Normal Tumor Markers But Diagnosed with Testicular Cancer?!

[vpirh]

I might be this one outsider, but I have recently went through the ocrhiometry just to learn that the solid mass that I had was not cancer but "testicular infraction".
I too had clear CT scan and normal blood work. My only symptom was sharp pain in the testicle (which seems very similar to cases like this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316981/)
Right now I feel very depressed about having to do that, it feels like I lost a ball "for nothing". I feel like my doctor should at least have mentioned it so I would be prepared.

[Trekga]

VPIRH~ Ugh!!! So sorry this happend to you. Usually an u/s can provide clear results on tumor. Again sorry.

SILVER~ I see the u/s results, but not the CT Scan or the results from MRI (which in the States is not usually used for pelvic imaging in TC). The orchietcomy is not a complex operation, and usually outpaitent procedure.

[Silver]

Hi Silver.

If I understand you correctly, the ultrasound did show a solid mass in the testicle? If that's the case, then I agree that you should get an inguinal orchiectomy done as soon as possible. It's likely to be a tumor (I was told the ultrasound is a very accurate predictor).

Have you noticed any change in size over the last 2 months?

In my case, I saw the urologist on a Friday. He was apprehensive about waiting until the following Wednesday for the surgery, but with a holiday on Tuesday there wasn't much of a choice. He considered trying to get it done on Monday but I needed to get a pre-surgery exam first. That may give you an idea of the timeline involved.

There is a small chance that it's something else, but if it is T/C then the sooner it's out the better. It'll make later treatment decisions easier. Considering that you've already waited 2 months, I guess I'm not sure how much of a difference 2 more weeks might make. But the less chance it has to spread, the better off you'll be. My understanding is that it's inadvisable to try to do a biopsy of the testicle while it's still in your body; they have to cut the tissue which gives it a path to spread inside the testicle itself - that just makes things worse. It's much safer to just remove the whole testicle and some of the cord.

A Radical Inguinal Orchiectomy surgery is not as bad as it seems. I was really scared beforehand (never had surgery before) and hated the idea of losing a testicle. My surgery was outpatient and the surgeon was done in around half an hour. I got to the hospital around 12:30 PM and left just before 5:30 PM that day. The incision is just above the groin (pelvic bone) so they don't cut the scrotum. They pull it up and out, then cut off a few inches of the cord. It hurt for a few days and I had some trouble sleeping as a result. The pain meds helped. It basically felt like I had very low abdominal muscle strength (even though he didn't cut the muscle), so I moved slowly for a couple weeks. I had some pain, sensitivity, and numbness around the incision area for a few weeks. Some people have different extent of swelling & pain; my swelling was pretty much limited to the incision area. I developed numbness from the incision down toward the scrotum, which I didn't expect, but it went away after a few weeks.

I think I don't feel the size has changed or increased. Also all of the three doctors assured me that I'm considered in early stage 1 of cancer and I do have plenty of time to do the surgery.
Nevertheless, if it's cancer, the sooner the better of course, the two weeks waiting is giving me a psychological torment.

[SchoolOnHold]

FYI, non-seminoma frequently doesn't show elevated serum. I have stage 2 non-seminoma and the only high marker I've ever had was ldh and even then it wasn't above normal enough to call my serum markers "high" from a staging sense

Also like most on this site probably, once I learned I had masses I just wanted that a-hole gone. Surgery was same day in and out, I was on opiods for like 3 days and then after that it was mostly fine. More than anything it was an excuse to hang around for a week. I'm at 6 weeks out and I'm back at 100% save for a bit of numbness where my pelvis and my right leg meet which is only noticable if I mess with it

[Arch]

vpirh- I'm sorry to hear that. I never heard about that condition when I read up on testicular problems (when I was trying to figure out what was happening with me).

Silver- It'll work out one way or another. The fact that tumor markers are normal and nothing shows up on MRI (I assume) is encouraging for now. As others have said, the risk is that some types of testicular cancer can grow very quickly. The silver lining is that treatment of testicular cancer, even in later stages, is very effective (even if those treatments can have other drawbacks).

[Silver]

UPDATE:

I visited my urology doctor again at 16 SEP and we had decided to do the orchietcomy on 20 SEP.
The testicle with the tumor was sent to the lab after the surgery and the result came as following:

- Seminoma, classic type, confined to the testis.
- Tumour size 1.8 x 1.5 x 1 cm.
- Epididymis: Free of tumour.
- Spermatic cord margin: free of tumour.
- Surgical margins of specimen: free of tumour.
- Lymph-vascular invasion: Not seen.
- Pathological stage: pT1, pNx, pMx.

Also part from the microscopic description:
- Tunica albuginea, epididymis, testicular hilum and spermatic cord are free of tumour.

Now I have been assigned to meet the oncology doctor this saturday (7 OCT) in order to do the CT scan and blood check for tumour markers in order to decide the next course of action.

Based on the NCCN Guidelines, one of the risk factors for Seminoma type is the "Rete Testis Invasion" which I didn't found it mentioned in my lab report, does it mean it doesn't exist?!


As regarding to my experience with the surgery, it wasn't as bad as I expected, only the first 3 days which I found it difficult to walk around or do any activities, but after that I got much better by the day. It's been 10 days now since the surgery, I can now do any normal (non-tensing) activities with no problems, The incision part still hurts when coughing and laughing though.
I have also started to come to terms with the reality of the situation for losing my testicle, I understand this is the right thing to do. The psychological part is healing nicely but it'll take some time.


Notice: While I didn't find any clinical studies regarding it, but I have noticed that those with history of testicular atrophy tends to get Seminoma type in their TC, this info is based on 4 patients which I have read their stories in this forum plus my case.

[MamaAng]

Hi Silver, glad it's OUT and you're on your way to wellness!!!