This is how Rafael, NHS IT whizz and 18 year resident of London, started his journey with kidney cancer. At only 39 years old it was hard to believe that it would be cancer, but after a series of scans it was revealed that Rafael had two tumours, one on each kidney.
The tumour on his left kidney was 13cm (a kidney is about 9cm) and the tumour on the right was 8cm. As there were large tumours on both kidneys, preserving as much normal kidney tissue was as important for Rafael as treating the tumours effectively.
TUF-trained surgeon, Mr Ravi Barod, told Rafael that it was likely he would have to remove the whole left kidney but he could try and save some of it using an 'ice-cooling' echnique he learned during his TUF funded fellowship in the USA. The tumour on his right kidney, although smaller, was still very large and Ravi wasn't sure how much of the normal kidney he could save.
Ravi Barod received robotic surgery training that was funded by donors to The Urology Foundaiton and now robotic surgery is a part of his day to day work.
Robotic surgery is different from open surgery; by creating small incisions and using robotic instruments with greater agility than the human hand, Ravi is able to perform life changing surgery that simply wasn't possible a few years ago.
All this allows Ravi and his team to perform more complex surgery than before and send patients home in less pain and back to work far sooner than they could do with patients who underwent open surgery.
"Ravi told me that I might lose one of my kidneys and the chances for the other kidney weren't great, either.
"On it's own, that comment was enough to make me nervous about going into surgery, but I was also quite overweight and had been on the waiting list to have stomach reduction surgery done, only to be told it was too risky to perform.
"The first operation was in early April, it took 5 hours and I was in the Intensive Care Unit the next night. It took me a little while to recover, but I was back in work a month later. By early August I was ready for the next operation, which only took 4 hours and required no ICU."
The funding that Ravi received from TUF allowed him to travel to Detriot to learn a surgical technique that allows him to perform robotic surgery on large and complex kidney tumours. This involves introducing ice to cool the kidney during Rafael's robotic procedures, which allowed him to keep the normal part of both kidneys. Using this technique, he was able to operate for longer and completely remove the tumours while preserving as much normal tissue as possible in both kidneys.
Ravi told us, "This skills is unique in the UK and it's thanks to TUF that I am able to perform it. In the end we were able to completely remove both tumours and preserve the normal part of each kidney. Elsewhere, Rafael would have open surgery and would have almost certainly lost his entire left kidney, which would have dramatically affected his kidney function for the rest of his life.
"He would have faced a much longer period of recovery and a higher chance of complications afterwards. With robotic surgery he only needed to stay in hospital for 2 nights after each operation. Overcoming two operations would have been very difficult for him without robotic surgery and this ice-cooling technique."
Rafael told us, "At the end of this process, incredibly, I have one and quarter kidneys left. I had some initial pain in February and now, 6 months later, I've faced a kidney cancer diagnosis, had surgery twice, and I'm now free of cancer. I'm perfectly fine now.
"Ravi is a really nice guy. He was always very straight with me and didn't try to provide me with more hope than was realistic. He'd give me a reality check if I needed it and I really appreciated that. He always explained what was going to happen so clearly.
"Thanks to Ravi and his team I'm now back to doing the things I love; I'm working with computers and plunging myself into movies, music, and iRacing!"
Ravi is a TUF-trained surgeon who, thanks to his training, was able to make a huge difference for Rafael and his family. However, Ravi's influence doesn't end there. Ravi uses surgical skills that he gained with TUF to train other surgeons in the UK so that operations like Rafael's can become a regular part of treating kidney cancer in the UK.
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