To RPLND Or Not to RPLND, That Is...

[longsteeple]

The Question

Due to discuss options for future treatment with the consultant oncologist in a couple of weeks. To date, we have teratoma, left testicle removed (April 2006), 3xBEP (October-December 2006), and now - based on the lastest CT scan - at least a couple of lymph nodes sized at 15mm (about .59 inches). Not the oncologist but one of his team suggested on the phone that were the lymph nodes larger it would be RPLND now and if they were a little smaller there would be no need for an RPLND at all (fine, but not what the scan shows). I'm supposing the question will be whether to wait and see if the lymph nodes shrink further between now and the summer, or to take a more pessimistic and direct approach and go for RPLND now. I will be honest and put that to this point I've not looked at the specifics of my case in fine detail (I believe the lymph nodes were sized a little over 2cms pre-chemo). I'm minded to be aggressive and take the RPLND soonest (realising the pros and cons, is it, isn't, will it, won't it, etc) but that's because I'm out of patience. What questions should I ask? Would I be advised to wait?
David
Leicester, UK

[Scott]

I think the most important questions are:
If you choose surveillance now, what will be the schedule and tests? If you choose surgery now, how much experience does the surgeon have?The TCRC has a whole list of questions (http://tcrc.acor.org/RPLNDquest.html) to ask your doctors about RPLND. They won't all apply in your specific situation, but many still will.

Hang in there.

[Mom]

What do your markers show? Dianne

[dadmo]

How long has it been since you fininshed chemo? If your past 8 weeks you're already in surveillance and I would stay with it.

[longsteeple]

Thanks, both - you know, the markers haven't shown anything wrong since day one, which is unhelpful. Of course I still have my blood taken and tested every month but it's not saying anything useful.

[dadmo]

Having the markers normalize should mean that you have no active cancer. My choice would be to follow a tight surveillance schedule, but that can be a very personal issue. My son ruled out surveillance because he wanted anything that cancer touched removed. Of course if you have teratoma it will need to be removed and the sooner that's done the better.