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  • Just underwent Orchiectomy and what to do next?

    Hi I am 22 years of age. Recently I was diagnosed with testicular cancer. A detailed description of the diagnosis is as follows.

    -An extensive necrotic high grade mixed germ cell tumor of the left testis.

    -Invaded capsule, but no breaching outer aspect of capsule.

    -Spermatic cord resection and margin resection margin- clear.

    I did a CT scan right after the surgery and the results for spread were nil. However i visited an oncologist who said that a CT scan is not good enough and a PET CT has to be performed to get a more detailed result. So far there is no aches or pains in the abdomen area but this is a silent killer anyways right?

    Just a little background. I am from singapore but am studying overseas currently in Aus. I flew back to spore for a treatment and i want to resume my studies as I feel it will make me feel better. However i am taking my doc's advice on the PET CT and thought of doing it in australia with a blood test for the tumor markers. If they find anything existing inside my lymphnodes i would have to do a chemo as advised by the oncologist.

    I need some advice from anyone. I am lost. I feel as if I am in a bad dream or smth. My world came tumbling down. I have no family history of this disease and cancer for that matter. I have not harmed or hurt anyone in any way to incur bad karma on my side. How fast can this bugger spread?i will be going thru the mentioned scans next 2 weeks. I am confused. Hope to hear from some of you.

  • #2
    I will first address the PET-CT issue. Since your primary tumor was mixed, it is treated as a non-seminoma. Under those circumstances, a PET-CT is unnecessary because there is a risk of a false negative (teratoma, one of the five types of germ cell tumors, will not show up on a PET scan). Since you have no evidence of metastasis judging by your CT scan results, you are likely stage I-B. Can you provide some details on your tumor markers?
    "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
    11.22.06 -Dx the day before Thanksgiving
    12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.

    Comment


    • #3
      Well, my CT scan results were a bit vague & it was only the PET-CT that positively showed that I was stage 2 . I'd get the test, JMHO.

      There is no requirement of family history or bad karma to get this disease, & this bugger can spread very fast, but is one of the most treatable cancers even in advanced stages, so know that your odds are quite good at getting rid of it.

      You should be far more concerned with beating this than resuming your studies. There is plenty of time to hit the books once the docs are done fixing you.
      Dave
      Jan, 1975: Right I/O, followed by RPLND
      Dec, 2009: Left I/O, followed by 3xBEP

      Comment


      • #4
        Starting BEP

        Hi..Thanks for the advice and sorry for the late response. I was going through all kinds of tests and 2nd opinions before finally deciding on chemo. I just went for my 2nd session of BEP today. I have already started feeling weak and nauseous. But it aint that bad. The doc has advised me to do a 3 cycle BEP instead of a 2 cycle despite mine being a stage 1b non seminoma. The PETCT picked up a small dot at the lymphnode right above where the orchiectomy was done. Thus he doesnt want me to take the risk. What do you guys think? Is 3 too much for a stage 1b?

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        • #5
          If I recall correctly, any invasion into the lymph system moves you to stage 2 & 3xBEP is the standard for stage 2.

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

          Comment


          • #6
            Will there be any adverse effects on fertility? I have already done my sperm banking with 3 samples. Also I would like to find out about the effects on testosterone production after the treatment. Some people have stated that their beard or hair does not return to normal growth for a certain period of time. Any types of food to eat to keep the energy levels up? Your replies are very much appreciated.

            Comment


            • #7
              There can be fertility issues after BEP, and they're common enough that you made a good decision to bank sperm. As for hair loss, it's not due to a lack of testosterone, but the way chemotherapy works. Because chemo is ultimately damaging cells, its effects are seen in fast-dividing cells like hair follicles, cuticles, the lining of your mouth and gut, and most important, in cancers. It's likely (though not certain) you'll lose hair, but it will almost certainly come back a few months later.

              As for testosterone, BEP isn't likely to affect it long-term. If you've still got one testicle, odds are your testosterone will be about the same as it ever was.

              For me, the big thing with chemo is just to listen to your body. If it's telling you to sleep, sleep. If it's telling you you're hungry, eat. Sure, you need to force yourself to drink fluids, and lots of 'em. But by and large, the biggest thing is just to accept that you'll feel like you were hit by a truck, and deal with it.

              Good luck!
              sigpic

              28-Dec-09 Diagnosed with rt mass
              29-Dec-09 Blood Draw, AFP 141.9, hCG 647, LD 648
              31-Dec-09 CT Scan on torso, clear
              04-Jan-10 Right I/O, tumor 4.4x3.5x3.0cm, 50% embryonal, 30% yolk sac, 20% teratoma, possibly some choriocarcinoma, pT3
              11-Jan-10 Follow-up CT Scan on head, clear
              29-Jan-10 2nd Blood Draw AFP 3.6, hCG <3, LD 488
              22-Feb-10 Begin First of 2x BEP
              15-Mar-10 Begin Second of 2x BEP

              Current Status: 24 months clear, in surveillance

              Comment


              • #8
                Fed - I had zero tube invasion and my urologist said my tumor was confined to my testicle. As a follow up though he had me see an oncologist who ordered me to get a PET scan. After the PET scan he saw three spots (one on a lymph node, one in my chest and one on my lung) that he said were probably cancer so I began 3x of BEP.

                But reading what you wrote now I wonder if I did the right thing. Do PET scans often give false positives???

                Comment


                • #9
                  Thanks for youe responses..Am currently in the last week of my first cycle..Hair seems to be dropping rapidly. Especially the body hair. Also i have been developing some things in my body. First i detected a boil in my right butt cheek. Dont know if that is a side effect. My doc gave me a bactoban cream to apply. Today I also noticed dark (almost black) spots on my tongue. Hope that this is just a temporary side effect that will go off after chemo. Its been a little depressing looking at the changes that have been occurring. What about you guys? How long did it take before hair/beard growth returned to a perfectly normal rate? kinda feeling empty without the beard especially. All these weird alopecia spots..

                  Comment


                  • #10
                    Originally posted by bearyfella88 View Post
                    Thanks for youe responses..Am currently in the last week of my first cycle..Hair seems to be dropping rapidly. Especially the body hair. Also i have been developing some things in my body. First i detected a boil in my right butt cheek. Dont know if that is a side effect. My doc gave me a bactoban cream to apply. Today I also noticed dark (almost black) spots on my tongue. Hope that this is just a temporary side effect that will go off after chemo. Its been a little depressing looking at the changes that have been occurring. What about you guys? How long did it take before hair/beard growth returned to a perfectly normal rate? kinda feeling empty without the beard especially. All these weird alopecia spots..
                    I never got boils, or dark spots anywhere on my skin. I did get some darkness in my fingernails & the large toe nails, which is still visable but growing out. Hair/beard growth are actually two separate things for me. My 'stach & body hair came back pretty quick & has looked normal for months now, although my facial hair growth in general seems slower than I recall.

                    My head hair is quite full again, but curly. Think white guys with afros in the 70's & you got it about right. There is just no way to know with the hair, it'll grow back in time & you will look (more or less) like "you"once again. I expect my curls to straighten out eventually, my neighbor's did within a year or two of her chemo treatments
                    Dave
                    Jan, 1975: Right I/O, followed by RPLND
                    Dec, 2009: Left I/O, followed by 3xBEP

                    Comment


                    • #11
                      Thanks man. Anyways just started cycle 2 today and I seem to feel way weaker than before but countering that with the food etc. My doc gave me a good news though. Said that after cycle 2 he's gonna send me for a PETCT again to see if the 2 pink dots detected before chemo still exist.

                      He said most likely they'll be gone and he's giving me an option to stop at the 2nd BEP if all is well. What do you guys think? From all the reading and previous experiences of other users, 2 X BEP for stage 1b non-seminoma seems to be sufficient.

                      Comment


                      • #12
                        wesmom

                        My son broke out on his chest and back with red bumps which darkened (turned black). The Dermatologist said the Bleomycin caused it. He also has dark marks (look like claws) on his back and neck from scratching. He wasn't supposed to scratch but kept forgetting. The bumps look like they are slowly disappearing. They probably would go away if he would use the ointment he was given. My son completed Chemo 2 months ago and has grown a goatee and his hair feels like baby hair. So far its flat and silky.
                        Son Diagnosed 6/24/10
                        Right I/O 6/28/10
                        (65% Teratoma, 10% EC, 10% Yolk Sac, 10% Seminoma, 5% Choriocarcinoma)
                        3XBEP 8/10-10/10
                        RPLND 11/2/11 (cyst in right pelvic area was mature teratoma and lymph nodes were clear)

                        Comment


                        • #13
                          On BEP I have broken out with lots of acne on chest, scalp and around the place... I am told this is due to the steroids they pump you with on the BEP days and with the bleo push. Also wounds take longer to heal, and in some places skin can darken.

                          Before cancer I also had folliculitius which was cured, but has come back. Expect your body to be completely out of whack for the duration of BEP, and don't be afraid to ask your Dr for drugs to manage the side effects.

                          Also I notice you are in Perth, a fellow aussie/visitor!.

                          Edit: I run my hands throuhgh my yead yesterday (week 3 of chemo) and clumps of hair started to come out. My beard also started to shed (and elsewhere I can't mention in the presence of the ladies), so I got a number 0 shave. My mother just finished the chemo compoenent for Breast cancer/herceptin and her hair is growing back soft and fuzzy.
                          Initial diagnoses: Elevated hCG, Left I/O 17-June-2010. Prosthetic implant.
                          Pathology: Stage 1b, Seminoma/Teratoma
                          Treatment: Surveillance. hCG normalised 07/10
                          Relapse: Elevated hCG. 3xBEP finished 24/01/2011

                          Comment


                          • #14
                            Hey Tglover! Awesome to hear you're from Perth mate. I am just an international student there. Back in my own country undergoing the treatment.

                            Yeah it's a horrible feeling when the hair starts coming out but it aint that bad as I did what u did by getting a number 0 shave. Now its just the annoying feeling of having a dry mouth despite drinking loads of fluids daily.

                            How many cycles are you going thru?

                            Comment


                            • #15
                              3 in total but if my blood markers dont drop today, a switch to another type of treatment.
                              Initial diagnoses: Elevated hCG, Left I/O 17-June-2010. Prosthetic implant.
                              Pathology: Stage 1b, Seminoma/Teratoma
                              Treatment: Surveillance. hCG normalised 07/10
                              Relapse: Elevated hCG. 3xBEP finished 24/01/2011

                              Comment

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