DESCRIPTION Joshua Silva did not take lower back pains and gastrointestinal issues seriously until they worsened, forcing him to visit an emergency room.  A CT scan revealed inflammation of his appendix, necessitating an appendectomy.  A urologist said the scan also showed a problem in his left kidney, later diagnosed as clear cell renal cell carcinoma, a type of kidney cancer.  Joshua underwent a partial nephrectomy knowing before the procedure he may lose the kidney.  When