My dad did seek a second opinion from an oncologist and he, along with some other specialists that my sister spoke to, pointed at the histology as the first point of review. Although he was impressed with the recommended follow-ups, he was puzzled on why they guessed the primary site is the pancreas. His primary reasons are:

(1) My dad's kidney cyst (which turned out to be cancerous) was first detected 9 years ago and had been growing gradually. If it is true that the pancreas is the primary site of the cancer and that it then spread to the kidney, the cancerous pancreas would already had caused, among other effects, much pain earlier but even to today, my dad experiences no pain whatsoever.

(2) The gradual growth of the cyst with no other effects is consistent with kidney cancer.

Of course the primary oncologist relied on the pathologist's report to conclude that the cancer metastasised from somewhere else and the high tumour marker supports this. Hence, it's important to get another review of the kidney block. So the tricky bit is to be as nice as possible in requesting them to send the sample to another hospital and hoping that they wouldn't be offended.

Another recommendation is to dad to go for OGDS and colonoscopy to rule out stomach and colon cancer as one of them can turn out to be the primary site. This will be done in Seremban and at a price that's at least 50% cheaper!

Meanwhile, redo tumour marker tests once every 3 months to observe the trend.

It is quite possible, however, that all these will result in the same conclusion i.e. cancer in kidney metastasised from somewhere else and the primary site remains unknown. In that case, follow-up with the 3-monthly tumour marker tests, and look out for loss of appetite and weight. If elevated, go for the necessary scans. Chemo is an option, if my dad wants.
4 Responses
  1. William Says:

    Hopefully things become clearer in the coming days

  2. Twilight Man Says:

    Please be strong for your dad's sake during this difficult period. I have seen many patients recovered from various complicated cancers.

  3. Jaded Jeremy Says:

    Twilight Man,
    Thank you.