Kidney Cancer First Appointment
Your first appointment at Fred Hutchinson Cancer Center is a time for you and your care team to meet. You will talk about your diagnosis, disease outlook and likely treatment. This visit is also a time for us to start getting to know you as a person. This helps us fit our recommendations to you. Together, you and your team will decide what needs to happen next.
We encourage you to bring a family member or friend to your first appointment (and any future visits).
What to Expect
When you come to Fred Hutch, we match you with the health care services and providers that are right for you. Your care here is always personalized. We tailor your first appointment — and all your visits with us — to your unique situation.
The plan for your first appointment will depend on features of your cancer and:
- The histologic subtype from your pathology report
- If your tumor is only in the kidney, or if it has spread to other parts of your body
- Your other medical history and problems
We will also think about any treatment you have already had.
To help you get ready for your first appointment, a patient care coordinator will call you to tell you where to go and who you will meet. When you arrive, you and your physician will get to know each other, and this physician will explain your disease and answer any questions you have.
Localized Kidney Cancer With No Prior Treatment
If you have localized kidney cancer and you have not had treatment yet, our urologists are the experts who will plan and provide your care. Your first visit will be with this type of physician. Most people in your situation have surgery to remove the tumor. After surgery, your urologist may refer you to a medical oncologist to consider any adjuvant medical treatments (treatments to help keep your cancer from coming back) for your cancer.
Metastatic Kidney Cancer With No Prior Treatment
If you have metastatic kidney cancer and you have not had treatment yet, our medical oncologists are the right match for your needs. You will likely start by seeing one of them first. Most people in your situation do not have surgery. Medical oncologists specialize in medicine-based treatments for kidney cancer. Most patients will be treated with immunotherapy or targeted therapy.
Metastatic Kidney Cancer With Prior Treatment
If you have metastatic kidney cancer and you have had other treatments that are not working or caused too many side effects to continue, our medical oncologists will review your records to help you choose the best options for new treatment and supportive measures for managing symptoms. Our Physicians will consider both standard treatments and clinical trials to find the best option for your situation.
“The greatest pleasure of my job is getting to know my patients: understanding what drives them, exchanging stories and learning about the impact of their disease. These personal details help me provide comprehensive, individualized care.”
— Yaw A. Nyame, MD, MS, MBA, urologic surgeon
What to Expect at the Kidney Cancer Multispecialty Clinic
If you have metastatic kidney cancer and are being seen in the Kidney Cancer Multispecialty Clinic (KCMC), you will meet with your urologic oncologist, medical oncologist and radiation oncologist. You may meet with a registered dietitian or genetic counselor, too.
You will talk about your diagnosis, your subtype, disease stage and likely treatment. This visit is also a time for us to start getting to know you personally. This helps us fit our recommendations to you. Together, you and your care team decide what needs to happen next.
Here’s what you can expect to happen at your first appointment at the KCMC.
Hour 1 — Exam
The first appointment at the KCMC usually takes about three to four hours. You will spend about three hours with your physicians in the duration of the visit. In the first hour, you will first meet with a physician who will discuss your cancer and other health history and do a physical exam.
Hour 2 — Team Meeting
Your team of physicians will meet to talk with each other about your cancer and the most effective ways to treat it. During this time, you can meet with one of our oncology nutrition specialists, social workers or patient care coordinators, or you can visit the Patient and Family Resource Center and other Fred Hutch services.
- Your doctor will present the details they learned from talking with you and examining you.
- Your pathologist and radiologist will review and explain the results of any biopsies, other tests and imaging scans you have had.
- Your urologic oncologist, medical oncologist, radiation oncologist and geneticist will use their experience and knowledge about the best treatment approach for people in your situation.
Together, the team will design a treatment plan specifically for you.
Hours 3 and 4 — Recommendations
You will meet one-on-one with each physician from your team. You will stay in the same room and the physicians will come to you. We will explain the treatment we recommend for you and why. We are here to answer your questions and talk through your options so you can make decisions you feel good about.
What Happens Next
Before you leave, you will meet the KCMC patient care coordinator. We will schedule any appointments you need next. Your schedule will depend on your exact needs. We are here to handle the details and make the process as worry-free as possible for you.
First Appointments with Your Urologic Oncologist or Medical Oncologist
For many of our patients, the first step is to see a single physician who specializes in the main type of treatment they will probably need.
If you have a localized kidney cancer, you will see a urologic oncologist at UW Medical Center – Montlake who can talk with you about surgery options.
If you have already had the primary kidney tumor removed, or if you have metastatic disease, you will see a medical oncologist who knows the very latest about treating kidney cancer with systemic therapies. Your medical oncology appointment may be at the South Lake Union Clinic; we will make sure you know where to go.
First appointments with these physicians usually last about one hour. Here’s what you can expect to happen.
Confirming Your Diagnosis
To help us plan the right care for you, we start by checking your diagnosis. Our experienced pathologists carefully review your previous biopsy or surgery results. They specialize in kidney cancers.
This step helps your physician predict how your disease might behave and which treatment approach will likely work best. We often take another look at any test results and imaging that you have had elsewhere. Then, we update your diagnosis and disease stage in important ways that can change your treatment choices.
Explaining Your Disease
Your physician will talk with you about your health history and do a physical exam.
They will explain what kidney cancer is and how it typically behaves over time. They will talk with you about how the disease is affecting your body, and they will describe what happens for most people in your situation.
The subtype, stage and grade of your cancer are important information. Other things, like your overall health and the exact size and location of your tumor(s), also matter. Your doctor will explain these things in as much detail as you would like.
Discussing Your Treatment
Based on your test results so far, your physician will explain the treatment we recommend for you and why. If you need any other tests to tell us more about your disease, we will talk about your personalized treatment again after we have the results. We want to make sure you understand all your options.
These appointments are also a time for you to tell us about yourself. Each patient and family has their own needs and preferences. We want to get to know you so we understand the best way to care for you.
Answering Your Questions
Starting with your first appointment (and after), we are here to answer your questions. We want you to know as much as you want to about your disease, your treatment and how care happens at Fred Hutch. We invite you to bring a friend or family member with you to help keep track of your questions and the information that your team gives you. We also encourage you to talk with your care team about your hopes and concerns. Knowing more about you helps your team recommend the right treatment for you.
Before you leave, we will make sure you know what is going to happen next and how you can reach us if you have questions. We will also schedule your next visit.
Videos on Kidney Cancer Care at Fred Hutch
Medical oncologist Scott S. Tykodi, MD, PhD, explains who you meet at your first visit and how your team comes up with a complete game plan for you in a single day.
For access to the widest array of treatment options, it’s best to get a second opinion sooner rather than later. Medical oncologist Scott S. Tykodi, MD, PhD, explains why.
Resources for Patients and Caregivers
Here are tips about how to prepare for your first appointment at Fred Hutch and what to bring.
Caregiving at the First Appointment
As a caregiver, you can give your loved one both emotional and practical support for their first appointment. Ask them if you can help with things like these:
- Helping them manage their stress, worry or other feelings.
- Planning how to get to and from the appointment, what time to leave home and where to park.
- Making a list of questions they want to ask the physician. Fred Hutch’s Guide to Your Care has a list of questions they may want to ask the care team. At the appointment, make sure that all their questions get answered.
- Taking notes during the visit. The physician will be giving a lot of details, which can be hard to remember later without notes.