Husband with T3b N0 M0 RCC, Leibovich score 7 how to cope

Hello...

I really hope someone answers my reply.  My husband was diagnosed with stage 3b N0 M0 clear cell renal cell carcinoma in April 2019.  His tumour showed necrosis and measured approximately 6 inches on all sides. Complicating things, there was a thrombus in the vein in his kidney and the tumour was so large, it wrapped around his kidney. Though his cancer was localised, it was reaching for the adrenal gland so they removed the tumour, adrenal gland, and the thrombus was treated with medication before surgery.   . 

My husband was told immediately that at his stage t3b N0 M0, he had a bit less than 50% chance of living five years possibly less due to the necrosis but it’s “a guide”.  They also said his recurrence rate was at about 40% due to it reaching the adrenal gland. They insisted he try to qualify for a trial called RAMPART which is treatment by immunotherapy.  After jumping through every hoop to qualify, he was accepted and as it’s not a blind trial he was told how he was randomized.  He is receiving two immunotherapy drugs and a new scan every four months. He had his first infusion of each drug and a week later was in the hospital for extremely severe colitis. 

My husband is a GP himself so he’s seen lots of people with cancer his 20 plus years in practice. I asked him if he’d seen this before (stupid question) and he began rattling off a list of “remember that gift from that family, remember the guy, remember the lady who sent a gift for the dog...and on and on”, all of these patients are gone. So ?

I’m petrified.  His trial treatment is a year long and it literally says at the top of his information that it’s for high to highest risk patients. When he tried to return to work this week, his only other partner in the practice chose to take his SECOND 3 week holiday in three months. He went on one the week my husband had his nephrectomy  in May. ****!  Now, as they want my husband off work another two weeks , he’s being treated like a pariah. Keep in mind, he’s one of only two partners and only two full time doctors. Other help comes from two part time salaried doctors who refuse to work extra, and a nurse practitioner who wants higher pay all the while he’s feeling guilty for trying to live!

 

Can anyone be boldly honest with me, do they know a stage 3 or 4 kidney cancer patient who survived past the 5 years.  

 

any honest response would help me prepare either way.

  • Hi cari don't know if this will help but my brother in law had kidney cancer about twenty years ago we saw the surgeon after operation he said he couldn't understand how it hadn't killed him it was falling apart sorry no idea what stage it was he was stitched up and sent home no treatment at all, about five years later, got it in other kidney again take it out stitched up and home on dialysis about five years then got doner kidney OK again another five years in hospital cancer all over his body,, just to show five years with no treatment just shows how long it can take if there's treatment available, why he didn't have treatment we've no idea at the time we didn't know about all this treatment available, we thought it's out that's it cured, best wishes.. Billy 

  • Thank you, Billy, for your honest response.  If not for a yearly blood test my husband has for gout they never would have picked up something off in his blood work.  He became a vegetarian about a year ago so he attributed weight loss to change of diet, he felt something like a lump in front and to the side but it would come and then disappear for months at a time so he wrote that off as also something he just felt due to weight loss but his fatigue finally did him in and instead of putting his blood work off another month, or months, he went to see his GP which doctors never do. They agreed it was a lump, he had an emergency scan two weeks after and more blood work.  He was on a planned week off when he had these tests, the trip away was canceled to have the scan etc. He went back to work and two days later he called me from work, he said he’d had a call from his doctor and he started the conversation laughing so I thought good news but he suddenly started crying, in 11 years I’ve seen him cry once, when our dog passed away. He didn’t want to tell me over the phone but wanted me to be first to know and he had to tell his practice that day because his partner was about to take his first of several holidays. 

    Just a note about GPs, some care and I married one who cares. A patient he saw the day before he was going into the hospital said she’d book in to see him for something that was due soon. He said we can do it today because I’m going to be out of the practice a while.  She said something about him having just taken a holiday and he bluntly said, “I’m not taking a holiday, I have cancer”.  It shut her up at least. 

    I am afraid. His cancer would have killed him within six months without surgery and it was all by chance. He thought he lost a bit of weight and was tired simply because he became a vegetarian and was working long hours we never imagined this. Never. He’s got about a 47-50% chance at five years. My grandmother died of kidney cancer but they chose not to treat her because of her age and other conditions. My husband is 46, I’m American and I moved my whole life here to marry him back in 2011 after being in a long distance, frequently travelling back and forth between California and the UK for years before we chose to get married so I don’t have a support system here except my in laws.  And his parents apparently want to family discuss what to do when he dies as if it’s happening tomorrow. Forget what he wants or what we’ve discussed about that stuff long before he was sick. 

    My husband has one concern, me and our pets. 

     

    I greatly appreciate your reply and anyone who can add to it.  I’m a person who needs to know and everyone is so vague around me. 

     

    Just afraid

     

  • Hi cari I'll tell you about me (don't worry you'll get full facts on forum we know what it like,) in Feb 2016 I was diagnosed with non curable prostate cancer it gone to lymph nodes, spine, ribs, pelvis and a lung, its stage 4, t3b _n1 _m1b it is metastases, they can't operate so I have cemotheropy now and again to slow it down, they gave me five years,, i also look after my disabled wife she needs 24 /7 care which can be hard sometimes but we manage just I've arranged a carer for when I get to bad, hopefully a while yet, i hope others will come to talk to you soon best wishes... Billy 

  • Hey Billy 

    Thank you for sharing a bit about yourself. I sympathise with your situation. I’m from California but married a Scottish GP, I’ve lived here ten years. I never expected my husband to have a t3b RCC but we’re learning.  I’ve run the Cancer Research UK event a few years but it’s never been this personal.  There’s another person in my life I help care for, my dad.  He lives in the US but I usually go home three times a year to give my stepmother a break.  My dad has advanced Parkinson’s and CLL (chronic lymphocytic leukaemia). His leukaemia isn’t active but we worry anyway. Now, with a husband with cancer and a dad back in America with advanced Parkinson’s I feel tugged in two directions. 

    Im grateful for your comments. There’s so much here on the chat groups to read, I’m navigating and trying to be helpful if I can. It’s hard to watch someone you love go through this but you do what love drives you to do. We keep a sense of humour but my husband being a doctor and having seen a lot of cancer patients over the years, he just looks at things different than I do. 

    Wishing you and your wife the best 

    Thank you  

    cari