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Starting 4 X EP Should I get a Port?

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  • Starting 4 X EP Should I get a Port?

    Hey Guys - 4 years after the original diagnosis of Stage 1A Seminoma and orchidectomy and after 4 years of surveillance the CT and PET scans show relapse and biopsy tomorrow to confirm what they already suspect. My Doc I've seen since the beginning is so confident that she has already scheduled me for 4 cycles of EP starting on 2/6. The nurse says my veins look good, but wonder after 20 infusion days, that will be the case. My research is beginning to show most folks do the port and those that don't might regret? We're also scheduled to go on a 7 day Caribbean cruise the weekend after the 2nd week of treatment. The Doc and Nurse have differing opinions on whether we should try and go. Part of me thinks it's crazy to travel during the treatment, but the other part of me thinks the R and R mid treatment might be good. Thanks for anyone's experience on port vs. intravenous and traveling in the middle of Chemo. Dave

  • #2
    You do not need a port. I did not have one, and the last week pokes were a little annoying but tolerable. A port has its own set of complications. I was an otherwise very healthy 32 y/o with great veins.

    I would not go on your vacation :-(. If that falls on day 14-21 of the first cycle, you will be feeling OK but your immune system is very vulnerable at this point. If you caught something bad being on the ship and needed medical attention pronto you are looking at a life threatening situation with an expensive helicopter ride. Traveling a long way from home to international waters and other countries isn't something I'd do during chemo for both the risk of adequate care, and the risk of nasty bacteria/viruses not found around home. I'd wait at least a month after your final round.
    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 - 9/18/15: 4xEP
    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!
    3/29/2018 all clears up to this date!

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    • #3
      My 17 year old just had a port placed Friday, and 3 xBEP started Friday night. He is thrilled how easy it is to dispense chemo, other meds, and draw blood! He says he does not feel it. His is a Power Port., visible above the skin.

      The crusie would make me nervous if you contracted a bad infection. But if you wear a mask, wash hands, maybe it would be okay?
      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.

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      • #4
        I would nix that cruise. Your immune system will likely be compromised at that point. If you get an infection at that point without medical intervention you could be gone within hours...not trying to scare you...but it's just a reality that comes with this kind of chemo.

        A port is not required but it something to consider. I recommend it, but that is based on my experience. Like some other decisions it's a personal thing...do what you feel us best for you after weighing the pros and cons.

        - Matt
        March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
        March 13th: Left IO 100% Classic Seminoma
        6.3 x 5.1 x 3.8 cm, no invasion of anything
        LDH never fully normalized
        Stage: IS
        Watchful Waiting
        May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
        May 12th: started 3xBEP
        Neupogen during Cycle 2 and 3
        July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
        August 4th: Post Chemo CT/PET scan
        September 4th: Port removed
        January 8th 2018: 3.5 YEARS ALL CLEAR !

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        • #5
          Thanks so much for the feedback everyone! I went ahead and got the port installed this morning while already at the hospital for the biopsy. I've yet to find someone that really regretted getting the the port. Also, we'll skip the cruise in March and go on vacation this summer once treatment is complete. Dave

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          • #6
            Sorry to read about your relapse. It must have seemed likely you'd managed to escape the main relapse timeframes. It must have been a shock.

            Best wishes with your treatment.

            Steve (seminoma, 1b Oct 2016)

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            • #7
              Good choices! Best of luck! You will enjoy that vacation even more after this!
              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 - 9/18/15: 4xEP
              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!
              3/29/2018 all clears up to this date!

              Comment


              • #8
                Good choices all around on port, and skipping the cruise. Honestly, cruise ships, which are notorious for having all sorts of germs and contamination issues are the LAST place someone fighting cancer should be, with a compromised and/or weak immune system. Heck, my wife won't set foot on a cruise ship even normally as she's a germaphobe.

                Sorry to hear about the recurrence after so long, but EPx4 will knock this to the ground. Any reason for EPx4? I personally would do BEPx3 at this point, if I could do it all over again. Lots of long term effects from so much Cisplatin. There seems to be fewer long-term effects from Bleomycin and BEPx3, but water under the bridge at this point. My best advice today is to just do BEPx3 rather than EPx4, unless you have a compelling reason and case for wanting to avoid Bleomycin. Good luck!
                Young Adult Cancer Survivorship by Steve Pake
                April is Testicular Cancer Awareness Month!
                www.stevepake.com
                Feb 2011, Stage IIB, 4xEP, RPLND, PTSD
                My Survivorship Thread | All of my Blogs
                C
                ONTACT ME ANYTIME!

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                • #9
                  What stage are you now? Stage 2A or 2B? I would recommend RPLND. Although this is only used in trials at the moment for seminomas.
                  Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

                  7/1/2015: felt tiny lump on side of R testicle
                  7/30/2015: Ultrasound shows 2 intra-testicular masses.
                  7/31/2015: tumor markers normal, CXR clear
                  8/5/2015: R orchiectomy
                  8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
                  8/14/2015: CT abdomen/pelvis clear, Stage 1b
                  8/24/2015: started 1 x BEP

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                  • #10
                    Yeah, the relapse sure was a shock. I've kept my Surveillance appointments religiously. Thankful that the guidelines call for CT scan at the 4th year. Biopsy came back today confirming Seminoma Stage 2B. Doc recommended the 4 cycles of EP over the BEPX3 due due to the potential lung toxicity with the bleomycin in "older" patients. I'm 50 - so I followed her advice.

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                    • #11
                      Well, my doc recommended 3xBEP for me & I was 55, I did have shortness of breath during chemo, but recovered nicely afterwards. IMHO, I would not recommend RPLND for a late relapse like this, chemo will attack any TC anywhere, RPLND might miss some micro mets that have moved beyond the field of surgery.

                      Dave
                      Jan, 1975: Right I/O, followed by RPLND
                      Dec, 2009: Left I/O, followed by 3xBEP

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