Went to the 2% group ...

[Caio Ferrari]

Hi there.

I got my first TC in Jan 2008. It was a mixed tumor, 70% classic seminoma and 30% embryonal carcinoma. My BHCG where a little high (2,0) and AFP where ok. Me right testicle was removed and I got 4 EP shots. My last check-up was Oct 2013 and it was all clear.

Last week I felt a little mass on my left testicle. The ultrasound showed a 7 x 5 mm hipoecoic nodule. With my history of a previous cancer and a severe microlitiasis its written that is an another tumor. I don't know if I should be happy but, either the BHCG, AFP and LDH are ok.

Now I'm struggling to have an appointment with the doctor ASAP to get the another testicle removed and start the chemo all over again.

[No nuts]

Sorry to hear your bad news. It is a hard thing to get it the first time crushing to hear the second. It is a different journey for everyone. You should definitely get in ASAP and get it done. If you don't have children and think you you might want them. I would store some sperm before surgery. Second you will have to do testosterone therapy and I would start right away. Talk to your doctor about the different choices. Also you need to talk about what you are going through to friends family or a professional and this site is a great place to get help too.

[Kiwi]

Slow down - you do not yet know the Pathology and make up - you might qualify for surveillance? and you could have a different type e.g seminoma. Any way with you and this crap time, but you will get through it, hey a few years ago I decided to make the T replacement work for me and now I am fitter and healthier than I have even been by hitting the gym - any way worked for me. Quite happy to.

Think about prosthetic/s but NUMBER ONE you need to ask and get on the way to getting it started. DONOT let the docs delay this.

[Caio Ferrari]

Hi there, I went to three urologists that are not sure about the diagnosis. The first one thought it was something in my epididymis and asked for a MRI and prescribed one antibiotics until I wait for the results. The second one, from a cancer specialized hospital told me that is probably another cancer ( either a seminoma or a teratoma) but he wasn't sure. He asked for a MRI too. Depending on the results I'm going to surgery and depending in the result I would get my testicle off or not. The third doc, witch ace my first surgery ( an awesome doc, a professor of one best university in Brasil an so on) where more conservative. He is not sure about the diagnosis. It's a solid mass, but it's painful by touch and the blood markers are ok. According to this doc, the best alternative is to remove only the tumor and preserve the testicle. That's all about hormonal replacement because according to him it's not a good idea in my age (27). Now, I'm waiting oft the MRI results, tomorrow I'm doing another ultrasound of the testicle and I'm waiting for the hormonal blood tests too. I'm very calm because all docs told me that I'm not going to die because of this. It's just another step that I need to go through.

[Davepet]

A solid mass on an U/S is almost always TC. The test is very reliable. I personally would not waste time getting into surgery & getting that traitor out. I would never allow a doc to just remove the tumor, My doc wanted to try that & I said NO. It is not worth the risk of possible cancer spreading. They can do something called a "frozen section" & get an immediate pathology read on that. telling them if it is cancer or not, all while you are out on the table. They did that with me but I made sure to tell the doc that if it's cancer I want it out.

You probably caught this early & can avoid chemo if you act quickly. If they try to remove just the tumor & it is TC, it will almost certainly spread to your nodes quickly. While still very treatable at that point, why put your life at risk to save one small part? Life goes on without testicles pretty much same as before.

Dave

[Caio Ferrari]

For me, removing all the testicle is the best alternative too. But I'm struggling to let the doc do his job and trust on his knowledge to choose which is the best option for me. By the way, I'm still playing on the "remove everything" team and I'll have to be convinced by the doc that preserving my testicle is the best option.

I think I caught this early too. My blood levels are ok, even the LDH, and my testicle nodule is small, less than 1,5 cm. My lungs are ok, and right now I'm just waiting for the MRI results and make de I/O. Lets see if the chemo will be necessary this time. Crossing the fingers to be a classic seminoma and avoid de chemo.

[Kiwi]

We have not seen to much of partial removals - this seems to very rare and maybe a developing procedure?.

[Caio Ferrari]

I'll go back to a appointment soon and ask my physician about that. He appeared to be very concerned about my life after the surgery since a TC isn't lethal anymore.

I got my MRI results and it obviously showed the mass in my testicle, vascularised but it could't tell about it's nature: benign ou malignant which was a surprise for me.

[steffo]

i've spoken with 4 (italian) doctors about partial removal: they all seemed against it and they are used to let you choose between full and partial removal only in the case you've already lost a nut.
one of them (my uncle) told me last EU reports on partial removal showed a very high rate of TC relapses. another doctor said if you try a partial removal, the cancer stage increases (e.g. if your stage is 1 and you have a partial removal performed, they will cure your TC as stage 2).
boa sorte

just googled something interesting
on the procedure + 2011 review http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183701/
2001 article (?) http://reference.medscape.com/medline/abstract/11696727
on eligible patients for partial orchiectomy: http://emedicine.medscape.com/article/1450806-overview

[Caio Ferrari]

Hi there. I made my surgery yesterday. They did a biopsy of the tumor and they didn't find evidence of germ cell tumor. The frozen biopsy is never definitive since it has a accuracy of 85% but they felt secure to remove only the solid mass. Ih the final result of biopsy shows a germ cell tumor they will do the surgery again to remove all the testicle.

[Kiwi]

That is not common - they will usually have a vision and maybe check some quick pathology and then remove, have not see this approach before, there may have been a bit of doubt.

[Tom123]

Hi there.

I got my first TC in Jan 2008. It was a mixed tumor, 70% classic seminoma and 30% embryonal carcinoma. My BHCG where a little high (2,0) and AFP where ok. Me right testicle was removed and I got 4 EP shots. My last check-up was Oct 2013 and it was all clear.

Last week I felt a little mass on my left testicle. The ultrasound showed a 7 x 5 mm hipoecoic nodule. With my history of a previous cancer and a severe microlitiasis its written that is an another tumor. I don't know if I should be happy but, either the BHCG, AFP and LDH are ok.

Now I'm struggling to have an appointment with the doctor ASAP to get the another testicle removed and start the chemo all over again.

did any of you second guess the symptoms you were having the second time around.. being the occurance is so low and your mind probably plays tricks on you for every little thing you feel after the first time? I find myself wondering if any ache is abnormal or not and and any size or firmness changes throughout the day get my attention. Anyone else relate?

[kevcody]

@Tom123 I am wondering the same thing. I am experiencing a similar dull ache and possible increase in firmness in my remaining testicle (previous IO was in June 2013). I called my Oncologist's Office at the Cleveland Clinic to ask if it is anything of concern, or if I should wait for my next 4-month check-up, and I've been directed to come in and have an ultrasound and meet with my Oncologist.

My worry is that it may just be completely a mental thing. I don't have the other one to compare to (like I did last time), so I am simply not sure. From reading through these threads, I understand it is high improbable (~2%) to have a second primary cancer; however, we all beat the odds the first time.

[Davepet]

I find myself wondering if any ache is abnormal or not and and any size or firmness changes throughout the day get my attention. Anyone else relate?

First off: If you are checking your remaining guy any more often than once a month, you need to assume that you are the cause of any pain or swelling you experience.Once a month after a hot shower or bath. Any more than that or at other times is totally unreliable & should be ignored. That said, it's quite normal to relate every ache & pain to your TC, but the odds are they are just the normal aches & pains every human gets from time to time.

Dave

[kevcody]

Thanks for your follow-up, Dave. I understand they are sensitive in nature, but I don't think I realized that a simple check could cause they symptoms I am seeing (as naive as that my sound). I will certainly take that into consideration. Personally, my ultrasound is tomorrow... so I will know for certain then. However; in the future, trying to remain positive that there will be one with the remaining guy in it, I will be sure to abstain to checking it less frequently.


I sincerely appreciate all the effort and work you all put into these forums. I spend a lot of time reading, but don't post much. That said, it is immensely helpful to have such a great resource to be able to research. Cheers to you all, and will post after my appointment tomorrow.