Stage iv Papillary Case

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What would be the best option for a stage IV papillary case of 30 years old woman who has undergone radical nephractomy, vebractomy of the L1 bone and hemicolectomy, but currently only shows some metastisized nodules on the pelvis bone, on which the standard radiation trials were unsuccessful ? Thanks

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Epictetal

I was diagnosed with stage IV papillary renal cell with bone and liver mets Apr. 05. underwent radical nephrectomy May 05. Started Tarceva and avastin (as well as zometa for bones) in June 05 and had last set of scans 12/05: disease stable with no progression. I think you will find if you review the literature there is almost no really good data on the treatment of metastatic papillary renal cell as there are so few cases (5-8% of 12,000 stage iv cases/yr is only 600 cases/year). I would strongly recommend seeing an oncologist with a concentration in genitourinary malignacies if you can. Zometa is a medication indicated for treatment of bony mets from solid tumors.

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Papillaryrcc

Thanks a lot for taking time to provide us with these important information that most likely will play a major role to effectively fight this cancer. I wish you a speedy recovery. May I ask you some more questions? 1) I understand from your message that we should consider the metastatic cancer as distinct entities that will need different drugs for each mets region. For the mets cancer in the bones, Zometa seems to have some positive results for your case. a) Did the cancer tumor shrink or just the propagation rate significantly decreases after your treatment? b) who is your Doc please? 2) Are your Docs considering a therapy or investigating an experimental therapy that may stop/slow down all metastatic phenomena, something that is actually effective against the Papillary RCC? 3) Did you consider the drugs recommended in some Doc messages appeared in the discussion labeled: Papillary Type, Spread to Lymph Node(s)? 4) I will appreciate it if you can give us more info on your current personal health data so we can understand more. I am going to go to MSKCC/New York for my first therapy investigation. I got some great recommendations for this Center. Please advice Best regards

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Epictetal

Zometa is not a specific therapy for any particular cancer. It is a drug (biphosphonates) which has been shown to lessen complications of bone metastasis in a number of solid tumors including renal cancer. It is also used for osteoporosis. THe treatment I am getting for the cancer per se is avastin and tarceva. It is in a sense experimental as neither Tarceva nor Avastin has yet to be approved by the FDA for renal cancer (they are both approved for other types of cancer and are therefore available). The treatment has resulted in the disease remaining stable with no growth but has not resulted in tumor shrinkage. Other than some mild side effects from the drug I feel fine and continue to work ect. As long as the disease remains stable they will continue me on this regimen, if it progresses than we'll try something else. There is to my knowledge no study indicating that any specific treatment is effective in papillary RCC , as almost all the studies are on clear cell RCC as it is far more common. MSKCC is one of the top cancer hospitals in the country, I am sure you will recieve good care there.

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Papillaryrcc

Thanks a lot for your answer and encouragements. I will let you know about the progress of my therapy and drug specifications. Please let me know about any other person you know having similar diagnosis. I wish you a complete recovery. Best regards

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Trishpm

MSKCC is a fine cancer center, but will not give you all the options available for treating a papillary RCC. Suggest you see Dr. Janice Dutcher at Our Lady of Mercy in the Bronx, who is one of the top RCC experts in the country and has experience in treating rare subtypes. You can contact other people with papillary RCC on the KIDNEY-ONC mailing list (see http://cancerguide.org/kofaq/ to join).

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