pT3aNxM1; Fuhrman Grade 4

It's been another lengthy interval since my last post. My old friend Gerhard from the beautiful city of Heidelberg asks whether my feelings about the blog have changed. It's not that I've lost interest or questioned its usefulness. The reason for the 'silence'  has everything to do with the ongoing discomfort/pain I continue to experience when I sit for any length of time.

So the update on my condition is a mixed one. I continue to make progress in terms of the wound and the surgery but the leg/back sciatica-type pain persists and sometimes causes despair.

I have had two recent consultations at the Queen Elizabeth Hospital; the first with the urology surgeon, Mr Patel, who expressed some justifiable pride on examining my scar. He gave us the mathematical expression in the title. Succinctly it means that I have renal cell carcinoma (RCC); p stands for pathology (the condition of the organ), T3a means 'the cancer extends into the renal vein or the fat around the kidneys but not the fibrous tissues (Gerota's fascia)', Nx means that the lymph nodes were not examined (unnecessary as they already  knew that cancer had spread which is what the M1 denotes, M meaning metastases.)

Fuhrman grade 4 means that the cancer is aggressive, 4 being the highest grading.

So, that didn't appear so good........ we didn't stay long. Some weeks ago we had taken out membership of the University of Birmingham's, Winterbourne Gardens, which lie close by. It has become our custom after every hospital visit to spend some 'recovery' time amid the trees and flowers. We drove there directly.

The follow-up meeting with the oncologist took place two days later. We had more time with Doctor Karina to talk through the treatment programme that would now follow from the histology results. She had some further bad news when she explained that the metastases had spread to both lungs and numbered 4 or 5, rather than 2, as we had been previously informed.

However she was upbeat about my longevity - though there are of course no guarantees. She explained that aggressive RCC responds well to the oral medication I would start in a few weeks time. She also added that this was a drug I would be on for the remainder of my life. The cancer would eventually find a way 'round' the medication; the treatment was palliative and not a cure.

I have another CT scan in a couple of weeks and the drug treatment commences a few weeks later - the delay is to give my body a chance to recover from the surgery.

Meanwhile these damn back/leg symptons continue - I have been re-referred to the Royal Orthopaedic Hospital and see the consultant in October. I'm still being 'twin tracked' though Dr Karina has raised a new linkage possibility - that the neurological condition stems from some, as yet undiscovered, tumour.

I've more than used up my tolerance-at-the-computer time and your capacity to absorb medical information.

I hope to blog more discursively in the near future................