Kidney Cancer: A Survivor's Story
Rolling the Dice with Kidney Cancer
Barbara and husband Tony
Barbara Cohen-Chiarelli has been to Las Vegas many times, but she’ll never forget her trip there in May of 2007. She and her husband, Tony, had tickets to an Elton John concert at the Bellagio. But just before the show, Cohen-Chiarelli noticed a large amount of blood in her urine. She spent the rest of the trip in a panic about what this might mean.
When she returned home to Smithtown, Long Island, Barbara immediately made an appointment with a local urologist. The doctor felt it was probably nothing, but ordered a CAT scan nevertheless. Barbara was not so sanguine—a nurse by profession, she expected the worst. Barbara has worked for 21 years as a nurse at North Shore University Hospital, and although urology is not her specialty, she says, “I had a feeling this wasn’t just a urinary tract infection.”
Two days later, just before Memorial Day weekend, she received a phone call from her doctor. The news was not good: she had an inch-and-a-half–long tumor on her right kidney, and another smaller tumor in her bladder. “I told the doctor that he must be looking at someone else’s films,” recalls Barbara. “I couldn’t believe it. I got very angry.”
The following week, Barbara went back for treatment of the two tumors. Her urologist was able to remove the tumor in her bladder. The kidney tumor, on the other hand, was near a difficult-to-reach location known as the renal pelvis, and could not be removed easily. Barbara’s urologist told her that he would have to remove the entire kidney to get the tumor out.
“I was devastated. I didn’t want to lose a kidney,” says Barbara. “I thought, ‘The tumor is so small, why do they have to remove the entire kidney?’ I had heard so much about partial nephrectomy.”
In a partial nephrectomy, the cancerous portion of the kidney is removed, but the remaining healthy kidney is preserved. In contrast, the traditional method of surgically treating kidney cancer—radical nephrectomy—involves removal of the entire kidney. Radical nephrectomy is a much simpler operation than partial nephrectomy, and is still the most common procedure in most hospitals in the U.S. Partial nephrectomy, on the other hand, is a more complex operation, requiring the suturing of many blood vessels and carrying the risk of delayed bleeding and urine leakage. However, new evidence is mounting that partial nephrectomy can have health benefits later in life.
Although her doctors assured Barbara that kidney cancer was treatable, she still imagined she was at death’s door, and spent the summer in a state of paralyzing fear. Barbara leaned heavily on a strong support network that included her nursing colleagues at North Shore.
Taking a chance on partial nephrectomy
Although Barbara’s urologist on Long Island felt that partial nephrectomy would be impossible, when she asked for a second opinion, he recommended Dr. William Huang, a member of the NYU Cancer Institute and a urologist in the Division of Urologic Oncology at NYU Langone Medical Center. Dr. Huang has been a strong proponent of partial nephrectomy. Building on his work as a fellow at Memorial Sloan Kettering Cancer Center, he has pioneered much of the research on the impact of radical nephrectomy on kidney function and overall health of patients following surgery for kidney tumors.
Barbara made the trip to Manhattan for a consultation with Dr. Huang, who ordered additional imaging studies of the diseased kidney. After getting the results of a 3-D MRI, Huang could see that the tumor was indeed in a difficult location. But while all of Barbara’s other doctors had said that a partial nephrectomy was out of the question, Dr. Huang felt that it was feasible.
The doctor and patient had a lengthy discussion about the pros and cons of partial nephrectomy versus radical nephrectomy. Despite the risks of the partial nephrectomy surgery, Barbara was determined to keep her kidney. “I felt that if I had only one kidney, I’d be at risk of high blood pressure, cardiovascular disease and other illnesses later on.” The pair decided that Dr. Huang would attempt the partial nephrectomy, and if things looked bad during the operation, he would take out the entire organ.
“He saved your kidney!”
Barbara remembers waking up in the recovery area after the operation, where her husband greeted her with, “He saved your kidney!” The operation had been difficult, but successful. Dr. Huang had removed the tumor and the surrounding areas, which showed no signs of cancer.
Barbara was left with 70% of her original kidney intact, and post-surgical testing showed that her kidney function was normal. Although it was a major operation, she was able to return to work six weeks later. She now goes back for follow-up ultrasound exams twice a year—and so far, there’s been no sign of any recurrence of kidney cancer.
Today, Barbara feels like she’s back to her old self, and has recently returned to her old stomping grounds in Las Vegas for a vacation with her husband. Although she sometimes worries that the cancer might come back, she is determined to live each day to the fullest. “It was a wake-up call,” she says, “I don’t take anything for granted any more, and I don’t put off anything I want to do.”
What advice would she give someone who has received a diagnosis of kidney cancer? “I’d send them directly to Dr. Huang,” she says, “I cannot say enough good things about him. He took a chance on me when no one else would. I’m eternally grateful.”
