzed him. At that point, the conversation ended and I was under the assumption that he had been cancer free since that surgery.

Fast forward about two years, to when we started to plan our wedding. We wanted to choose a date in May and were meeting with our pastor in mid-September. Robert ended up going to the emergency room where we found out that the cancer was back. Family members suggested that we bump up the date a bit so that he would be able to see us get married, so we did this hoping that he would be able to make the new date.

In a matter of a few months time, Robert looked horrible. His skin started to look pale, his hair was changing, he wasn’t able to walk with the walker much, and was hospitalized until the week of our wedding. From that point on, he was in and out of the emergency room and rehab.

As all of this was happening, I began to get more curious about what the cancer is, how a person is diagnosed, the symptoms, and if it is hereditary (since I’m married to Cole, Robert’s son, and we have our own little boy with another baby on the way). I made the mistake of always asking Cole these questions, who was not willing to give any answers especially when I asked him how he felt about his dad suffering from cancer. Even when I asked Robert; Cole’s step-mom, Cathy*; or Cole’s sister, Claire*; the answers were vague and I still felt clueless.

Well, I’ve been in the family about five years now. Robert has aged about ten to fifteen years in my eyes and I don’t even know what he looked like prior to the cancer. In the past year, he has been in and out of the hospital with many urinary tract infections. He has a bump on his forehead that grows to the size of a baseball, but settles when he takes his cancer medication. He has a hard time getting out of bed, so he stays in bed all of the time. His bedroom is actually down in the family room so when we visit we get to see him all of the time.

This marks the beginning of my journey to finding out what renal cell carcinoma is and any and all information that goes along with it.

*I’ve changed the names of my husband and his family to protect their identities.