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  • Questions regarding risk of contralateral

    Hello all,

    Being a cancer survivor, of course that lots of fears are still hunting me.
    Today I was to an urologist/andrologist regarding infertility, he told me that my survivor is smaller (aprox 3cm length in the ultrasound) than usuall size. He took as a normal thing, your remaining testicle is just smaller and this is not a serious problem at all, but it may explain oligospermia. He said in his opinion this does not pose a risk (for contralateral tumour), and no way for biopsy, he would recommend. (i wouldn't like the ideea either)
    I so much want to believe him

    Anyway I remeber all the articles I've read about risks of contralateral and testicle atrophy...
    What do you think? Is there anybody more informed on this matter and could tell me if this is usually a serious problem or not ?

    Thank you all
    03/28/2017 - felt a tiny lump on my right testicle
    03/29/2017 - urology, ultra sound confirmation of tumour
    04/03/2017 - MRI abdomen/pelivis, 0.8/0.8/0.75 tumour confirmed, on upper pole of testicle, no lymph node enlarged
    04/03/2017 - blood markers normal.
    04/19/2017 - orchiectomy of the right testicle
    05/08/2017 - histopatology: 0.7/0.7/0.6 tumour, embryonal carcinoma, invasion of albugineea, LVI+ near albugineea. Spermatic cord not invaded. Associated lesions with seminoma in-situ. T2N0
    05/19/2017 - CT pelvis/abdomen/toracal , no metastasis, no adenopaties -> stage 1b
    06/11/2017 - MRI pelvis/abdomen for a restage, still no enlarged nodes, blood markers normal.
    06/13/2017 - started adjuvant 1xBEP

  • #2
    I had the same situation. I don’t recall seeing any information suggesting this was in increased risk wrt to cancer, it can indicate decreased testicular function though.
    6-20-2014 - HCG 43 mIU/mL 6-27-2014 - pathology: 3.6 x 3 x 2.3 cm seminoma, classic type 8-15-2014 - 1x carboplatin 1-15-2021 - recurrent seminoma with distant metastasis, HCG normal 2-8-2021 started 4xEP 3-29-2021 switched to 2xEC after 2xEP

    Comment


    • #3
      I agree that it's not a big deal as far as cancer, might be a fertility thing, but that is not a given.
      Jan, 1975: Right I/O, followed by RPLND
      Dec, 2009: Left I/O, followed by 3xBEP

      Comment


      • #4
        If you have atrophy, then I don't think it is unreasonable to see if you can be followed with a yearly scrotal ultrasound if you are concerned. Overall, the rate of bilateral testicular cancer is low. Traditionally, it was said to be around 4% but I have seen repeated data that it is more like 2% of those diagnosed. The window for the second primary can be long too, so yearly ultrasounds might be a burden though too. Self- exams for survivors seem even more important, to me.

        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

        For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

        Comment


        • #5
          Mike, I am not really sure what is considered atrophy and what is hypotrophy, and where I stand with about 3cm in length
          of course, I think I will live all my life with yearly ultrasounds and MRIs.

          the articles I was refering to:
          https://pubmed.ncbi.nlm.nih.gov/9751353/
          and
          https://www.semanticscholar.org/pape...7f400f52996da1
          03/28/2017 - felt a tiny lump on my right testicle
          03/29/2017 - urology, ultra sound confirmation of tumour
          04/03/2017 - MRI abdomen/pelivis, 0.8/0.8/0.75 tumour confirmed, on upper pole of testicle, no lymph node enlarged
          04/03/2017 - blood markers normal.
          04/19/2017 - orchiectomy of the right testicle
          05/08/2017 - histopatology: 0.7/0.7/0.6 tumour, embryonal carcinoma, invasion of albugineea, LVI+ near albugineea. Spermatic cord not invaded. Associated lesions with seminoma in-situ. T2N0
          05/19/2017 - CT pelvis/abdomen/toracal , no metastasis, no adenopaties -> stage 1b
          06/11/2017 - MRI pelvis/abdomen for a restage, still no enlarged nodes, blood markers normal.
          06/13/2017 - started adjuvant 1xBEP

          Comment


          • #6
            I'd say self exam is probably adequate. Also no point in worrying about a second primary, as you will deal with it if it happens. I did, 35 years after my 1st
            Jan, 1975: Right I/O, followed by RPLND
            Dec, 2009: Left I/O, followed by 3xBEP

            Comment


            • #7
              I don't know if I would put a lot of worry into those two articles. Plus, they are measuring volume (in ml) and not one dimensional size of (in cm) as you are mentioning, so it is impossible to compare, I think. In easiest terms, I think atrophy and hypotrophy can be considered the same thing.

              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

              For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

              Comment


              • #8
                I will talk with my urologist to measure volume, but as far as I've read, as a rule of thumb, 3cm length puts me somehow in that borderline 12ml volume. As you said, maybe are just numbers from a study, and I should not care that much. If I look on the charts from that study, there are lots of contralateral with high volume, and lots of healthy with very low volume ...
                03/28/2017 - felt a tiny lump on my right testicle
                03/29/2017 - urology, ultra sound confirmation of tumour
                04/03/2017 - MRI abdomen/pelivis, 0.8/0.8/0.75 tumour confirmed, on upper pole of testicle, no lymph node enlarged
                04/03/2017 - blood markers normal.
                04/19/2017 - orchiectomy of the right testicle
                05/08/2017 - histopatology: 0.7/0.7/0.6 tumour, embryonal carcinoma, invasion of albugineea, LVI+ near albugineea. Spermatic cord not invaded. Associated lesions with seminoma in-situ. T2N0
                05/19/2017 - CT pelvis/abdomen/toracal , no metastasis, no adenopaties -> stage 1b
                06/11/2017 - MRI pelvis/abdomen for a restage, still no enlarged nodes, blood markers normal.
                06/13/2017 - started adjuvant 1xBEP

                Comment

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