Fox Chase study aims for better identification of aggressive kidney masses

ABINGTON, Pa. (WPVI) -- To treat or not to treat?

It's a common dilemma when cysts and masses are found by accident during tests for other medical conditions.

A new study from Fox Chase Cancer Center aims for better guidance for kidney masses.

"I love the shore. We have a house down the shore," says Joe Weldon.

And there's nothing he likes better there than being with his family.

"Three daughters and a son. We do a lot of things together," he notes.

Joe first saw Dr. Alexander Kutikov of Fox Chase Cancer Center to monitor a prostate issue.

But scans a few years ago revealed something else.

"They found tumors in the kidney," he recalls.

"Over 50% of people, over 50 years of age, have cysts on their kidneys," says Dr. Kutikov.

He says those cysts often form when a tiny cubicle in the kidney gets blocked and fills with fluid.

Doctors have long thought the cysts were seldom cancerous.

"Even if they are cancer, they're sort of not the cancers that spread and the cancers that can be watched," he says.

Fox Chase wondered if, as Dr. Kutikov says, were there sharks hiding among the minnows - among the harmless cysts? And can doctors better recognize them without surgery?

"And how do we really identify those patients that need surgery?" he says.

Doctors analyzed Fox Chase's big database of both imaging scans and tests on surgically removed cysts.

"We found that about 1 in 5 actually harbored cancers that were more aggressive than we expected," he says.

Joe's softball-sized tumor was monitored by CT scans for about a year, but when it changed too much, Dr. Kutikov wanted it out.

"They were able to remove it and save my kidney and all at the same time," Joe remembers, even though a large incision was needed to get the big mass out.

But Dr. Kutikov says most operations are far less drastic.

"A lot of these we do minimally invasively through robotic techniques," he says.

Bottom line is that knowing when it's safe to watch a cyst or time to operate is essential.

"The goal is to not overtreat them and also not to undertreat them," he says.

Dr Kutikov believes artificial intelligence will be big in the future, mining the X-ray and CT images for clues in better identifying more aggressive masses.