I recently saw a 75-year-old gentleman who presented to the emergency room with lower back pain and blood in his urine.

He had a cystoscopy (passing a lighted tube in his bladder). This did not show any cancer in the bladder. He also had a biopsy of the spine, which confirmed metastatic disease to the bone.

He had an outpatient PET scan in our office. It showed widespread metastasis to the bone, lymph nodes and lung. He also had a large mass in his kidney.

His cancer started from the kidney and spread to multiple places. This is stage 4 kidney cancer and considered incurable.

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys.

Kidney cancer becomes more likely as you age. Risk factors include smoking, having certain genetic conditions and misusing pain medicines for a long time. The presenting symptoms include blood in the urine, back pain, weight loss, etc. At the time of diagnosis, he had marked weakness, he was in lots of pain and required narcotics to relieve the pain. His quality of life was very poor.

He was started on immunotherapy. Immunotherapy stimulates your own immune system to kill cancer. It carries much fewer side effects than chemotherapy. He developed some increase in liver enzymes, which were promptly addressed.

After a few months of therapy, he is responding very well to treatment. His pain has subsided and he is not taking narcotics. He has now restarted playing golf. His quality of life is very good.

One of the common myths is if cancer is incurable, why bother with any treatment?

Some people are understandably concerned about the toxicities of therapy. If he elected not to have any therapy, he would have had a very painful death. Modern therapies are more effective and less toxic. Also, there are lots of new advances in cancer care.

Fear of therapy should not make you decline all treatment. Also, if you are one of the unfortunate ones who has more toxicities than you can handle, your doctor can modify therapy or stop therapy.

Therefore, keep hope alive and fight against cancer as much as possible.

Dr. Sunil Gandhi is a hematologist and oncologist; volunteer medical adviser of the Citrus Unit of American Cancer Society. Email sgandhi@tampabay.rr.com or call 352-746-0707.

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