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Diagnosed Yesterday, June 30

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  • #16
    SULLYATL~ Glad you moved things along, and are recovering okay. Waiting for the path will confirm, but sounds correct. Update us.
    17 year old son Grant dx 12/21/16
    pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
    pre/o CT Scan 12/22/16 normal
    r/o 12/22/16
    Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
    PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

    -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
    2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
    BEP x 3 1/27/17
    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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    • #17
      Recovery continues to go well after the I/O. I have my follow up appointment Monday, 7/18 with my urologist. I also received my pathology report on Friday, 7/14. Details as follows:
      • Classic seminoma;
      • pT1 tumor limited to the testis;
      • Tumor was 2 cm;
      • Tumor involves rete testes but not epididymis;
      • No lymphatic vasular invastion; and
      • Surgical margins clear;
      The radiologist did not have access to my CT scan or blood work during the pathology; however, the CT scan showed no metastases and my markers were normal.

      Given this information it looks like I will be Stage 1A - pT1, N0, M0, S0. So, assuming my urologist appointment on Monday goes as expected, it appears my options will be surveillance or one round of chemo.

      If I go the chemo route, how soon after my orchiectomy can I begin chemo? I am on short term disability and would very much like to not start-and-stop the benefit and start my chemo ASAP (again, assuming I go the chemo route).

      Thanks again for your support and answers!
      06/30/17: Diagnosed with TC
      07/03/17: Formal ultrasound results showing five masses on left testicle, largest at 1.6 cm
      07/06/17: Initial blood panel shows tumor marker levels normal. AFP at 3.3 ng/mL, HCG at 3 mIU/mL, LDH at 137 U/L
      07/10/17: CT scan with clear results. No metastases in pelvis, abdomen, or pelvis.
      07/11/17: Left I/O performed with no complications.

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      • #18
        SULLYATL~ Yeah on recovering okay, and getting the pathlogy back. I'm not expert, but probably surveillance might be an option. Hoping other with Seminoma will chime in soon.
        17 year old son Grant dx 12/21/16
        pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
        pre/o CT Scan 12/22/16 normal
        r/o 12/22/16
        Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
        PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

        -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
        2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
        BEP x 3 1/27/17
        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


        • #19
          I am glad that you advocated for your self and got things moved up. Glad that the new urologist showed a sense of urgency. The negative imaging and tumor markers is obviously a best case situation as well. Did they find more than one tumor? I thought you had mentioned that it looked like multiple tumors but only one in the pathology report? If stage I seminoma, then yes, your options will be active surveillance, a dose of carboplatin or radiation therapy (most avoid radiation therapy, especially at such a young age). I would assume that they could start chemo within a few weeks to a month after the orchiectomy. It is my understanding it is just to give you a chance to heal and with just one dose of carboplatin that timing may be shorter than full BEP chemotherapy.

          Let us know how your appointment goes today. If you are looking at further treatments and haven't done so already then you may want to look into sperm banking as well.

          Mike
          Oct. 2005 felt lump but waited over 7 months.
          06.15.06 "You have Cancer"
          06.26.06 Left I/O
          06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
          06.30.06 It's Official - Stage I Seminoma
          Surveillance...
          Founded the Testicular Cancer Society
          6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

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          • #20
            Hey sullyatl nice to know the recovery is doing well and that the results. I'm 20 days behind you on schedule and still waiting for my results.

            Please keep us posted on how things are going and what course of action you've chosen. All the best to you man.

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            • #21
              Hey Sully, I hope you're well. I'm kind of interested in what Mike had asked you as well about your pathology. I had 3 multifocal tumors but nobody could seem to give a answer why my pathology only listed one. My current oncologist said the US isn't always very accurate when they do it. Anyways, I wanted to make this comment and give you some info my oncologist gave to me as far as weighing your options. I was staged at 1A as well and he said we have about 20% chance of relapse. Your margins were clear, no invasion etc. My doctor recommended the surveillance route at least for me. He said if the stage was 1B he'd suggest that dose of Chemo or radiation and cited a statistic of 50% relapse rate for 1B,
              April 2017 - Scheduled physical with DR for testicular pain / ultrasound scheduled
              May 2017 - US shows 3 solid masses 1.2 x 0.7 x 0.7 cm/0.8 x 0.5 x 0.8 cm/ 0.4 x 0.3 x 0.4 cm
              June 2017 - Left inguinal exploration and left radical orchiectomy. Pathology - Seminoma, classic type and intratubular germ no neoplasia - seminomatous. CT scan shows 2 long nodules (most likely granulomas) and Borderline prominent but non specific mesenteric nodes within the right lower quadrant.
              July 2017 - 2nd CT scan all clear! Lung nodules stable. Active surveillance 5 years.

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