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Patient’s Risks Reduced With Partial Nephrectomy

Fall 2006 – The stealthy nature of kidney cancer means 90 percent of patients who develop the disease don’t experience any symptoms. For this reason, tumors often are discovered incidentally as patients undergo CT scans for other medical reasons.

This is the scenario that played out for David Laskowski, 54, last summer after he began experiencing discomfort in his lower abdomen. "As the evening progressed, the discomfort seemed to move around to my right side, and it became increasingly painful," Laskowski says. "My first thought was appendicitis, so my wife, Jan, and I went to an urgent-care center. That’s when I was diagnosed with kidney stones."

 Cancer Survivor David LaskowskiThe X-ray also showed two small nodules on the kidney, and the urgent-care physician suggested Laskowski follow up on those findings with his own physician. After a series of CT and MRI scans, Laskowski eventually was diagnosed with kidney cancer. His urologist said that because of the location of the tumor, the entire kidney needed to be removed.

"When Jan heard that, she became really concerned," Laskowski says. "A friend of hers works at Barnes-Jewish Hospital, and the friend recommended I see a physician there. The next day I was at the Siteman Cancer Center seeing Dr. Sam Bhayani. He told me that not only could he save most of my kidney by removing only the tumor, but he also could do it laparoscopically."

The laparoscopic urologic surgery program at Siteman treats more than 200 patients with kidney cancer each year, making it one of the largest kidney cancer practices in the world. Bhayani, assistant professor of surgery at Washington University School of Medicine, is an expert in laparoscopic nephrectomies and partial nephrectomies. The advanced techniques he uses enable him to perform these procedures in two to three hours, rather than in the usual three- to five-hour time span. His goal is to save as much of a patient’s kidney as possible.

"In an age when high blood pressure and diabetes are common diseases, the ability to remove a tumor while saving half or two-thirds of a patient’s kidney is an important goal," Bhayani says. "for David, removing his entire kidney could have resulted in serious consequences sometime in the future. if kidney stones developed in his remaining kidney and blocked it, he would go into kidney failure. Now that can’t happen because he still has two functioning kidneys."

Laskowski’s surgery was done on a Thursday, and he was released from the hospital the following Sunday morning. Although he had some restrictions regarding lifting for the first few weeks, he experienced little pain and was back to work as a project manager for a mechanical contractor within a week.

For the next several years, Laskowski will undergo a CT scan every six months, but Bhayani feels a recurrence of the cancer is unlikely. Laskowski, the father of two grown children and the grandfather of two, is grateful for Bhayani’s skill as a surgeon and the confidence he instills in his patients.

"Dr. Bhayani makes you feel comfortable and at ease, and his upbeat attitude just spills over to you," he says. "The recommendation to get a second opinion from him was the best thing that could have happened to me and my family."