Johns Hopkins is under 1 patient per 100 in the last 5 years with 
Dr. Marshall as the surgeon. Dr. Marshall is the surgeon-in-chief 
for all patients taking part in this study. You will be in the 
hospital for about 1 week after the operation. After 3 to 6 weeks, 
almost every patient with your level of health is recovered to 
resume normal activity including employment. Heavy lifting should 
be avoided for six weeks. 
If the tumor in your kidney is not kidney cancer when studied 
by the pathologist, treatment will be recommended which is 
indicated for the type of tumor diagnosed. Only cases of kidney 
cancer can take part in this study as the technology of cell 
preparation has only been developed to the point of testing for 
side effects in cases of kidney cancer. Because patients who take 
part in this study will be re-injected with their own inactivated 
kidney cancer cells after they are prepared specially for this 
study , patients who chose not have surgical removal of the cancerous 
kidney could not have the cells prepared and could not take part in 
this study. 
Surgery is a standard form of treatment both to make the 
tissue diagnosis of the abnormal growth and to control local spread 
of kidney cancer. The benefits to patients after surgery are 
prevention of local problems which very often, but not always, come 
from disease spread out of the kidney. Problems prevented by 
surgical removal of the kidney are pain due to invasion of nearby 
organs, tumor invasion of major blood vessels causing blocked blood 
return to the heart, tumor invasion of the liver causing liver 
failure, and bleeding into the urinary tract from the tumor 
requiring blood transfusions. Patients who elect not to have 
surgery at this time can potentially have surgery later if these 
side effects develope. However, often at such a point surgery is 
more hazardous than it is now for several reasons your doctors can 
explain to you. 
2. TREATMENT FOLLOWING SURGERY 
The X— rays and scans you have had make it unlikely that 
surgery alone could cure you. There is evidence in your case the 
cancer has spread to organs beyond the kidney and not all of the 
cancer cells can be removed from your body by surgery. Only 
patients with clear evidence of cancer spread outside of the kidney 
are eligible for this study. The spread of the cancer outside of 
the origninal organ is called metastasis. Unfortunately, at least 
one in three kidney cancer patients have metastases when the tumor 
is first picked up. In 1993 doctors still do not know how kidney 
cancer is caused, and do not know how to prevent it. 
No widely effective treatment exists for metastatic kidney 
cancer, called renal cell carcinoma, or RCC for short. Currently, 
at Johns Hopkins RCC patients are offered (interleukin-2) IL-2 
therapy or phase I therapy. Phase I therapy can follow IL-2 
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