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Ultrasound on second, remaining testicle

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  • GD1345
    started a topic Ultrasound on second, remaining testicle

    Ultrasound on second, remaining testicle

    This past week I asked for an ultrasound on my left testicle after feeling slight soreness in my waistline area. The result showed the following results:
    "There is a subtle 5 x 4 mm hypoechoic to isoechoic rounded lesion in the superior left
    testicle, which is concerning for a neoplasm. There are a few dystrophic calcifications seen within the left testicle peripherally. No hydrocele. There is a small left-sided
    varicocele."


    This is all after I have had right orchiectomy and RPLND surgery in the past two months. I was hoping to be moving into surveillance, but am returning to worry about a recurrence of my TC. The right testicle was determined, by pathology, to be 100% pure embryonal carcinoma.

    Any idea what. is meant by "hypoechoic to isoechoic"? How serious are dystrophic calcifications and varicocele? Looking for support of anyone else who has been through the removal process once already and possibly looking for a second removal.

  • Davepet
    replied
    Great to hear the all clear!

    If you are still getting hot flashes, something isn't right. You might want to try a different brand of gel or even switch to injections. Some guys find one works better for them than the other.

    Leave a comment:


  • GD1345
    replied
    Thanks so much for the kind words. I appreciate it and all the support this forum has provided over this past year.

    Leave a comment:


  • Doryman
    replied
    Fantastic news!!!!

    Leave a comment:


  • GD1345
    replied
    Oh, and I had my four-month scans/blood work done this month and they came back all clear!

    Leave a comment:


  • GD1345
    replied
    Sorry for the delay in responding. I had another T level check on Dec 7 again and it's back up to 328 ng/dL. It's headed in the right direction. I feel about the same overall. I still get periodic hot flashes in the evening, but they are not significant or frequent. I have noticed increased morning erections.

    Leave a comment:


  • Davepet
    replied
    Your t levels seem pretty low, but how are you feeling? That is the most important thing.

    Leave a comment:


  • GD1345
    replied
    Hey everyone! It's been awhile, but just wanted to update this thread. I had my last full round of surveillance in August and was all clear. Then, I had a blood tumor markers check in October and the results were normal range/clear of cancer. I was pretty happy about it to the say the least.

    I have my next full round of surveillance in three weeks.

    I also am working with my urologist to get my testosterone levels set right. I saw them a couple weeks ago and my level was at 221 (Nov, 2020). They just increased my dosage from one packet per day to two packets per day. I am going to go in for another test a couple weeks (coincidentally the week before my cancer scans). I am feeling pretty good with minimal hot flashes. I just don't want the testosterone levels to continue dropping without frequent monitoring.

    Hope all has been well since I've last participated.

    Leave a comment:


  • GD1345
    replied
    I've been on TRT gel for seven days now. How quickly does it begin to impact the body? I am curious what other guys' experiences have been. My hot flashes and night sweats are not as common as before starting the TRT. I have noticed a soreness in middle-lower back that is helped by stretching. Does low, or no, testosterone, impact muscles in the body? It has me freaking out a bit about metastasis or recurrence of the cancer.

    Leave a comment:


  • GD1345
    replied
    Ah, thanks for explaining. Dr. McGuire cleared it up at the appointment this past Monday. He explained that the "lymphovascular invasion" did not mean the cancer metastasized beyond what was removed in the left orchiectomy. When I read "lymphovascular invasion," it made me think of the lymph node removal surgery (RPLND) I had done in February and I thought the cancer had returned to that area. It sounds like this tumor did not spread as quickly because there were no lymph nodes in my abdomen to attract it.

    Does that sound right?

    I have a new round of surveillance scans scheduled with my oncologist in the first week in August. Dr. McGuire suggested this after conferring with his oncology doctor. I also heard from Dr. Einhorn that this is an appropriate plan of action for surveillance.

    Leave a comment:


  • Mike
    replied
    Good to hear that you heard from Dr. Einhorn. The pT2 is the pathological stage of the tumor only. It is pT2 because of the lymphovascular invasion. IGCN is intratubular germ cell neoplasia, that was mentioned in the path report and is basically a precursor of germ cell cancers.

    Mike

    Leave a comment:


  • GD1345
    replied
    I met for my follow-up today. The tumor in my removed left testicle was Stage 1 nonseminoa, embryonal carcinoma. There is no sign of metastasis elsewhere. The urologist recommended a new round of surveillance scans in August including bloodwork, CT abdomen, and chest x-ray.

    Leave a comment:


  • GD1345
    replied
    Oh, I forgot to include in the previous post. that Dr. Einhorn emailed me yesterday to share his input after he saw the pathology report from my left testicle. He recommends that the continued surveillance schedule is sufficient based upon my 05/12 surveillance scans and bloodwork.

    Leave a comment:


  • GD1345
    replied
    Thanks for the doctor recommendation. I will see what happens at the follow-up appointment on Monday with my Northwestern urologist who did the surgery last Tuesday.

    I don't know what IGCN means?

    On the pathology report, the lesion on the left testicle was classified as T2Nx. When I looked up the meaning of this, it says that "T2" means spread beyond testicle and Nx means unknown if cancer has spread to nearby lymph nodes. If this is true, is there any way to have indication of where the cancer would have spread? Is it possible that the doctor labeled it "T2" because the lesion was on the outer layer of the testicle and not actually inside of the testicle?

    Leave a comment:


  • Mike
    replied
    I would assume, if scans and tumor markers are negative that you could enter into a "new" surveillance program with more frequent monitoring but I am not sure, given that you have already had an RPLND so that may play a role in the schedule.

    The path showing IGCN in the surrounding tissue is like a 50% odds of it turning into cancer in 5 years so even if they could have salvaged part of the testicle it likely would have meant radiation therapy with long-term effects on testosterone. Personally, as hard as it is, I would be happy to have had it removed.

    If you have access to NW, Dr. Robert Brannigan there is a top thought leader on testosterone and a nice guy as well. https://www.feinberg.northwestern.ed...html?xid=10530

    Mike

    Leave a comment:

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