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  • TIN/CIS questions

    Hi to all of you.

    I’m getting closer to the final follow-up visit 5 years after my relapse (pure seminoma, initially i got TC 7 years ago.)

    When i had my I/O 7 yrs ago they took a biopsy of the remaining testicle. The report says that there was no sign of malignancy or TIN/CIS in the testicle.
    Can i then almost conclude that my right stone is safe (i know there are few false-negative biopsy results) or can TIN/CIS develope over time spontaniously.

    And the other question - it seems like there are different standarts in different countrys about making biopsy. Did you have it done, and if not - why?

    Regards from Denmark/Europe

  • #2
    Regarding your question about remaining testicle. I would say regardless of what tin/cis concludes you should be relativity certain odds are in your favor 7,8,9,10 years later, for the most part getting tc in remaining testicle is treated as a seperate cancer issue. So more than likely again odds are in your favor you wont get tc of remaining testicle. I wont say never cause you never know for sure.

    As for your second part of the question my response pretty much answers the question for you. I did some reading on tin/cis, im no doctor but i would guess because it's not full proof. Lets say you had tin/cis done it would just confirm at the present time no situ, but lets say 3 months later you develop pre cancer cells because at the time of tins/cis you werent quite at the point for pre cell development, does thay make sense? The other issue is that there are some risk factors that may or may not elevate your chances of getting TC cancer, but again lets say 3 months later your environment changes and you are subject to things that could evelated your chances of develping tc cancer or the oppsite happens your evironment changes and your risk is lowered. By environment i am not strictly speaking of the air you breath etc..... Just like why is TC cancer more likely in countries like Norway, Denmark and less likely in Asian countries. Not saying if i move to Asain im less likely to develop TC. But genetically speaking is what i am gettimg at. Just to many unknown variables to say for certain.
    Last edited by eodtech2001; 08-29-18, 07:31 AM.
    Jan 2012- U/S mass in Left testicle
    Feb 2012- I/O performed to remove cancer
    Mar 1,2012- pathology pure seminoma
    Mar 7, 2012 PET SCAN stage IIa
    April 2012 Mayo clinic carbolite.
    May 2012 carbolite failed, started BEP x3
    August 7th 2012- BEP complete
    April 2013 CT/PET show relapse
    May 2013 RPLND
    Aug 2013 Relapse again Started VIeP x2
    Oct 2013 HDC AUTOLOGOUS
    Dec 2013 HDC completed CT/PETSCAN 1.1 cm x .8 cm right lower lung lobe
    Feb 2014 confirmed false positive all clear FINALLY !
    Jan 2015 1 year cancer free Pet/CT scan
    Jan 2016 2 years cancer free "Pet/CT scan
    Jan 2017 3 years cancer free "Pet/CT scan
    Jab 2018 4 years cancer free "Pet/CT scan, labs, xrays

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    • #3
      Thanks for your reply - and congratulations with your own good results - you have been through a lot!

      I was just on the impression that the CIS/TIN was something you were born with (a defekt from the fetus-period) and could be detected by doing the biopsy, except the small percentage of false-negative lab answars.
      And they sort of are like a loaded gun that can be triggered by environment etc like you are talking about - but still detectable no matter when the biopsy is performed (I guess im moving to asia :-))

      And what you mean are that the reason that not every country/region are performing biopsies on the remaining testicle is that it just will just show a limited result?
      Last edited by JesperDK; 08-29-18, 09:21 AM.

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      • #4
        My attempt at searching on CIS/TIN turns up info in the tin market? What are we talking about? Afraid this abbreviation is unfamiliar to me.

        As far as far as #2 being safe, no,it's not. Getting TC1 increases the odds of getting TC2, it happened to me 35 years later, so while the odds are still quite low, it can happen. I suspect that since so many of us are now surviving many years past TC1, that we will see an upsurge in TC 2 cases in the years ahead, but that is just my supposition, not based on any scientific studies.

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

        Comment


        • #5
          Hi Dave

          CIS or TIN was also new to me a while ago - I also visit the tin-market on the internet :-))

          As I understand its changes in a testicle - a precursor for cancer that can be discovered, taking a biopsy. In Denmark its standard to make a biopsy of the remaining testicle when the I/O is performed. They take a sample (3x3mm) to the lab to look for CIS/TIN (carcinoma in situ). I read that if CIS are present they say that 50% will develope tc-cancer in 5 years - 70% after 7 years. They believe that all cases of CIS will lead into tc cancer at some time.
          When CIS is discovered they offer low dosis of radiation against the testicle or I/O - carboplatin is not so useful in that situation as i read.

          There are a discussion about making the biopsy from land to land because there are a cases of false negative tests and because that the procedure can cause swelling, bleeding etc and they will make this procedure in a lot of guys When only a few will have CIS compared to the fact that TC cancer is so curable.

          My doubt was that if CIS was developing suddenly out of the blue or if its present from the beginning cause to the genetics.

          I actually mailed Dr Einhorn Yesterday and he tells that if a CIS biopsy is negative, the risk of a contrelateral tumor is down to about 1%.

          Jesper
          Last edited by JesperDK; 08-30-18, 09:12 AM.

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