Renal Pelvic Cancer: Questions on Diagnosis and Treatment

Q: Renal Pelvic Cancer: Questions on Diagnosis and Treatment

Hello： 1. The biopsy of the bladder tumor confirmed renal cell carcinoma. Does this situation count as metastasis, or is it another condition? -- Since it is renal cell carcinoma, it should be classified as metastasis, but it has been surgically excised. 2. Aft

Renal pelvis cancer?

Hello, Doctor.
I have been diagnosed with renal pelvis cancer for five years, and my follow-ups have shown no issues during this time.
However, during my most recent endoscopic examination, a tumor was discovered in my bladder.
It is an early-stage tumor, and after a resection and biopsy, it was confirmed to be renal cell carcinoma.
I have since started the bladder cancer intravesical chemotherapy regimen.
Since my next appointment is still some time away, I have a few questions I would like to ask:
1.
The bladder tumor biopsy confirmed renal cell carcinoma.
Does this situation indicate metastasis, or could it be another condition?
2.
After the resection, I underwent my first Mitomycin intravesical treatment, and two days later, I began experiencing intermittent red rashes and itching in various locations on my body, which have persisted for a week.
Five years ago, after my first surgery, I also received Mitomycin for bladder prophylaxis, but I did not experience this rash at that time.
Could you please let me know if Mitomycin can cause such side effects? Additionally, which specialty should I consult for this condition?
3.
Over the past six months, my weight has decreased from 75 kg to 68 kg, but I have not experienced any discomfort or loss of appetite during this time.
In December, I was hospitalized for kidney examinations, and a recent lower body MRI showed normal results.
Should I consider consulting another specialty regarding this weight loss?
I appreciate your clarification on these concerns.
Thank you.

WU, 40~49 year old female. Ask Date: 2023/01/09

Dr. Du Shixi reply Urology

Hello:
1.
The biopsy of the bladder tumor confirmed renal cell carcinoma.
Does this situation count as metastasis, or is it another condition? -- Since it is renal cell carcinoma, it should be classified as metastasis, but it has been surgically excised.
2.
After the excision, the first Mitomycin infusion was performed, and two days later, a rash began to appear intermittently on various parts of the body, accompanied by itching, which has persisted for a week.
Five years ago, after the first surgery, Mitomycin was also administered for bladder prophylaxis, and there were no such rash occurrences at that time.
I would like to know if Mitomycin can cause such side effects? Additionally, which specialty should I consult for this condition? -- Any medication can potentially cause side effects.
You should inform your physician during your follow-up visit, and it would be helpful to take photos of the rash.
3.
Additionally, in the past six months, my weight has decreased from 75 kg to 68 kg, with no other discomfort or loss of appetite during this period.
In December, I was hospitalized for kidney examination, and a recent MRI of the lower body was normal.
Should I consult another specialty regarding this situation? -- You can discuss this with your current physician, as weight changes can be complex.
Further evaluation is necessary.
Wishing you good health.

Reply Date: 2023/01/09

More Info

Hello, thank you for your detailed questions regarding your health situation. It sounds like you have been through a lot with your renal pelvic cancer and the recent developments with your bladder. I will address your questions one by one, providing insights based on medical knowledge.

1. Regarding the bladder tumor biopsy confirming renal cell carcinoma: If the biopsy from the bladder indicates renal cell carcinoma, this could suggest that the cancer has metastasized from the kidney to the bladder. Renal cell carcinoma can indeed spread to other parts of the urinary tract, including the bladder. However, it is also possible that the tumor in the bladder is a separate primary tumor, although this is less common. The distinction between metastasis and a second primary tumor is crucial for treatment planning. Your oncologist will likely consider your entire medical history, imaging studies, and pathology results to determine the best course of action.

2. Concerning the side effects of Mitomycin: Mitomycin is a chemotherapy agent commonly used in bladder cancer treatment, particularly for intravesical therapy. While it is generally well-tolerated, side effects can occur. Skin reactions, including rashes and itching, are not typical but can happen as part of an allergic reaction or sensitivity to the drug. Since you have not experienced this side effect in the past, it is important to discuss this with your healthcare provider. They may refer you to a dermatologist or an allergist to evaluate the rash and determine if it is related to the Mitomycin or if there is another underlying cause.

3. Regarding your weight loss: A drop in weight from 75 kg to 68 kg over six months, especially without any accompanying symptoms such as loss of appetite or discomfort, can be concerning. Weight loss can occur for various reasons, including metabolic changes due to cancer, stress, or other underlying health issues. Given that you have had recent imaging studies that were normal, it would be prudent to discuss this weight loss with your oncologist or primary care physician. They may recommend further evaluations, such as blood tests or additional imaging, to rule out any other potential causes.

In summary, your situation requires careful monitoring and communication with your healthcare team. It is essential to keep them informed about any new symptoms or changes in your health, including the rash and weight loss. They can provide the most accurate assessments and adjust your treatment plan as necessary. Regular follow-ups and open discussions about your concerns will help ensure that you receive the best possible care during this time. Wishing you strength and health as you navigate this journey.

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