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3xBEP or 3xBEP+1EP for good risk!?

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  • 3xBEP or 3xBEP+1EP for good risk!?

    hello all,

    I have been diagnosed with stage 3A tc.Here are the details:
    before i/o:
    AFP-14.9
    HCG-773
    LDH-364 ref 120-246

    after i/o
    AFP-2.16
    HCG-3303
    LDH-351

    CT scan-
    no retroperitoneal lymph nodes.
    But lung mets with 3 small nodules
    5mm, 10mm and 1.8 mm (all less than 2cm)

    My doc started off with telling me we would be starting 4x BEP.
    Im done with first cycle, at the beginning of second cycle the markers:
    AFP:1.3
    HCG:49
    LDH:349

    My doc told me we will be doing 3xBEP +1EP and omitting bleo in last cycle as Im in good risk group.
    But I did some searching around Dr.E's papers, google etc, and many people here say 3x BEP is the recommended standard treatment for good risk group!
    Any experts/ experienced people!? what do you think about the treatment!?
    Fed, mike!? Can you guys help me out!?

    Look at my sigpic for pathology.
    painless lump rightside over 5 month
    tumor markers- afp-14.9 hcg-773
    06/2018- right i/o

    path- teratoma/yolk sac/chorio

    afp down at 2.3 hcg-3303

    ct- no lymph involvement, lung mets (stage IIIA)

    07/2018- start of 3xBEP +1EP

  • #2
    Although I am not sure which is the best treatment, the 4th cycle may be due to you being on the higher end of good risk, approaching intermediate. Cutoff is 5,000 for HCG marker. Check the following guidelines out.

    https://www2.tri-kobe.org/nccn/guide...testicular.pdf

    Entire guideline is informative but refer to the chart on page 27.

    Comment


    • #3
      Originally posted by Leanersnail4 View Post
      Although I am not sure which is the best treatment, the 4th cycle may be due to you being on the higher end of good risk, approaching intermediate. Cutoff is 5,000 for HCG marker. Check the following guidelines out.

      https://www2.tri-kobe.org/nccn/guide...testicular.pdf

      Entire guideline is informative but refer to the chart on page 27.
      thanks for the link.
      But im a little confused about getting over treated because to start with im in good risk.
      painless lump rightside over 5 month
      tumor markers- afp-14.9 hcg-773
      06/2018- right i/o

      path- teratoma/yolk sac/chorio

      afp down at 2.3 hcg-3303

      ct- no lymph involvement, lung mets (stage IIIA)

      07/2018- start of 3xBEP +1EP

      Comment


      • #4
        I understand the confusion. I was the same way before I was set to begin 4 x BEP. I would seek a second opinion or contact Dr. Einhorn by email leinhorn@iu.edu

        *sent u a msg
        Last edited by Leanersnail4; 08-24-18, 11:51 PM.

        Comment


        • #5
          I could be wrong, but I seem to recall that lung mets put you at stage 3, plus yolk sac & chorio, are both aggressive forms. I don't want to worry you because both can be treated, but it seems to me that we have lost more members to chorio than any other type recently. I would personally want to hit this hard for the best shot at a cure the first round.

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

          Comment

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