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Starting the road of surveillance

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  • Starting the road of surveillance

    Hello guys,

    This forum has been a good way to get information, get hope and meet other survivors.

    Last week I had my first follow-up appointment with my oncologist after chemotherapy. I had my blood work and my abdomen/pelvis/chest CT Scan (since my insurance didn't approved a PET Scan). I never got a true stage because with what I read I should have been stage IIC seminoma, my doctor said 3A, but at my documents it was 3B (weird).

    Blood work: Before starting chemo I had my LDH at 650, now 5 weeks after chemo it is 210 (within the range of 220). Other markes never been escalated.

    CT Scan of my lymph nodes: I had 3 enlarged lymph nodes - a) 3.7 x 3.7cm which now is 1.1 x 1.5 cm - b) 2.5 x 2.8cm which now is 1.2 x 0.6cm - c) 5 x 6 cm which now is 2.4 x 0.8cm
    I was looking at the images of the CT Scan and even the 2.4 x 0.8cm lymph node was just some small dots and it looked like they were trying to measure it. This was also the opinion of my oncologist, who said that it looks like they were just trying to give an estimate of it. What my doctor told was that probably what is left are just scares or concrete, so I did good during my chemo. Even with guidelines everything under 3cm with seminomas goes under surveillance.

    Giving this details, I have some questions that I need some opinion from others:

    1) Is the follow-up schedule after 6 months good with seminomas?
    2) What are the chances that those nodes more than 1cm could still be cancer?

    Thank you guys!
    Dec 2017 - felt lump and never checked it out. 07.17.18 - Diagnosed with TC 07.20.18 - Left I/O 08.04.18 - Pathology - Seminoma 08.24.18 - CT Scan shows 3 enlarged lymph nodes (3.3x3.1cm & 3.3x3.2cm & 5.1x3.9cm) no other organs met 09.04.18 - OFFICIAL STAGE 3A Seminoma 09.06.18 - Started 4xEP @ MD Anderson 11.12.18 - Finished 4xEP 12.20.18 - Lymph nodes under 3cm - Starting surveillance 06.16.19 - Lymph Nodes continues to shrink 12.18.19 - Tumor markers in good level. Lymph nodes are even smaller.

  • #2
    Happy NEW year to you! I do not know Seminoma NCCN Guidelines, sorry.
    Son Grant
    dx 12/21/16 at age 17

    BEP x3
    Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
    2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
    Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

    Comment


    • #3
      NCCN recommends a 3 month follow up for imaging/labs if I am reading it right. After that follow up, then it goes to a 6 month, then it goes to annual for imaging, and labs remain at every 6 months.

      I think chances of there being any remaining cancer are pretty low, given your response and the way you fall into the guidelines.
      6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
      6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
      7/7/15: bHCG 56, AFP 42, LDH 322
      7/13/15: begin 4xEP, end 9/18/15
      10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
      10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
      4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
      4/20/16: RPLND @ IU - teratoma only!
      10/22/19: all clears up to this date!

      Comment


      • #4
        Hello guys,

        Just a follow up for my 1 year scan and labs. Good news everything is OK. Labs came all within normal. CT scan came with results showing that lymph nodes continue to shrink, and now only 2 of them are more than 1cm.

        Left paraortic 0.9x1.1cm (previously 1x1.2cm) (before treatment 3.7x3.7cm)

        Left external iliac 0.7x1.4cm (previously 0.7x2cm) (before treatment 5x6cm)

        And the left common iliac is not shown in the report, meaning that's less than 1cm (previously 0.7x1cm) (before treatment 2.5x2.8cm)


        Hope they will continue to shrink and I can have another clean next year.

        Marry Christmas & Happy New Year everybody, wish you all the best
        Dec 2017 - felt lump and never checked it out. 07.17.18 - Diagnosed with TC 07.20.18 - Left I/O 08.04.18 - Pathology - Seminoma 08.24.18 - CT Scan shows 3 enlarged lymph nodes (3.3x3.1cm & 3.3x3.2cm & 5.1x3.9cm) no other organs met 09.04.18 - OFFICIAL STAGE 3A Seminoma 09.06.18 - Started 4xEP @ MD Anderson 11.12.18 - Finished 4xEP 12.20.18 - Lymph nodes under 3cm - Starting surveillance 06.16.19 - Lymph Nodes continues to shrink 12.18.19 - Tumor markers in good level. Lymph nodes are even smaller.

        Comment


        • #5
          Thank you for the good news. I am here really happy hearing such good news!

          Best wishes to you!

          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


          • #6
            Originally posted by Ryan Bi View Post
            Thank you for the good news. I am here really happy hearing such good news!

            Best wishes to you!

            Ran’s mom
            Thank you, hope Ryan is continuing to do well. Have a blessing holidays
            Dec 2017 - felt lump and never checked it out. 07.17.18 - Diagnosed with TC 07.20.18 - Left I/O 08.04.18 - Pathology - Seminoma 08.24.18 - CT Scan shows 3 enlarged lymph nodes (3.3x3.1cm & 3.3x3.2cm & 5.1x3.9cm) no other organs met 09.04.18 - OFFICIAL STAGE 3A Seminoma 09.06.18 - Started 4xEP @ MD Anderson 11.12.18 - Finished 4xEP 12.20.18 - Lymph nodes under 3cm - Starting surveillance 06.16.19 - Lymph Nodes continues to shrink 12.18.19 - Tumor markers in good level. Lymph nodes are even smaller.

            Comment

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