Radical nephrectomy (kidney removal)
Peter from Romford in Essex, had radical nephrectomy (kidney removal) surgery at Spire Hartswood Hospital in Brentwood, Essex in 2010.
Peter, 60, from Romford in Essex is a School Business Manager at a school in Dagenham and is married with three sons and underwent total kidney removal following the diagnosis of kidney cancer.
Peter was experiencing pain in his testicles and visited his GP Dr Quigley at Western Road surgery to get it investigated but could not have predicted what would happen next. Peter explains more: “I had pain there for a little while but visibly I looked the same so I wasn’t concerned. I saw my GP who referred me for an ultrasound scan. I used my private medical insurance to pay for this.”
Peter’s ultrasound revealed a mass on his kidneys and he was booked in by the radiologist to see a consultant that evening. He continues: “I did not expect my kidneys to be involved. As far as I was concerned they were investigating much lower down. The minute the radiologist came across the mass it was taken very seriously by the medical staff and I was offered a consultant appointment that evening.”
Peter was referred to consultant urologist Mr Sandy Gujral who booked Peter in for further screening the next day. Peter said: “The CT scan was to provide more detailed analysis but Mr Gujral was already speaking about cancer treatment and surgery. That was a real shock as cancer was the last thing I expected as I had no other symptoms.”
Peter had undergone an ultrasound, CT, seen a consultant and been diagnosed with renal cell carcinoma RCC or hypernephroma (cancer of the kidneys) within 48 hours and 17 days later underwent radical nephrectomy (total kidney removal) surgery at Spire Hartswood Hospital. The whole process had taken less than a month.
Peter continues “I was already familiar with Spire Hartswood Hospital in Brentwood, as my wife and sons have been seen there before so this was a small reassurance at a very unsettling time.
“It was a whirlwind but absolutely necessary as my particular cancer is known to be aggressive. I spent my first night after surgery in The Hartswood’s high dependency unit (HDU) and then was moved into one of their private rooms to recover over four days. When I spoke to Mr Gujral he said that during surgery he discovered the cancer had started to spread into a vein leading to my heart and the initial mass on my kidney was over 12 cms long. To think that it was on its way to my heart was frightening. Thanks to the speed at which I was diagnosed and treated I only had to undergo surgery and avoided further treatment which was a relief.”
Peter’s wife had been at Peter’s side throughout his diagnosis and treatment and added: “It has been very stressful but we have been well looked after. The high dependency unit was great as I knew that Peter had a dedicated nurse watching him constantly in the room if he needed her. On the day of the surgery Mr Gujral himself called me to tell me it had gone well. Having a private space to recover and flexibility to visit when it was convenient for us just made everything that little bit easier to cope with. Everyone at The Hartswood has looked after us and I am grateful for that.”
Peter is now undergoing a five year programme of regular check ups at Spire Hartswood Hospital and although the cancer has been removed the worry is not gone for Peter yet: “A few days before a scan I am worrying that it has come back. The one year check up will be a milestone for me and a huge relief if I am clear. My wife and I have not been able to plan anything since this happened because we never know when I might need to come in. I look forward to my five year check up when we can finally plan a well deserved holiday.”
Peter had kept his private medical insurance from a scheme offered by a previous employer and believes this is the best investment he has ever made: “It’s your health at the end of the day. It isn’t cheap and there is the temptation to save a bit more cash by cancelling it but I’d go without a holiday to afford my medical insurance. I’m not sure where I’d be now if I had to wait for treatment on the NHS. I don’t like to think about it. All my family have medical insurance, it gives you peace of mind.”
The surgeon's view - comments from Mr Sandy Gujral
"Peter’s case is interesting in that he presented with testicular pain initially and this led to the coincidental discovery of a large kidney cancer. The reason he had testicle pain was because his veins draining blood from the testicle had become congested due to the pressure of the kidney cancer on his main vein the inferior vena cava*.
Most kidney cancers are now picked up coincidentally when the abdomen is scanned for other issues. Sometimes people present with loin pain or a mass. Often they may well also have blood in the urine.
Many small cancers can be cured by just taking out part of the kidney that is involved. This is called a partial nephrectomy and I do several of these cases every year.
Sometimes the whole kidney and the coverings have to be taken out together with the lymph glands. This can usually be done through key hole or laparoscopic surgery. I do about 20 of these cases every year. The patients usually recover very quickly and are in hospital for a couple of days.
In bigger cancers or those that have spread into the veins or surrounding tissues, like Peter’s, an open removal, rather than a keyhole removal, is needed with exploration of the vein and removal of this part of the tumour together with the kidney.
Again with enhanced recovery protocols as in Peter’s case, most patients are home in three to four days.
Peter is doing well and his follow up tests show there is no cancer recurrence to date."
* The large vein which carries blood from the lower part of the body to the heart.