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164: Joshua Silva survived clear cell renal cell carcinoma | partial nephrectomy | appendectomy | kidney cancer
Joshua Silva did not take lower back pains and gastrointestinal issues seriously until they worsened, forcing him to visit an emergency room.  A CT scan revealed inflammation of his appendix, necessitating an appendectomy.  A urologist said the scan also showed a problem in his left kidney, later diagnosed as clear cell renal cell carcinoma, a type of kidney cancer.  Joshua underwent a partial nephrectomy knowing before the procedure he may lose the kidney.  When he regained consciousness after the procedure, a nurse told him the kidney was spared.  Post-treatment medication and weekly visits to a therapist enabled him to get very close to his pre-diagnosis health.  Among other positive developments, Joshua Silva has resumed one of his major passions, that of playing golf.   Lots of people experience gastrointestinal problems and lower back pain, so when this happened to Joshua Silva of Houston, Texas, a man in his early thirties, he thought with time the problems would go away.  But that didn’t happen.  One night the pain became so bad that he couldn’t sleep, and he decided to go to the emergency room.   He underwent a CT scan which indicated an inflamed appendix but also showed problems with his left kidney.  What Joshua knew was that he would have to undergo an appendectomy.  What he didn’t know with certainty was just what was wrong with his kidney.  Some doctors said the problem might by a cyst or might be cancer.  Joshua prepared himself for the worst and began to think what life would be like if he was diagnosed with cancer and had to go forth with one kidney.   His appendix was removed, but he had to wait an excruciating four weeks to see a urologist, who said he didn’t need a biopsy to determine Joshua had clear cell renal cell carcinoma, a form of kidney cancer.    Because the diagnosis came shortly before the holidays, the urologist accelerated the timetable for a partial nephrectomy, seeking to form a care team before its members left for vacation.  The urologist said the margins around the tumor would determine whether he could spare the left kidney or have to remove it.    Even though he was under anesthesia for the procedure, as soon as he regained consciousness, he wanted to know the status of his kidney.  A nurse told him the urologist was able to remove the cancer without removing the kidney.   Just when it seemed like Joshua was on his way toward survivorship, he received some bad news.  The incision point for the partial nephrectomy was very close to the incision point for the appendectomy.  The appendectomy incision had not fully healed, resulting in an infection.  His abdomen area began to swell and turn red.  Antibiotics prescribed after the partial nephrectomy did nothing to address the pain. It was a very difficult three weeks, as Joshua dealt with the pain and sudden uncertainty as to whether he could keep his left kidney.   He was put on a different medication regimen and after three more weeks, the pain and swelling went away.  A subsequent scan showed that he was cancer free.   Joshua Silva says his health is now about 98 percent of what it was prior to his back pains and GI issues, and back out on the links with a single-digit handicap.   Additional Resources:   Support Group:   The Kidney Cancer Association  https://www.kidneycancer.org      
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