Medical Rounds with Dr. Jeffrey Laut

Did you know that kidney cancer is among the ten most common cancers in both men and women? That’s according to the American Cancer Society. Dr. Jeffrey Laut, a nephrologist at the Hartford HealthCare Tallwood Urology and Kidney Institute, talks more about this disease.



Q. Can you explain the role of the nephrologist at the Tallwood Urology and Kidney Institute?
A. In addition to the surgical urologists, and oncologists, the nephrologists treat patients with a wide spectrum of kidney diseases (mostly diabetes and hypertension), but also those who have had or are contemplating kidney reduction surgery and are left with less than optimal kidney function, and are at risk for progressive kidney failure.  We do not perform the surgeries or offer chemotherapy or radiation therapy.

Q. What are the signs and symptoms of kidney cancer?
A. There is both good and bad news to this question.  First, the good news.  The majority of kidney cancers these days are found "incidentally"; in other words, we find a kidney tumor while looking for something unrelated. For example a patient gets an x-ray or CT scan of the spine for low back pain and the radiologist notices an incidental and asymptomatic tumor. This is good news because it is usually early, small and easily resectable and curable.  The bad news is most kidney cancers offer no symptoms until they are large and advanced. And when they are,  the most common symptoms are hematuria (blood in the urine) and/or flank pain. Most of these are still treatable but may require not only surgery, but chemotherapy and/or radiation therapy.

Q. What are some of the treatments offered at Hartford Hospital for patients diagnosed with kidney cancer?
A. The full spectrum of care is available at Hartford Hospital; everything from laporoscopic and robotic surgery to chemo and radiation therapy, and even dialysis and transplantation for those that need it. The advantage of having experienced surgeons and laparoscopic/robotic technology means that many times we can get away with "partial" nephrectomy (partial removal of a kidney) vs. radical nephrectomy (total removal of a kidney) and spare that patient from developing serious chronic kidney disease (CKD).

Q. Well planned, coordinated care is something that the Tallwood Urology and Kidney INnstitute is known for…explain how a patient’s treatment course is mapped out from the time of diagnosis?  
A. Even though there are many commonalities to this disease, every patient and situation is different. And thus so is the approach. When patients are relatively young and healthy and their tumor is simple, they are easily treated with laparoscopic surgery. However, when the patients are elderly and have co-morbidities such as high blood pressure, diabetes or CKD, it requires a thoughtful team approach, sometimes actually no surgery, and what we call "active surveillance" where we wait and watch to see if that tumor grows. Small tumors tend to cause little trouble and sometimes those patients are better off simply being monitored.

 


For more information

Free Class: Understanding kidney cancer

Website: Tallwood Urology & Kidney Institute


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