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Possible after BEPx3, relapse with bone Mets?

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  • Possible after BEPx3, relapse with bone Mets?

    Hi everyone, since long time I have trouble with this website. I hope it is getting better.

    My son has his 11 months after BEPx3 and 9 months after RPLND follow up. CBC, AFP and LDH were all normal, bhcg was missing till Monday.

    Abdomen CT showed good but right hemisacrum showed increasing density. Radiologist said: this may present bone island, but blastic metastasis is not completely excluded. My son was suffered sometimes back pain. Will it be relapse with cancer spreading to bone? I could not find out any cases.

    Could you give me any advice? We are in panic!

    PS: ALP is also normal, bone scan and chest x-way Are scheduled next Tuesday! My son’s oncologist wrote to Dr. E immediately, but she said ,she won’t expect that cancer is return in bone when ALP is normal.

    Many thanks in advance

    Ryan’s mumm
    Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma ,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teratoma .Back to surveillance 05/02/19 Blood work all normal

    08/23/2019 normal
    12/04/2019 normal.
    04/01/2020 normal.

  • #2
    Hi Ryan's mom,
    I think bone metastases are extremely rare, but I'm curious if anyone else has ever heard of it as a possibility. Radiology reports are notorious for containing scary language that means nothing.
    When do you meet with the oncologist to discuss these findings? I hope soon.

    Good luck to you and your son, I'm glad he has such a strong advocate as you in his corner.

    Please let us know how things turn out.
    Painless lump 5/18/2017
    Orchidectomy June 2017 (4.5cm, rete testis involvement)
    Chemo Summer 2017 (2x7AUC carboplatin)
    No evidence of relapse since, but plenty of anxiety about it.

    I'm also an epidemiologist, and a professor at a medical school (with NO training in oncology), oh, and gay, too.

    Comment


    • #3
      I've never seen such a situation.betahcg ?

      Comment


      • #4
        We're all curious.Could you give us some information?

        Comment


        • #5
          Thank you!

          Now we are waiting for Bhcg and next steps with x-ray, bone scanning.

          BRs
          Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma ,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teratoma .Back to surveillance 05/02/19 Blood work all normal

          08/23/2019 normal
          12/04/2019 normal.
          04/01/2020 normal.

          Comment


          • #6
            it could some other damage from chemo too. biopsy would be the best.

            Comment


            • #7
              Got the blood results?

              Comment


              • #8
                Update.

                Bhcg is normal, lung CT is also normal! He is taking bone scan now! Very nervous!

                BRs

                Ran’s mom
                Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma ,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teratoma .Back to surveillance 05/02/19 Blood work all normal

                08/23/2019 normal
                12/04/2019 normal.
                04/01/2020 normal.

                Comment


                • #9
                  That's great news.... if there was cancer somewhere, afp and betahcg would pop up.

                  Comment


                  • #10
                    Originally posted by omerkulum View Post
                    That's great news.... if there was cancer somewhere, afp and betahcg would pop up.
                    Hate to say to say it, but that us not true in every case.
                    Jan, 1975: Right I/O, followed by RPLND
                    Dec, 2009: Left I/O, followed by 3xBEP

                    Comment


                    • #11
                      ALP is good .. very important..

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                      • #12
                        ALP indicates the problem in the bones.

                        Comment


                        • #13
                          Thank you guys for your replies.

                          Even the bone scans report is not ready, but my son’s oncologist told him already:everything seems fine, no bone Mets!

                          This is a really good news, we are very excited. The past week was horrible for my family.

                          Thank you everyone for your input or interesting!

                          Wish everyone all the best!

                          Ran‘s mom
                          Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma ,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teratoma .Back to surveillance 05/02/19 Blood work all normal

                          08/23/2019 normal
                          12/04/2019 normal.
                          04/01/2020 normal.

                          Comment


                          • #14
                            Really good news! I am really happy for you

                            Comment


                            • #15
                              I find that very often I can’t access to our forum, anyone has the same problem?

                              Yes, we are really released! I did some research, there is very rare low likelihood relapse with bone Mets, but all studies were retrospective. So were not very convinced.

                              Thank you for your guys replies, you are very very appreciated!

                              I hope everyone here staying good in upcoming holidaysseasons and forever!

                              Amy, Ran’s mom
                              Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma ,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teratoma .Back to surveillance 05/02/19 Blood work all normal

                              08/23/2019 normal
                              12/04/2019 normal.
                              04/01/2020 normal.

                              Comment

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