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New diagnosis (5/19)

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  • New diagnosis (5/19)

    Hey guys, unfortunate new member here, but before anything, I wanted to say thank you to the contributors for this website and forum as I've already gained most of my information from here alone.

    Anyways, down to the details.

    31 year old male, R testicle lump noticed probably 7 months ago. Should have had u/s months ago.

    US (05/15): Three hypoechoic masses (1.4 x 1.2cm, 1.2x1cm, 0.8x0.7cm)
    afp: 3.2 (05/16)
    hcg <1 (05/16)
    Orchiechtomy (05/19): 100% seminoma with no LVI or spermatic cord margin involvement. "Germ-cell tumor with seminioma (1.4cm in maximum dimension). Adjacent minute foci of germ cell neoplasia in situ (GCNIS) also present. No definitive lymphovascular invasion seen. Tumor limited to testis. Spermatic cord margin is uninvolved by tumor. Path stagin pT1. Tumor limited to the testis and epididymis w/o vascular/lymphatic invasion; tumor may invade tunica albicans, but not tunica vaginalis.

    I'm scheduled for CT scan w/ IV contrast, CXR, and bone scan tomorrow then will set up my oncology appt. My questions are considering the no LVI from path, what chances are my lymph nodes might be involved. Assuming there is no LN enlargement on CT, what treatment options are recommended. Surveillance vs 1BEP vs 1 carbo, radiation? Also, i'm going to need to set up my own oncology appt as I am moving next week to Savannah Georgia, do you think any oncologist (given the hopefully straightforward staging), or would you recommend going to tertiary or more academic setting? (ie, Mayo Clinic, Jacksonville or Shands). My insurance would cover local oncologist, but not the academic facilities.

    I'll also email Dr. Einhorn when I have all the imaging studies back.

    Thanks in advance!

  • #2
    Assuming, no enlarged nodes, your case looks pretty straightforward, I would think most oncs could handle it,

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

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