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  • Hi all

    Hi all, after lurking for the last month, I figured I should join the community and introduce myself. Several months back, I had some trauma, resulting in a swollen testicle. After a few months of hoping the problem would go away, I finally found a doctor that could see me. He sent me for a US the next day, then the urologist the day after, and then had it out the following day, seminoma. first CT came back clean, but my b-hCG hasn't normalized, and after an order of magnitude drop, went up a touch. Chest x-Ray raised a concern, and I'm back for another CT and more blood tests next week. So, my veins are beat up, anxiety is giving me issues (no sleep) and no idea what comes next. With all that said, i'm glad i found this community, and i'm grateful for all the information and experiences people have shared.
    Cheers

  • #2
    Sorry to have to welcome you here. If your hcg doesn't normalise, and it appears it hasn't, then you are probably headed for BEP chemo. It isn't pleasant but you will get through it quickly enough and the good news is that seminoma is extremely sensitive to BEP so you will beat this. Once you get the CT and chest x-ray results, people here may be able to give you more info but BEP looks likely to me.

    Comment


    • #3
      Thanks Mark. Initially the doc seemed to think that radiation might be a good option, but with the potential spread, will the BEP be the new route? He had also talked about a 1xchemo option(cargo maybe) I have a lot more reading to do...

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      • #4
        Carboplatin is only an option as an adjuvant therapy if you show no signs of spread. If your bhcg doesn't return to normal then that is taken as a sign there are some cancer cells in there somewhere. Radiation would possibly be an option if the new CT scan shows enlarged nodes as they would have a target to aim. If the CT comes back clean though, then I think chemo, in the form of BEP, is more likely. BEP is systemic so it will find the cancer cells wherever they are hiding and will deal with them very effectively.

        Both radiation and chemo are very effective against seminoma in the right situations. Both have there own set of risks and side effects. Make sure you fully understand your treatment options before you sign up for one or the other. That may mean speaking to more than one specialist. Let us know how the bloods and CT go and I am sure others will chip in with comments and advice.

        If you do some reading, make sure it's from respected sources and don't just hit Google.

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        • #5
          How high is you B-hCG level? What were the levels and he date if you have them?

          Otherwise, I agree with MarkOne in that the imaging and next blood levels are going to dictate your options.

          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


          • #6
            I was at 396 on June 1, surgery on June 2, down to 12 on June 20, and up to 16 on June 28.
            LDH / AFP went from 278 / 0.9 on June 1, to157 / 1.1 on the 20th.
            I'll have the next round the end of this week, I'm just trying to mentally prepare for the next bit.

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            • #7
              Friday should give you more information. Are they doing a chest CT or and abdominal and chest CT? A change from 12 to 16 in a week wouldn't overly concern me as the labs are not perfect. If the CTs are normal and the level is not significantly increasing then I would want a TC expert to give a second opinion on starting chemotherapy for just a beta-hCG level in the the low teens. I would also ask my doctor if low levels like that could be due to hypogonadism. Again, Friday's results will give you better information for questions to ask.

              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


              • #8
                Had another blood test and ct today, and not sure where this puts me.
                HCG went up to 20, seems to confirm my increasing trend.
                Radiologist comment on the ct: 'no pulmonary nodule to correlate with X-ray finding in right lung, no pulmonary finding suspicious for metastatic disease. There is a 3mm left lung pulmonary micro-nodule that very likely represents a benign post infectious or inflammatory nodule.' (Tumor / I/O was right side).
                Note from radiologist on X-ray: 'sub centimeter nodule projecting over right upper lobe'
                I don't have pre I/O testosterone results for comparison, but today's results: globulin 67, total testosterone 613, free testo, calc. 82.4. Could anything here be associated with the hcg going up?

                Any thoughts for me? How much weight do I put on the X-ray result vs ct? Before the chest X-ray the doc was ready to recommend radiation, I wonder if that will change?

                Comment


                • #9
                  It is my understanding that elevated levels of leutenizing hormone (LH) can interfere with the beta-hCG blood test. Did they check your LH and FSH levels along with your testosterone? You can ask your doctor if they should be checked and if they are elevated if a testosterone dose should be given to see if that decreases the beta-hCG. Another thing that hasn't been mentioned is that if you use marijuana then it can also elevate the beta-hCG levels.

                  Lastly, a study just release looked at patients with stage IS testicular primary germ cell tumors and they determined that the overall survival was basically the same for those that underwent observation or immediate adjuvant treatments with radiation/chemotherapy for seminoma or chemotherapy/RPLND for nonseminoma. It may be worth taking a look at the study and showing it to your physician. While it may not be perfect it is the largest data set we have on stage IS disease and may at least give some reassurance that time may be able to be given to figure out things before rushing into treatments. http://www.europeanurology.com/artic...508-0/abstract the full test is available on the page.

                  The CT on the chest is in much greater detail than the chest X-ray so I would not worry to much personally on the chest X-ray results.

                  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


                  • #10
                    Mike, thanks mucho. You are very helpful. I need to read that study.
                    i did not have results for the LH or FSH tests, I'll ask about those.
                    I have used cannabis occasionally, but not recently (I'm not certain when the last time was but at least a couple months). it's hard for me to picture that would be related to my current upward trend, but I have been looking for more info on the relationship, but haven't been very successful. i have seen that relationship reported frequently, but nothing with regard to the duration or magnitude of impact. (Additionally, others here in the forum have said that even frequent, recent cannabis use even had no impact on their tests, so that has made me think I can rule my last use as the cause of my current trend, but I wish I could find more data on the subject.)
                    Thanks for taking the time to respond, and run the site, you are helping a lot of people.

                    Comment

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