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  • The BIG day is almost here!

    My SIL finished 3XBEP for 2B seminoma on Nov. 11. CT scan is scheduled for Dec. 27-6 1/2 weeks post chemo. The onc. had originally talked about waiting til 8-9 weeks because seminoma shrinks slowly. It was only 1 node involved -2.7cm. Keep us all in your thoughts and prayers-excited and nervous to find out! Oh-his happiest thought-his hair is coming back!
    Last edited by highland850; 12-29-16, 09:48 PM.

  • #2
    All the very best, it's been a long road, thinking of you!

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    • #3
      UPDATE: So, found out today the node has shrunk to 1cm, 6 1/2 weeks post chemo. He had stage llB seminoma, so this should shrink further with time, no?
      Last edited by highland850; 12-29-16, 09:48 PM.

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      • #4
        It will likely shrink some more. However; being that it's Seminoma, do not be surprised if he has a residual sub-centimeter mass.

        Both of mine shrank down to about 1/2 cm and have been that way for the last two years.

        Did he have markers drawn too ?

        - Matt
        March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
        March 13th: Left IO 100% Classic Seminoma
        6.3 x 5.1 x 3.8 cm, no invasion of anything
        LDH never fully normalized
        Stage: IS
        Watchful Waiting
        May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
        May 12th: started 3xBEP
        Neupogen during Cycle 2 and 3
        July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
        August 4th: Post Chemo CT/PET scan
        September 4th: Port removed
        July 8th 2017: 3 YEARS ALL CLEAR !

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        • #5
          waiting to hear from the onc., who is on vacation. Should he have a PET scan, or just wait for another CT?

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          • #6
            Originally posted by highland850 View Post
            Should he have a PET scan, or just wait for another CT?
            With a 1 cm node the oncologist will most likely recommend surveillance. A PET scan is only really used in seminoma if the residual mass after chemotherapy is >3cm. Given that it is less than 3 cm they should just watch it. Doing PET scans in other situations can lead to false positives, that lead to other procedures, etc. Most experts only recommend a PET if it is seminoma and the residual mass is >3m as mentioned.

            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

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            • #7
              I can speak from my experience...but I am only one one of many Seminoma patients, so take it with a grain of salt.

              I had a PET/CT just before chemo which showed that my involved retroperitoneal nodes had a high level of PET activity. Then about 4 weeks after chemo we did a PET/CT which showed the results of the chemo: The nodes shrank to just under 1 CM and were not PET active. At my 6 month checkup my Onco. ordred a CT only. I was concerned about that because my first CT, was blown by the person reading it, and I did not trust them to read the scans again....I argued for one last PET scan. My Onco. grudgingly agreed to do it, as she realized that psychologically I needed it for my own sanity and confidence. However I had to pay for most of it as the insurance did not see it as needed (these scans are very expensive).

              The bottom line is that it may not be needed.

              Was he PET active before chemo ?

              Under 1 CM PET scans can have more false positives. That false positivity drops with larger post-chemo masses.

              - Matt
              March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
              March 13th: Left IO 100% Classic Seminoma
              6.3 x 5.1 x 3.8 cm, no invasion of anything
              LDH never fully normalized
              Stage: IS
              Watchful Waiting
              May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
              May 12th: started 3xBEP
              Neupogen during Cycle 2 and 3
              July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
              August 4th: Post Chemo CT/PET scan
              September 4th: Port removed
              July 8th 2017: 3 YEARS ALL CLEAR !

              Comment


              • #8
                Thanks for the feedback. I am not sure if he had a PET pre-chemo, but I don't think so. And b/c of the false positives, he didn't want to do one after either. I'm kind of confused tho- I know the NCCN guidelines call for surveillance if the node is < 3cm post-chemo, but his was only 2.7cm to begin-so does this still apply to him? The onc. has already said that he believes it will completely disappear, but if it doesn't, he should have an RPLND. And apparently with seminoma, there are varying views on that. One step at a time, I guess.
                Last edited by highland850; 12-31-16, 08:53 PM.

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                • #9
                  Originally posted by highland850 View Post
                  I know the NCCN guidelines call for surveillance if the node is < 3cm post-chemo, but his was only 2.7cm to begin-so does this still apply to him?
                  Yes, still applies, especially since it shrunk from 2.7 to 1 CM. The chances are excellent he is cured at this point. Waiting until the next CT seems like the right move to me.
                  Dave
                  Jan, 1975: Right I/O, followed by RPLND
                  Dec, 2009: Left I/O, followed by 3xBEP

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