Announcement

Announcement Module
Collapse
No announcement yet.

Tough decision. Anyone have a similar experience?

Page Title Module
Move Remove Collapse
X
Conversation Detail Module
Collapse
  • Filter
  • Time
  • Show
Clear All
new posts

  • Tough decision. Anyone have a similar experience?

    New user here. Hopefully some of you can relate and shed some insight. Any thoughts are appreciated. My history and situation are as follows...

    3/2017 - After a solid 24 hours of severe pain in my left testicle, I pay a visit to the ER. I undergo surgery, and lose my left testicle to torsion. My right testicle is at that time stitched to the scrotum (bell clapper). I recover and all is well.

    10/28/17 - I wake up with some pain in my right testicle. Not as severe as back in March, but there nonetheless. Fearing of making the same mistake twice, I choose to not wait it out, and once again head to the ER. Now living in a different county where my PCP and Urologist are not. A sonogram was performed. A shadow was present in my remaining testicle. The conclusion of my sono report read as ďSurgically absent left testicle. Hypoechoic region/mass in the lower pole of the right testicle. Neoplasm cannot be excluded from this exam. Orchtitis is possible however there does not appear to be hypervasularity that can be seen with inflammation.Ē I get a disc/images/copy of the report, and schedule an appointment with the urologist who performed my surgery back in March.

    11/1/17 - Appointment with Urologist along with blood work for TC markers. Markers come back as normal (urologist got these results after our appointment). Physical exam of the testicle seen as mostly normal. As with scar tissue and three permanent stitches. The urologist feels that this shadow is most likely not related to my past surgery. He also feels itís not related to infection. He tells me that ďif I had two testicles, he would recommend removing this testicleĒ. Being that I have only one, it puts him on the fence about the whole situation. He goes on to tell me I basically have three options at this point...

    1. Monitor the issue very closely for the next three months. With repeated sonograms, looking for growth, and checking my markers. Taking the gamble, and going from there.

    2. He normally wouldnít recommend this, but ďseeing as I have only one leftĒ. ďScoopingĒ the mass out, and doing a biopsy. Biopsy comes back as benign, Iím in the clear. Biopsy comes back as malignant, monitoring/treatment ensues. Cancer returns, obviously another surgery would be requires removing whatís left of the testicle.

    3. Remove the entire testicle now, biopsy, and go from there.

    He is now out of the office. Returning one week from the date of this post. I have a list of questions to ask him upon his return, and am very impatient about waiting this out. As Iím sure most of you know, this is scary stuff. My questions to my urologist are...

    Is the mass solid or fluid filled?
    Is there any increased blood flow to the shadow in question?
    Would an immediate additional sonogram, MRI or any test for that matter help determining anything at all?
    Can a biopsy be performed during surgery? Helping to avoid a possible additional surgery if the tissue is found to be malignant (eg removing the entire testicle at that time).
    If during surgery the issue found is not related to TC, will the testicle be returned to me?

    Any thoughts, similar experiences, additonal questions/info. I should seek etc. are all appreciated. Stressed out.

    Thanks guys (and gals lol)

  • #2
    I am not a medic, but from the lack of hyper vasculariity noted in the report I would say no there is not increased blood flow.

    One option (and I think it is what your urologist is referring to at your point 2) would be to do a frozen section biopsy where they basically open you up via the inguinal route, externalise the testicle, remove the lump and whilst you are still under anaesthetic it is analysed. If it is TC then they proceed to remove the testicle. If it is not TC then they can put back the remaining healthy testicular tissue. It isnít foolproof, there is a small error rate on the analysis, but it is an option given your situation.

    Comment


    • #3
      I agree that frozen biopsy is certainly an option before removal if it does come back as cancerous. I am not sure of the size of the mass but my understanding is that typically partial orchiectomies are with masses less than 2 cm. Monitoring with a repeat ultrasound is also an option. You may even be able to get one sooner and see if the appearance of the mass has changed which ma indicate a hemorrhage or infarct. Similar to what just happened with: http://www.tc-cancer.com/forum/forum...567#post305567

      The fact that your tumor markers are negative is good in that while negative markers can't rule out cancer positives ones would have ruled it in. Waiting a few weeks certainly is not expected to affect your outcomes if it is cancerous. Although waiting is the worst part.

      Mike
      Oct. 2005 felt lump but waited over 7 months.
      06.15.06 "You have Cancer"
      06.26.06 Left I/O
      06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
      06.30.06 It's Official - Stage I Seminoma
      Surveillance...
      Founded the Testicular Cancer Society
      6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

      Comment


      • #4
        I appreciate both of your replies greatly. Excellent points too. Helps to put my mind at ease some. Iíve decided on a plan of attack. Next week will be over two weeks since my last sonogram. Assuming my urologist thinks itís worthwhile, Iíll ask for another songram looking for any changes. If my urologistís feelings on the matter havenít changed, then Iíll move forward with the frozen biopsy asap. Iíll leave the surgery with an implant or two while Iím at it, have testosterone therapy on stand by, and continue with any needed treatment. Iíll update this thread when I know more. Aslo Iím 36. For what itís worth. Lol thanks again.

        Comment


        • #5
          Looking forward to hear back from you. I had the partial remove on my testicle which is not usual treatment. The frozen biopsy doesn't get clear result. My urologist keeper my left testicle. But the pathology result is benign after 5 days. but I still have concern about it since I still have lump and pain there.

          Comment


          • #6
            Due to other health conditions, here is my delayed update to this thread. My urologist's reply to my questions were...

            Sonogram showed solid lesion/mass
            No increased blood flow, no decreased blood flow, it is viable tissue of unknown significance.

            Testing
            This soon is unlikely to give us any useful information. Usually if we choose to observe (at least in the short term) repeat sono in 3m is the soonest I would recommend. The tumor markers are the only other testing to do which have all been normal. No further imaging study is any better than ultrasound.

            Surgery
            The only way to know if it is malignant or not is to do a biopsy during surgery and await the results. If it is malignant, we still have the option of partial removal (enucleation) vs complete removal of the testicle.

            This reply was given on 11/13/2017. I have since had an appointment with him and spoke in person. At this point I have scheduled surgery. It's this coming Monday 12/4/17. The mass was originally found 10/28/17. The urologist believes that even if the mass is found to be malignant, that returning the testicle to me after partial removal is the way to go. I'm kinda skeptical of this, but what do I know. I will be getting a prosthetic for my already missing left side, and possibly for the right depending on the outcome during surgery. Here's to hoping it's benign.

            I know it varies, but any thoughts on what to expect post surgery? Recovery wise. When I had my operation back in March, I had two roughly four inch incisions on my scrotum. This time around I will have one incision on my lower abdomen, and 1-2 incisions on my scrotum. The thought of having your testicle removed from where it originally dropped/through your abdomen is pretty cringe worthy. I look forward to any and all replies from the users on this site. I will update this thread after my surgery. Thank you sirs.

            Comment


            • #7
              Wow! Hopefully on Monday you will get some answers. so sorry.
              Son Grant
              dx 12/21/16 at age 17

              BEP x3
              Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
              2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
              Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

              Comment


              • #8
                I have not had scrotal surgery but I think the inguinal incision would be easier, at least in my mind. I am surprised that the urologist wouldn't do a 1 month or 6 week ultrasound but I suppose if the decisions are made for surgery and you are comfortable with them then that is the "safest" alternative. It was my understanding that if a partial orchiectomy is done and it comes back as cancerous, even if the margins are clean that they would need to irradiate the testicle too. I may be incorrect on that but I would ask. My thought is that with a partial testicle that then gets radiation therapy is there really going to be any function left in the testicle? Testosterone/Sperm function would be the only real reason to keep the partial testicle so I would want to make sure it all makes sense before they left a partial testicle that had cancer in it inside me. I'd rather just have the whole thing removed if the intra-operative results are showing cancer.

                Mike
                Last edited by Mike; 11-30-17, 10:16 AM.
                Oct. 2005 felt lump but waited over 7 months.
                06.15.06 "You have Cancer"
                06.26.06 Left I/O
                06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
                06.30.06 It's Official - Stage I Seminoma
                Surveillance...
                Founded the Testicular Cancer Society
                6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

                Comment


                • #9
                  I agree completely Mike. I did undergo surgery yesterday with both inguinal and scrotum incisions. The tumor was removed during surgey and the pathologist determined it to be benign. My right testicle was returned to me and my already missing left testicle, was replaced with a prosthetic. All in all great news. I appreciate all the insight I have received on this site, and it was a huge help. This site is an excellent resource. My heart goes out to all who are struggling or have struggled with all forms of this disease. I can only imagine what some people have gone through. Iíve lost many people close to me because of it. Both sides of my family and friends. I wish everyone on this site the best, to remain strong, and to overcome their illness. For now a weight has been lifted and Iím very grateful. Thanks again.

                  Comment


                  • #10
                    Hope you are recovering well. I can;t imagine how scary. Please keep us updated.
                    Son Grant
                    dx 12/21/16 at age 17

                    BEP x3
                    Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                    2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                    Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                    Comment

                    Working...
                    X