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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 29450
Experience:  Experienced Oncology Physician trained in New York City. I'm ready to help.
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Hi again Dr. David: I keep thinking of more questions.

Resolved Question:

Hi again Dr. David: I keep thinking of more questions.
Submitted: 9 months ago.
Category: Oncology
Expert:  Dr. David replied 9 months ago.

Dr. David :

Hello, this is Dr. David. I have read your question and I'm ready to help.

Dr. David :

yes, I remember.

Dr. David :

I think your anxiety is out of control and making you worried.

Customer:

I would agree with that. My wife and my son need me, and I want to be around for them for 20-30 more years! I can't believe that there is a chance I may have cancer. I just don't know what to do.

Customer:

I will go for this test Friday and I have a horrible feeling that the results are either going to be clearly cancer, or something highly suspicious of cancer. I can not imagine them telling me everything is ok.

Dr. David :

they could very well tell you that friday after the scan is read and interpreted by the radiologist.

Customer:

Up until last Monday when I had my kidney stone I felt great, very healthy. Now I feel very bad. I "sense" that cancerous or cancer-suggestive results are coming from Friday's CT Scan. I wish I didn't even know. If this is cancer I feel like it is a certain death sentence, and that they will only be able to "treat" me not cure me.

Dr. David :

this is your mind playing tricks on you from the report of the other scan.

Dr. David :

you need to be strong for your family

Dr. David :

and not completely break down

Dr. David :

and hang in there until the scan friday.

Customer:

Again do you think there is a great chance (80/20) that this 2.8 cm thing will show up as clearly benign?

Customer:

And if it is cancer, do you think the odds are that I can be cured with a surgery?

Dr. David :

yes, good chance it is benign.

Customer:

I don't know how I would talk to my wife and son to help prepare them for me dying.

Customer:

They are my whole world

Dr. David :

you don't need to worry about having that conversation now.

Dr. David :

there is no need for that.

Customer:

Okay, I am re-reading my CT scan report for the 100th time and I notice that it is very "repetitive" in that it refers to this area of decreased attenuation like 3 times. That doesnt mean there are 3 seperate areas does it?

Customer:

"there is 2.8 cm area of decreased attenuation in the posterior cortex of the right kidney. This likely represents a cyst although its margins do not appear quite smooth and regular, and further evaluation by contrast CT or ultrasound is recommended to ensure the absence of a mass".


Later on in the report it refers to it again, saying: "There is an area of decreased attenuation in the right kidney which may represent a cyst but its appearance is slightly irregular and further evaluation by contrast CT or ultrasound is recommended to assure the absence of a mass".


Then at the end it says "There is an approximate 2.8 cm area of decreased density in the right mid renal cortex of uncertain etiology. This may represent a cyst with slight irregular margins, regard is some concern followup contrasted CT or ultrasound is recommended".

Dr. David :

no, it does not mean there are 3 separate spots.

Customer:

Okay, why are they so repetitive in these reports? Once it says it is on the posterior cortex and at another point it says mid-renal cortex.

Customer:

See above

Dr. David :

radiology doctors can be repetitive.

Customer:

I need you to be honest, will I die from this if it is cancer?

Dr. David :

no, you most likely won't die from this if it is cancer.

Customer:

Thanks Dr. David, I am sorry to repeat myself and bother you. I have a terrible feeling that the results from Friday's test is either going to be very clearly cancer or highly suggestive of cancer; or want me to do a million more test to verify its cancer. I acn not even imagine that the results will clearly indicate "no cancer".

Customer:

Would you put my odds of no cancer at 80/20 or something like that? Would you put my odds of being permanently "cured" at 80/20 if it is cancer?

Customer:

You can be totally honest with me of course. I need that honesty.

Dr. David :

I have answered these questions for you already.

Customer:

I know I am sorry. I just enjoy the hope that you provide. It is all the hope I have.

Dr. David :

you have more hope than that.

Customer:

?

Dr. David :

I am not all the hope that you have

Customer:

Of course I trust in God too.

Customer:

But I feel so helpless. I have a whole life ahead of me.

Customer:

I want to be there to coach my son in baseball, his first day of school, to help him learn how to drive, to help him get to college, at his wedding, and to just be there for all the daily things that a boy needs his dad for. I don't want to die from this. He needs me Dr. David.

Dr. David :

yes, I understand.

Dr. David :

you will be there for him.

Customer:

This likely is not going to kill me?

Dr. David :

correct.

Dr. David :

that is what I have said to you before.

Customer:

On the report once it says "posterior cortex" but at another point is says "mid-renal cortex". How is that possible? Unless it is 2 different things?

Dr. David :

these are the same spot. . this is how the radiologist phrased it.

Dr. David :

he is not a robot. so he can describe the same area with different words.

Customer:

okay, I will let you go for today and of course I will leave a good rating below.

Customer:

Before I go

Customer:

...

Customer:

Could you please again give me your best brutally honest percentages guess on...this being non-cancerous, and on the liklihood of being cured if it is? I know you gave me them before, I just want to be certain.

Dr. David :

are you looking for me to give you different answers than before?

Customer:

Not if those are your honest medical opinion.... :-)

Customer:

I am just trying to hang on to anything I can Dr.

Dr. David :

I can understand.

Customer:

so you think 80/20 no cancer?

Customer:

80+ cureable if it is

Customer:

I meant to put a question mark

Dr. David :

yes, I still think that.

Dr. David :

very good odds this is not cancerous.

Customer:

Isn't 2.8 cm a little bit large?

Customer:

If this is cancer, can I let my urologist handle it or do I need to find a urology oncologist?

Dr. David : No that is small
Dr. David : and your urologist can handle it
Customer:

one more thing, I have been reading alot on the web about a "tumor thrombus", since this thing is in the mid-renal cortex or posterior cortex....is a tumor thrombus a worry for me or would 2.8 cm be too little to have a thrombus?

Customer: I thought a tumor thrombus might be more likely based on location of this.
Dr. David : The initial ct scan said this looked more like a benign cyst
Dr. David : a Kindney thrombus would not look like this
Customer: Forgive me for asking this question; but where in the world did the ct scan it looked like a benign cyst?
Customer: Forgive me for asking this question; but where in the world did the ct scan say it looked like a benign cyst? Thanks Dr David
Dr. David :

"The report said this is "likely represents a cyst although it's margins do not appear quite smooth and regular". Later on in the report it repeats "2.8 cm area of decreased density that may represent a cyst with slight irregular margins".

Customer: Okay, that's why you are the doctor. I didn't interpret it that way but it sounds comforting. I didn't see the word benign there so I didn't know that's what they were hinting at.
Dr. David :

cyst are benign

Dr. David :

there are really no malignant cysts.

Customer: Okay I was thinking there were simple cysts which were benign and complex cysts which could be cancerous.
Dr. David :

the report does not describe them as complex cysts.

Dr. David :

the report describes them as cysts with slightly irregular margins.

Customer: Ok. Good point. Last question for tonight .... Are there chances of an unexpected bad surprise on this upcoming ct with contrast. If the cancer had spread or if there were other areas of concern would the first ct have hinted at that?
Dr. David :

yes, most likely the first CT would have show signs of cancer spread.

Customer: Ok thank you. Thanks for being patient and honest with me. I will try to stay positive until I get the bad news Friday.
Customer: I will leave an excellent rating below
Dr. David :

good luck Friday.

Dr. David :

hang in there.

Dr. David :

thanks for leaving positive feedback.

Dr. David :

thanks for using JustAnswer.com

Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 29450
Experience: Experienced Oncology Physician trained in New York City. I'm ready to help.
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