Hi everyone,
Just three weeks ago I was diagnosed with testicular cancer, and a little over 2 weeks ago I had an orchiectomy. The pathology report found a 2cm tumor (or rather, a few small ~0.5cm tumors) made up of 100% Embryonal Carcinoma (EC), with no evidence of LVI (or any other invasion). All blood markers (AFP, b-HCG, LDH, PLAP) before and after the surgery were normal, and the radiologist did not see any spread on the chest/abdominal CT. So except for the 100% EC, this all sounded good and puts me at Clinical Stage 1a.
After being diagnosed I started reading the literature, and got a second and a third opinion. Now I have two doctors recommending active surveillance (estimating my risk of recurrence at 10-15% and 30%), and one strongly suggesting RPLND or Chemotherapy (estimating my risk of recurrence to be >50%). They‘re all experts on TC. I understand that there is no consensus on how important EC is as a risk factor, but this makes it difficult.
I am leaning towards the active surveillance, since I would really like to avoid unnecessary treatment and the potential long-term consequences of it. However, the third opinion raised some doubts again. My doctors (outside the US), did not even mention RPLND as an option for me, so the choice is between adjuvant chemotherapy and active surveillance.
I was wondering if anyone here was in a similar situation, and what you chose. How did you make the choice, and do you still feel it was the right one later on?
Just three weeks ago I was diagnosed with testicular cancer, and a little over 2 weeks ago I had an orchiectomy. The pathology report found a 2cm tumor (or rather, a few small ~0.5cm tumors) made up of 100% Embryonal Carcinoma (EC), with no evidence of LVI (or any other invasion). All blood markers (AFP, b-HCG, LDH, PLAP) before and after the surgery were normal, and the radiologist did not see any spread on the chest/abdominal CT. So except for the 100% EC, this all sounded good and puts me at Clinical Stage 1a.
After being diagnosed I started reading the literature, and got a second and a third opinion. Now I have two doctors recommending active surveillance (estimating my risk of recurrence at 10-15% and 30%), and one strongly suggesting RPLND or Chemotherapy (estimating my risk of recurrence to be >50%). They‘re all experts on TC. I understand that there is no consensus on how important EC is as a risk factor, but this makes it difficult.
I am leaning towards the active surveillance, since I would really like to avoid unnecessary treatment and the potential long-term consequences of it. However, the third opinion raised some doubts again. My doctors (outside the US), did not even mention RPLND as an option for me, so the choice is between adjuvant chemotherapy and active surveillance.
I was wondering if anyone here was in a similar situation, and what you chose. How did you make the choice, and do you still feel it was the right one later on?
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