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  • Writer's pictureJeff Kallis

A Window Within

When I searched the vast internet to learn more about patients with kidney cancer, I found that most patients who are diagnosed with kidney cancer are blindsided by it because kidney cancer rarely has symptoms. That was true in my case. Like many other cases, my cancer was discovered on a CT scan that was looking primarily to see where the kidney stone(s) was located. The secondary concern (a rule-out diagnosis if you will) was to look for anything more sinister.


That begs the question...should total body scans or CT scans of the abdomen and pelvis be done more frequently to screen for kidney cancer in populations where kidney cancer is more prevalent? Early detection increases the likelihood of a better prognosis. But what are the downsides of scanning your body looking for something sinister? Do you really want to know what is growing or lurking in your body? It’s kind of like learning how sausage is made. After you do, you kind of wish you hadn’t.

One downside is the unnecessary worry that can be created by seeing shadows within that are nothing to be concerned about. Another is the cost. Health insurance companies don't like to cover the cost of medical services that are not based on an indication to justify it. That makes sense to a point. The counterpoint to that argument is that detecting medical issues early can reduce the total healthcare costs in general. It's a preventative approach rather than waiting for a bigger shoe to drop.


Another question to be asked is who would / should be tested for kidney cancer? Kidney cancer only makes up about 4 percent of cancer diagnoses in the United States (about 82,000 new cases each year). Worldwide it is even less than 4 percent. Does it make sense to test 100 percent of the population to detect the 4 percent who have kidney cancer? It doesn't seem cost effective. Unless you are the one with cancer growing in your kidney.

The American Cancer Society tells us that most people diagnosed with kidney cancer are between ages 65 and 74. That is when patients are diagnosed with cancer. How long had the cancer been present before diagnosis? Kidney cancer usually doesn’t present with symptoms. That's when a CT scan (or MRI) needs to be done - years before the cancer is detected. For the population that is at higher risk. I was age 61 when the mass was detected, and it had been there between 5 and 14 years. Would a CT scan have picked up the mass when I was age 47 to 50? I’d like to think so. Kidney cancer is very uncommon in people younger than age 45. So, scanning for kidney cancer before age 45 would seem unnecessary. Maybe starting at age 45?

Kidney cancer is about twice as common in men than in women and it is more common in African Americans, American Indians, and Alaska Natives. The only category I fit of these is being male. If you are a smoker, diabetic, or like to drink more than most, you are at higher risk of getting kidney cancer. None of these fit my case. Yet, I got renal cell carcinoma-clear cell. I wouldn't be on anyone's radar as a likely candidate for a positive diagnosis. I wouldn't fit the criteria for having a body scan to search for this nemesis. Truth be told, I’m not sure I would have signed up for one had it been offered to me anyway. But other people likely would.


Like many kidney cancer patients, I had no symptoms. Had it not been for a kidney stone that was setting off alarm bells, I would not have had a clue there was cancer within. It's too bad our bodies are not transparent. It would make it so much easier to see what is going on. Probably best we don't have that close a view. As the saying goes, beauty is only skin-deep. Perhaps that fits here.

Illustration by D. Bicker, pixabay.com




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