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Can I do chemotherapy instead of orchidectomy?

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  • #1

    Can I do chemotherapy instead of orchidectomy?

    My Right testis has pT1 embryonal carcinoma, I have done orchiectomy.
    However my left testis also have suspicious 6mm lesion with vascularity. Can I do chemotherapy instead of orchiectomy for my left testis?
    Last edited by hinear; 02-06-17, 07:47 AM.
    30/12/16 2.5cm on right testis, 6mm on left testis.( B-HCG 0.34 <2,AFP 4.5 <7)

    24/01/17 Right I/O
    (Pure embryonal carcinoma, no lymphovascular, no invasion of tunica albuginea, rate testis, epididymis, spermatic cord. )

    14/02/17 AFP 2<7, 6mm on left testis
    17/02/17 Survelliance
    06/03/17 CT scan (Visible lymph nodes in the mediastinum . probable benign reactive appearance)

    28/07/17 AFP 35 (normal 7), relapsed confirmed
    04/08/17 CT scan (new metastatic para-aortic lymph node 1.6cm AP1.5cm)
    10/08/17 Start 3 BEP, AFP201 (normal 7)
    06/10/17 End of 3 BEP, AFP3 (normal7)
    17/10/17 CT scan
    27/10/17 Prev left para-aortic lymph node not seen. AFP2(normal 7), B-HCG <2, LDH 208( normal 118-220)
    Tags: None
  • #2
    As I understand it, for some reason chemotherapy cannot reach the testicle tissue. So no, I don't think it is an option.
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15 - 9/18/15: 4xEP
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    3/29/2018 all clears up to this date!

    Comment

    • #3
      Chemotherapy would not be an option. However, a partial orchiectomy, with frozen section biopsy in the operating room may be an option. If it is benign then they put the testicle back and if it is cancerous they would remove the testicle. Another option may be to monitor it with ultrasound if they are not sure it is cancer or not.

      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
        Thank you for your reply.

        My doctor recommended me to monitor it. Currently it is growing at 1-2mm per 3 weeks.
        Since my right testis was pure EC. I strongly think that the other testis is cancer.

        It means that I should do another orchiectomy for the Left testis. Then I can start the chemotherapy for prevention.
        30/12/16 2.5cm on right testis, 6mm on left testis.( B-HCG 0.34 <2,AFP 4.5 <7)

        24/01/17 Right I/O
        (Pure embryonal carcinoma, no lymphovascular, no invasion of tunica albuginea, rate testis, epididymis, spermatic cord. )

        14/02/17 AFP 2<7, 6mm on left testis
        17/02/17 Survelliance
        06/03/17 CT scan (Visible lymph nodes in the mediastinum . probable benign reactive appearance)

        28/07/17 AFP 35 (normal 7), relapsed confirmed
        04/08/17 CT scan (new metastatic para-aortic lymph node 1.6cm AP1.5cm)
        10/08/17 Start 3 BEP, AFP201 (normal 7)
        06/10/17 End of 3 BEP, AFP3 (normal7)
        17/10/17 CT scan
        27/10/17 Prev left para-aortic lymph node not seen. AFP2(normal 7), B-HCG <2, LDH 208( normal 118-220)

        Comment

        • #5
          Originally posted by hinear View Post
          Thank you for your reply.

          My doctor recommended me to monitor it. Currently it is growing at 1-2mm per 3 weeks.
          Since my right testis was pure EC. I strongly think that the other testis is cancer.

          It means that I should do another orchiectomy for the Left testis. Then I can start the chemotherapy for prevention.

          Make sure you are watching it! The fact that it's growing is concerning.
          Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

          7/1/2015: felt tiny lump on side of R testicle
          7/30/2015: Ultrasound shows 2 intra-testicular masses.
          7/31/2015: tumor markers normal, CXR clear
          8/5/2015: R orchiectomy
          8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
          8/14/2015: CT abdomen/pelvis clear, Stage 1b
          8/24/2015: started 1 x BEP

          Comment

          • #6
            I check from the internet that if the tumor size is 30% of testis and the patient only have 1 testis left.
            He can choose to remove the tumor only. Is that correct?

            Since cutting the tumor from the testis has possibility of spreading the cancer. I am not sure if I should take that risk.
            30/12/16 2.5cm on right testis, 6mm on left testis.( B-HCG 0.34 <2,AFP 4.5 <7)

            24/01/17 Right I/O
            (Pure embryonal carcinoma, no lymphovascular, no invasion of tunica albuginea, rate testis, epididymis, spermatic cord. )

            14/02/17 AFP 2<7, 6mm on left testis
            17/02/17 Survelliance
            06/03/17 CT scan (Visible lymph nodes in the mediastinum . probable benign reactive appearance)

            28/07/17 AFP 35 (normal 7), relapsed confirmed
            04/08/17 CT scan (new metastatic para-aortic lymph node 1.6cm AP1.5cm)
            10/08/17 Start 3 BEP, AFP201 (normal 7)
            06/10/17 End of 3 BEP, AFP3 (normal7)
            17/10/17 CT scan
            27/10/17 Prev left para-aortic lymph node not seen. AFP2(normal 7), B-HCG <2, LDH 208( normal 118-220)

            Comment

            • #7
              Partial I/O is very rare , it would not be worth the risk to me. Taking a frozen section for immediate biopsy might be worth a try, they did that on my #2, but ended up with a full I/O. I would not wait very long to see if it keeps growing, you are risking spread if you wait too long.

              Dave
              Jan, 1975: Right I/O, followed by RPLND
              Dec, 2009: Left I/O, followed by 3xBEP

              Comment

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