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found mass in Feb 2017, given 3 options, now decided for orchiectomy. am I too slow?

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  • found mass in Feb 2017, given 3 options, now decided for orchiectomy. am I too slow?

    First of all, glad to find this community. Sorry to see you guys here and Bless for every member.
    here is my story to share. I have decided to go full orchiectomy for safe. scheduled on 9/26. But welcome comments. I will update with follow up info for reference.

    Feb 2017,
    diagnosed by ultrasound, a solid mass in right testis, 0.5x0.4x0.3cm. (originally the ultrasound is for the cyst in the head of left epididymis. unfortunately & fortunately found this mass. )

    Feb 2017,
    a blood test of LDH indicates nothing. level is normal. ordered MRI

    Apr 2017,
    MRI report confirmed the mass:
    FINDINGS: The testes are of normal size. In the right testis there is a 5 mm enhancing nodule which is isointense on T1-weighted sequences hypointense on T2-weighted sequences and demonstrates enhancement following contrast administration. There is a small hydrocele on the right. On the left there is a fluid intensity mass in the epididymis consistent with a cyst. This demonstrates no enhancement. There is a small hydrocele on the left. There are normal-sized inguinal lymph nodes bilaterally.
    IMPRESSION: Small enhancing nodule in the right testis corresponding with the recent ultrasound suspicious for malignancy, possible seminoma.
    My urologist gave me 3 options:
    1. do nothing and watching it;
    2. partial orchiectomy;
    3. full orchiectomy.
    it's hard for me to pick with zero background knowledge

    Aug 2017,
    a follow up ultrasound. triple confirmed the mass. but no change in size. measuring 0.5 x 0.4 x 0.5 cm.

    Sep 2017
    decided to go full orchiectomy after few months asking around and self-study. surgery scheduled on 9/26 ...
    reasons: safe, life is more important than one ball. I am 40 yrs old with two kids. was told one ball functions the same as two balls. hopefully

    btw, I am in southern California. is this a simple surgery? should I spend effort to pick a good person to cut?

  • #2
    Well, I can't really give you any input on what the "best" choice in your situation is, but I had an I/O done just over three weeks ago, and can tell you a bit about my experience.
    I arrived at the hospital around 7:30 AM, and got on the tram back home around 4 PM. Normally I'd have been able to go home a lot sooner, but due to some delays, the fact that I ALWAYS take forever to wake up properly, and not being able to pee afterwards made me have to stay for a few extra hours.

    The pain wasn't too bad at all, and I had this jockstrap thing on for extra support to help stop blood from filling the scrotum the following 4 days. Moving around, getting out of bed, standing up and sitting down was a bit of a pain, but I have a feeling it was mainly 'cause of the catheter I had put in. It wasn't painful, just very uncomfortable.
    The first couple of days after the surgery I was numb from about an inch below the incision to halfway down the inside of my thigh, but after about a week the numbness had gotten a lot better, and I could move around pretty freely, although I did experience a bit of pain in the groin area if I went for 20 minute+ walks.
    The only times I've experienced pain in the incision area has been when I've sneezed, coughed, or used the bathroom. OH, wait, I nearly forgot, laughing did hurt quite a lot as well the first few days. Now, about 3 weeks after the surgery, there's no real pain, but more like a numb, itchy feeling in both the groin and incision area. I still don't find wearing jeans or belts very comfortable, but all in all, it hasn't been too bad at all!

    Also, life is DEFINITELY more important than a ball. Sure, it's hanging slightly to the left due to lack of support and I can tell something's missing if I look down there, but now I don't have to make sure everything's in place as frequently, and the risk of sitting down on one of your balls has decreased by 50%, so it's not ALL bad!

    I hope your surgery goes well, and I'm sure there's a whole bunch of people on here who can answer pretty much any question you might have!


    • #3
      I'm a bit confused, you said you were given a choice of surveillence, Partial Orchiectomy or Full Orchiectomy. When you say partial do you mean just removing the tumor from your right testicle, without removing the entire testicle? To me it looks like you were saying you had the option to remove one testicle or both! Please don't take both of them out or you will be on testosterone therapy your whole life. If you just mean you are to only the testicle with the tumor removed then the term you'd want to use is Radical Inguinal Orchiectomy.

      My second question what was the reason for getting the initial ultrasound, did you feel pain, do a testicular self-exam and find a growth or did your doctor just happen to check and felt a growth? In terms of a tumor that is pretty small and if it hasn't grown could it be benign? In any case the safe thing to do would be to remove the one with the tumor. But, that is your decision to make and it looks like you've already decided on that.

      Good luck with the surgery.


      • #4
        Sir Lurkington, thanks for sharing your exp! very useful for me to get some idea about what will happen. you are right! in the future I should be able to bike with 50% less concern.

        Daniel, good point. the partial Orchiectomy means only remove the tumor from my right testicle. full orchiectomy (#3) means remove the right testicle.
        the reason i had my initial ultrasound is because of the cyst attached to my left testicle. it is outside of the testicle so I can feel it. ultrasound always check both balls. The cyst was found in 2015 and in Feb 2017 I was doing a follow up checking.
        for the tumor, i had the same question to my doctor. but he said he cannot tell if it is benign until they cut it out to see. I cannot image if they tell me it is benign after the surgery. should I be happy or angry? why our
        scientists can send car to Mars but not able to identify tumor in my testicle?


        • #5
          My story is like yours, i had partial orchiectomy and results of pathology report is bening cyst and when i had surgery i was 22 yo. But after 6 months of surgery i know it was right decision, living with cancer suspicion is terrible.


          • #6
            My story is like yours, i had partial orchiectomy and results of pathology report is bening cyst and when i had surgery i was 22 yo. But after 6 months of surgery i know it was right decision, living with cancer suspicion is terrible.


            • #7
              Originally posted by speeder View Post
              I cannot image if they tell me it is benign after the surgery. should I be happy or angry?
              I'd say be happy. You have lost a nut, but found no cancer, if cancer was found, you would probably need further treatment, & even if you got lucky, there is a lifelong possibility that the TC or some other cancer might show yuo. If you lose a nut that had a mass& they find no TC, do your happy dance & move on. You just succeeded in dodging a bullet.

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


              • #8
                I lost a nut to testicular infraction, when my urologist was convinced it was cancer. I am still coming to terms with losing it because some urologist seem to be able to identify infractions, but mine could not. Right now I feeling very conflicted. I am somewhat relieved that it was not cancer but I definitely did not do a "happy dance". This is a ****ty situation all around, with no good outcome.


                • #9
                  I can not offer much, but say that feeling angry is normal since seemingly the surgery was done for no real reason.
                  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.