Kidney cancer patients have choice, doctors say

Given the choice of being "cut in half" or of having surgeons create four small holes for surgical instruments to do their work, it's hard to believe kidney cancer patients would choose the more radical option — particularly if the outcome was the same.

Yet because many Utahns don't know they have a choice, they opt for more radical surgery, according to Dr. Jay Bishoff, a urologist and medical director of the Intermountain Urological Institute at Intermountain Medical Center.

Bishoff and his fellow urologist at the institute, Dr. Scott Chidester, will answer questions about kidney cancer, prostate cancer, kidney stones and other related topics on Saturday from 10 a.m. to noon during the monthly Deseret News/Intermountain Healthcare Hotline. Callers can reach them toll free at 1-800-925-8177 or by e-mail on Saturday only at hotline@desnews.com.

The rate of kidney cancer in Americans has skyrocketed during the past 35 years, up 70 percent from 1973 to 1998, and up another 23 percent from 1998 to 2008. Why?

"We just simply don't know," Dr. Bishoff said.

There are approximately 235 cases of kidney cancer in Utah each year.

Yet the advent and prevalence of CT scanning has dramatically increased the rate of early detection, though it usually happens while doctors are examining patients for some other ailment, he said. The disease has no real symptoms in and of itself, and when patients learn they have the cancer, their family members become nervous, he said.

"I haven't treated a case of kidney cancer in the past several years where at least one family member didn't ask me if they should be screened as well."

The only sign that the cancer may be present is blood in the urine, but typically there is no pain associated with that condition, which is also present in a variety of other ailments.

Because chemotherapy and radiation are not effective against kidney cancer, surgery is the only option for treatment.

Though laparoscopic surgery for the disease was first done in 1990, "it's taken the urology community a long time to say this is a good idea," Bishoff said, noting many older urologists were never trained in the procedure.

In Utah, only 30 percent of surgeries are being done with laparoscipic techniques, yet 90 percent of those cancers can be treated this way, Bishoff said.