For Karee White, standing up to turn off the television before
bed one night was the beginning of months of fear.
The Lee's Summit, Mo., resident felt nausea and chest pain so
intense she thought she was having a heart attack. Much to her
relief, doctors at the hospital told her it was only a stress
attack.
Two months later, White felt the same pain. Thinking it was
another stress attack, she just stayed home this time. But the pain
continued into the next day.
After friends speculated she might have gallbladder problems,
White called the doctor and set up an ultrasound. Her friends were
partly right. White did need her gallbladder removed.
She also needed her kidney removed.
Doctors had discovered a malignant tumor on her kidney.
Last week film director Steven Spielberg also had a kidney
removed. Though his doctors would say only that they discovered an
``irregularity'' on the kidney, other doctors have speculated that
the most likely reason for Spielberg's kidney removal, also called
a nephrectomy, was a mass on the organ. Masses, often cancerous,
are the most common cause for removal, doctors say.
``Most of the time a kidney is removed because they find a spot
on the kidney or an abnormal mass on a kidney X-ray,'' said Kirk
Duncan, a Kansas City area nephrologist. ``The concern is that it
could possibly represent a tumor or a malignancy.''
Kidneys also can be removed due to serious infections, abscesses
or accidents that damage the kidney, doctors say. When both kidneys
stop functioning, dialysis or transplantation usually is needed.
Although the kidney is needed to clear the body of waste, people
can live normally with less than one kidney. The remaining kidney
usually enlarges and picks up much of the work load. Typically, the
remaining kidney works hard enough to achieve about 80 percent of
the functioning of two normal kidneys, Duncan said.
In fact, the body still can function with about one-third of one
kidney, said J. Brantley Thrasher, chief of urology at the
University of Kansas Medical Center.
Doctors do recommend, however, that people who have a kidney
removed make a few changes in their lives. Because they don't have
a kidney on reserve, they must be extra careful.
Many doctors advise that those with only one kidney drink lots
of fluids to prevent kidney stones, decrease their protein
consumption and monitor their blood pressure. They also warn that
contact sports can lead to kidney damage and possible need for
removal.
Kidney problems come as a surprise to most people. Noticeable
symptoms include blood in the urine, difficulty urinating, more
frequent urination -- especially at night -- and pain in the back,
according to Teresa Pavia, health information manager for the
National Kidney Foundation in New York.
But many times a kidney problem goes unnoticed. Problems often
are detected by doctors during a routine physical exam (as was the
case with Spielberg) or through an X-ray or other tests done to
examine an unrelated concern.
Of the masses detected on kidneys, about 90 percent are
cancerous, said Thrasher, a urologic oncologist. Because the
symptoms often are unnoticeable he calls kidney cancer ``a silent
killer.'' The American Cancer Society estimates that this year
there will be 31,200 new kidney and renal pelvis cancer cases
diagnosed. And 11,900 people are expected to die of the disease.
The bad news, Thrasher said, is that the causes of kidney cancer
are unknown. But some studies have listed family history of cancer
and exposure to cigarette smoking, cigars and pipes as risk
factors. In addition, radiation and chemotherapy don't kill kidney
cancer, he said. The most effective cure is to remove part or all
of the kidney.
``Surgical therapy early is the best chance for a long-term
cure,'' Thrasher said. ``Once it spreads outside the kidney, it's
very difficult to cure and long-term survival is rare.''
If the cancer does spread outside the kidney, it spreads to the
lungs 55 percent to 60 percent of the time, to the bone or
lymphnodes about 30 percent of the time, and to the brain about 10
percent of the time, Thrasher said.
White, who had her kidney removed by Thrasher last November,
lives daily with the fear the cancer will return. After her
surgery, doctors told her they had removed all the cancer, but she
still has to go for checkups every six months.
``I'm happy that they said they got it all, but there's a big
doubt there,'' said the 33-year-old White, personnel manager at a
Lee's Summit Hy-Vee.
White said she's trying to forget about the surgery, but the
emotions are hard to escape. She remembers clearly the day the
doctor told her she had cancer.
``After my first meeting, he told me it was malignant,'' White
said. ``And I said, `That's the good kind?' And he said `No.' So I
freaked out. I thought instantaneously I was going to die.''
White said she became an emotional recluse after learning she
had a cancerous tumor. She remembered the pain her parents went
through when her grandmother died of cancer about 13 years ago, and
she didn't want them to have to go through that again.
``I kept praying,'' she said. ``I just wanted to live. I
thought, `I'll go through any anguish between now and the surgery
as long as I can live.' It just wasn't time for me to die. I just
wanted to let everyone know what they meant to me.''
Three months after the surgery, White feels healthy physically,
but mentally she has changed. She is more careful to tell family
and friends what they mean to her and she doesn't worry about ``all
the stupid little things'' anymore.
Lolita White (no relation to Karee) was also startled when
doctors told her she had cancer. White, of Kansas City, Kan., was
having tests done to examine a hormone problem when doctors found a
malignant mass on her kidney.
``I was just kind of surprised,'' said White, now 78. ``I never
thought of myself as having cancer.''
But White began to research her family medical history and
discovered cancer ran in her family. Knowing she didn't have
another choice, White had her kidney removed in January.
The surgery has made her a little weak, but White said she's
working hard in physical therapy to regain her strength. She's
staying with her son Marcellus Hughes while she recuperates and has
taken up the card game solitaire to keep her busy.
``At this age, each day is a blessing,'' she said.
