More on surgical options from my doctor

Last May my urologist/surgeon, Dr. Andrew Wagner, graciously did an informal interview with me about surgical options for kidney cancer. That post is here.

People on my kidney cancer patient community on ACOR.org were recently discussing the different ways their surgery was done. I asked Dr. Wagner for his thoughts about "open" surgery vs laparoscopy (I had the latter), and he responded:

There are several options for open nephrectomy, some incisions removing portions of rib and some not.

All of the open options ("back or front or side or flank etc.") are generally decided on based on surgeon preference and training. For example I have a "go to" incision for open nephrectomy called a thoracoabdominal incision, it is a flank incision but extended to also open the diaphragm. This is a fairly common urologic incision for open kidney surgery.

I need to remove a piece of rib about half the time with this incision. I like this (rather large) incision because the only time I do open kidney surgery is if the tumor is very large or if the patient has had major abdominal or flank surgery already. In my opinion and experience, over 90% of kidney tumors should be able to be completed laparoscopically.

(reprinted with permission)

My hospital's renal tumor program web site, with contact info for the doctors, is at www.bidmc.org/renaltumor.

BIDMC's Dr. David McDermott on medical options for kidney cancer patients

In May I posted an interview with Dr. Andrew Wagner, the surgeon at Boston's Beth Israel Deaconess Medical Center who removed my cancerous kidney (and adrenal gland) in March 2007. In that interview we discussed the surgical options available to kidney cancer patients.

Here's the second in what I hope will be a series of podcasts for kidney cancer patients. This time it's oncologist Dr. David McDermott, of the famous Atkins-McDermott team.

Doctors McDermott and Wagner head the renal tumor program at BIDMC, which is an integrated "solution shop," a term used in some of the latest views of how to design healthcare delivery systems. More on that, another day. But for now, here's the interview.

p.s. Yeah, I know 40 minutes is too long. But y'know what else? Concerns about things like that are what keep people from trying things. And for better or worse, I just ain't the kind of guy who's afraid to try. Having been through this twice now, I can see a LOT of things I hope to do better in the future.

So hey, what are YOU not trying because you figure you gotta first know what you're doing?
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Next in this series, Sept. 1, 2009:
Dr. McDermott discusses MDX-1106, an experiment treatment

Or, view all my podcast posts.

BIDMC's Dr. Andrew Wagner on surgery options for kidney cancer patients

Dr. Andrew Wagner, the surgeon who brilliantly removed my kidney (which had tumors sticking out on two sides), kindly agreed to discuss the options available to kidney cancer patients.

I'm putting the audio here in two versions. First, here's my attempt using Utterli, a new website that lets you upload any kind of audio.

Here's another copy from the BlogTalkRadio web site where I recorded it:

Dr. Wagner is co-chairman of the renal tumor program at my hospital. A five minute video about that program, and how it brought me back from the brink, is here. The program's web site, with contact info for the doctors, is at www.bidmc.org/renaltumor.

Update 12/29/09: In response to a discussion in my patient group on ACOR.org, I asked Dr. Wagner for some additional thoughts. His response is here.

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Next in this series – June 2009: Dr. David McDermott discusses medical treatment options.