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  • Relapsed extragonadal primary mediastinal non-semienoma

    Hi, this is my very first post on this forum. I found this site soon after I was diagnosed, but never had the courage to post myself. It has nevertheless been a great resource, the combined knowledge of the people here is amazing. This will be quite a long post , but please bear with me.

    Now to my story, which starts a little over a year ago. After a high-intensity training in February 2015, I had asthma-like symptoms with shortness of breath and chest pain. I've had severe astma as a child, so it was natural to assume asthma. The next day I went to see a doctor. A chest x-ray was made, showing apparently no abnormalities. I was put on cortisone inhalation medication, and the symptoms disappeared after a few days. During the spring I had several appointments with another doctor, and my asthma medication was intensified as the initial medication had no affect. In July I had strange chest pains and some periods of shortness of breath. These eventually disappeared, so I thought all was good. Strangely I did a lot of sports this summer, as usual, and was doing ok. By the end of August the chest pain was back, and my general condition was deteriorating. In September I finally went to the ER, where I was found to have a large tumor in my chest. Naturally I freaked out, since the only cancer in the chest I knew of was lung cancer.

    Three days later, after being told I probably have lymphoma, I was diagnosed with germ cell cancer in the mediastinum. My testicles were checked with ultrasound, and while these showed some calcification and strange structure, no actual tumor was found. Therefore I was diagnosed with extragonadal mediastinal nonseminomatous germ cell cancer. The next morning I was sent to the sperm bank (in vein it turns out, I was found to be sterile), in order to start BEP chemotherapy the same day. The first round was however VIP/PEI, due to the tumor obstructing my lungs. After the second cycle of BEP, my bHCG was not declining by its nominal decay speed. My protocol was intensified and changed to TIP, and my stem cells were harvested to be able to move to high dose chemotherapy (HDC) if necessary. After the last round of TIP however, my markers normalized. I was scheduled for surgery to remove the residual mass, which had shrunk significantly. The surgery went fine, and the pathology of the tumor showed immature and mature teratoma. As the tumor markers were still normal, I was put on surveillance. For a month I thought I had beat it, and started planning things that had been put on hold due to the cancer.

    This week however, unfortunately, I was told by my oncologist my tumor markers are rising again. There were no spots on the CT to be seen. Now I’m scheduled tor a brain MR and a full body PET/CT to see if anything shows up there. If no isolated spot appears, the next step will be high dose carboplatin and etoposide. I know that previous results of standard HDC for relapsed primary mediastinal nonseminomas are not very encouraging with very low cure rates. Therefore I would like to explore other options. Two studies in particular have caught my attention. First, Shamash et al. have used topotecan-based high-dose chemotherapy (http://annonc.oxfordjournals.org/con...dm002.full.pdf) with promising results, Secondly, Garrett et al. have used a combination chemotherapy consisting of BOP/CISCA/POMB/ACE (http://www.annalsthoracicsurgery.org...99)01472-1/pdf), also that with encouraging results.

    My question is, what should be my next step? Should I go with the carboplatin/etoposite HDC after all? Or should I try to find a more novel therapy, like the ones above? Are there any other options than high dose or combination chemotherapies, which are likely to cause severe side effects? I should say that moving to another treatment than carboplatin/etoposite HDC would probably mean relocating to another country (I live in Sweden), and possibly paying for the treatments myself. I am however prepared to take this step, if it improves my chances of recovery.
    Last edited by Blondie; 08-06-16, 12:48 PM.
    Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
    Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
    Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
    March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
    April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
    July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
    Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
    Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
    March-April 2017: cisplatin, gemcitabine. PD.
    May 2017: pazopanib. PD.
    June 2017: imatinib.

  • #2
    Hey blondie,

    Sorry to hear your story.

    There's not much data in the medical literature since there's not lot of cases like you.

    Maybe you should contact Dr Einhorn or Dr Hanna at Indianapolis. They are well known medical experts in TC.

    Maybe you should look for a clinical trial ?

    I found this : https://clinicaltrials.gov/ct2/show/...ank=1#contacts

    Keep us updated and sincerely good luck.

    jp
    December 15, 2015 : Right I/O. Markers normal.
    December 24, 2015 : Merry Christmas ! 100 % pure EC, no LVI.
    January 7, 2016 : CT scan : 2 RPLN of 8 and 9 mm
    February 2016 : Markers normal.
    March 2016 : Markers normal.
    April 2016 : Abnormal B-HCG (43). 14 mm (from 8) and 10 mm (from 9) lymph nodes.
    April 25, 2016 : Happy birthday ! Relapsed confirmed.
    May 2, 2016 : BEP x 3 begins.
    July 3, 2016 : BEP x 3 ends.
    July 2016 : Serum tumor markers normal. 10 mm (from 14) and 6 mm (from 10) lymph nodes. Back on surveillance !
    December 23, 2016 : Merry Christmas ! Serum tumor markers normal. 6.8 mm (from 10) and no more visible (from 6) lymph nodes. Surveillance continues.
    June 2017 : Serum tumor markers normal. 4 mm (from 7 mm) lymph node. Surveillance continues.

    Comment


    • #3
      You need an expert. At the very least, email Dr E & get his opinion. You cannot go qo wrong following his advice. His expertise is absolutely your best chance to beat this. Do it!.

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

      Comment


      • #4
        Thank you Dave and jp for your replies. I have emailed Dr. Einhorn for his advice, hoping for a prompt reply. I do realize I need an expert, not only in TC but in mediastinal non-seminomas. While my oncologist is very experienced in TC, probably the most experienced in Sweden, she will not see too many cases like mine based on the limited size of my country. I saw the study you linked, jp. While I have had intensified TIP chemo, this was part of the first line treatment. Also my tumor markers normalized, which should mean my tumors are cis-platin sensitive, shouldn't it? In terms of clinical trials, wouldn't this one be an almost a perfect fit?: https://clinicaltrials.gov/ct2/show/...al+germ&rank=3

        Jonathan Shamesh, who is behind the clinical trial above, seems to be quite experienced with mediastinal germ cell cancers. I found a poster where they claim a 59% cure rate for relapsed (!) primary mediastinal nonseminoma with either GAMEC or high dose chemotherapy with carboplatin, topotecan and thiotepa. This would be revolutionizing, as it exceeds current cure rates for patients at initial diagnosis. I could not find a published study confirming this however, does anyone know more? I know most here are from the other side of the pond, but has anyone been treated by Dr. Shamesh or at St. Bartholomew's in London? UK and Sweden being part of the EU/EEA (so far), means I could in theory be treated in the UK and not having to cover the expenses myself, provided the treatment does not exist in Sweden. Has anyone had experience being treated in another EU/EEA country than their own?
        Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
        Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
        Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
        March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
        April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
        July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
        Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
        Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
        March-April 2017: cisplatin, gemcitabine. PD.
        May 2017: pazopanib. PD.
        June 2017: imatinib.

        Comment


        • #5
          Hey blondie,

          I think you're right about platin sensibility, but not sure at 100 %. Maybe Dr Einhorn will have the answer.

          The trial you found seems a better fit than the one I posted you, for sure. I haven't found it on my first search.

          I think you should contact Dr Shamesh. He will verify your eligibility on the clinical trial. He must also have all the data you wish on this poster, as he have access to all the data.

          If you're in a clinical trial, I think you don't have to pay for drugs and follow-up, only travel expenses.

          Keep us updated, blondie, and don't give up, you're a true fighter !

          jp
          December 15, 2015 : Right I/O. Markers normal.
          December 24, 2015 : Merry Christmas ! 100 % pure EC, no LVI.
          January 7, 2016 : CT scan : 2 RPLN of 8 and 9 mm
          February 2016 : Markers normal.
          March 2016 : Markers normal.
          April 2016 : Abnormal B-HCG (43). 14 mm (from 8) and 10 mm (from 9) lymph nodes.
          April 25, 2016 : Happy birthday ! Relapsed confirmed.
          May 2, 2016 : BEP x 3 begins.
          July 3, 2016 : BEP x 3 ends.
          July 2016 : Serum tumor markers normal. 10 mm (from 14) and 6 mm (from 10) lymph nodes. Back on surveillance !
          December 23, 2016 : Merry Christmas ! Serum tumor markers normal. 6.8 mm (from 10) and no more visible (from 6) lymph nodes. Surveillance continues.
          June 2017 : Serum tumor markers normal. 4 mm (from 7 mm) lymph node. Surveillance continues.

          Comment


          • #6
            Blondie, have you had an orchiectomy? If so, which side? I am asking this because you mentioned some calcification. It is not very common, but sometimes cancer starts in the testicle, spreads, and then disappears in the testicle.This was the case for me. We were able to look at the spread pattern in the abdominal lymph nodes, and determine which testicle it started from. My cancer completely occluded the inferior vena ceva, which is a tell for a right-sided testicle involvement.

            The reason I am telling you this is to find out if there is a possibility that your cancer actually started in the testicle and now it is back in that same or the other testicle. As you know, chemo does not effectively go through the blood barrier in the testicles. You also told us you were sterile. Again, this is telling me that there is something wrong in the testicles... What are your thoughts?
            Jan '11 - Stage IIIc, Mets in lungs and liver, abdo 7*7, pulmonary embolism
            Right I/O AFP 13,000, bHCG 110, Scrotal Hematoma, IVC Filter
            4*BEP AFP 20 end of 4*BEP
            May '11 - RPLND @ Indiana U - inferior vena cava dissected, necrosis, AFP<5
            Surveillance (blood & X rays) and all clear for 24 months
            April '13 - AFP 26 , went up to 46 in a week, Negative CT Scan, Ultrasound and head MRI
            4xTIP - almost normal AFP, but started rising again
            2 x HDC with Autologous Stem Cell Transplant - AFP almost normal but started rising again
            Lost kidneys, damaged liver, chirhosis, ascites 2 liters per day, dialysis 3 times per week, disabled
            2 Lung Wedge Resections -

            Comment


            • #7
              Jp, thank you for the information. I was not aware that all medical costs are generally covered in a clinical trial. I have contacted dr. Shamash to ask for his opinion also. I will keep you updated of course.

              Tarc, thanks for your reply. I have seen your story here on this forum, and I am very sorry. I know you have been through so much hell, it cannot be easy. My oncologist has also had this thought, it might have originated from the testicle, although she is treating it as extragonadal. It would indeed be a blessing if it was the case. I would still have relapsed cancer, albeit a much better kind. There are two possible faults with this scenario that I can see. First, both my testicles are calcified and looked similar on the ultrasound. The chance that cancer starts in both, spreads and then regresses should be very slim, shouldn't it? Second, I have no affected abdominal lymph nodes at all, only mediastinal involvement. This would be a very atypical spread pattern for tc, as far as I understand. Also, there appears to be a link between sterility and mediastinal nsegct, which could be the case with me.
              Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
              Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
              Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
              March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
              April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
              July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
              Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
              Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
              March-April 2017: cisplatin, gemcitabine. PD.
              May 2017: pazopanib. PD.
              June 2017: imatinib.

              Comment


              • #8
                And answering your initial question, I've not had an orchiectomy.
                Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
                Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
                Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
                March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
                April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
                July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
                Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
                Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
                March-April 2017: cisplatin, gemcitabine. PD.
                May 2017: pazopanib. PD.
                June 2017: imatinib.

                Comment


                • #9
                  An update. I have received answers from both Dr. Einhorn and Dr. Shamash. Einhorn reckons HDC (carboplatin, etoposide) or surgery are the only curative options. Shamash notes the poor performance of carboplatin and etoposite for relapsed mediastinal EGC, and recommends either GAMEC or their GAMMA trial. I am inclined to follow Dr. Shamash' advice, given his promising studies. If things don't take an unexpected turn (testicular primary is found, or isolated operable disease), then I will most likely go to St. Bartholomew's for my treatment. Thank you for your support, and I will keep updating.
                  Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
                  Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
                  Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
                  March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
                  April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
                  July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
                  Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
                  Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
                  March-April 2017: cisplatin, gemcitabine. PD.
                  May 2017: pazopanib. PD.
                  June 2017: imatinib.

                  Comment


                  • #10
                    Best of luck, blondie.

                    Keep us updated,

                    jp
                    December 15, 2015 : Right I/O. Markers normal.
                    December 24, 2015 : Merry Christmas ! 100 % pure EC, no LVI.
                    January 7, 2016 : CT scan : 2 RPLN of 8 and 9 mm
                    February 2016 : Markers normal.
                    March 2016 : Markers normal.
                    April 2016 : Abnormal B-HCG (43). 14 mm (from 8) and 10 mm (from 9) lymph nodes.
                    April 25, 2016 : Happy birthday ! Relapsed confirmed.
                    May 2, 2016 : BEP x 3 begins.
                    July 3, 2016 : BEP x 3 ends.
                    July 2016 : Serum tumor markers normal. 10 mm (from 14) and 6 mm (from 10) lymph nodes. Back on surveillance !
                    December 23, 2016 : Merry Christmas ! Serum tumor markers normal. 6.8 mm (from 10) and no more visible (from 6) lymph nodes. Surveillance continues.
                    June 2017 : Serum tumor markers normal. 4 mm (from 7 mm) lymph node. Surveillance continues.

                    Comment


                    • #11
                      Blondie, my HDC was somewhere between a trial and standard treatment at MD Anderson. Please note that mortality and toxicity may be very high for trials, and that's why they are called trials. Your quality of life after you beat this is just as important as beating this. It's hard to understand what I am saying now.. My two cents of advice would be to 1) identify the tumors on imaging, 2) reduce them as much as possible through standard HDC/kill microcells that may have been spread, and 3) have multiple surgeries to remove the remaining nodules in a short amount of time not to allow more spreading.

                      I am very very very sorry you are here with this situation. I wanted you to understand how toxic these trials can be. I would have liked a standard HDC in retrospect and then attack with surgeries understanding that my overall chances of survival are around 20-30 percent anyway.

                      Another point to consider is that a surgery is 3,450,790 times better before HDC. It gets very difficult afterwards to recover. So, another viable strategy might be surgery + HDC + surgery. This all depends on what's visible on the scans. It would also be a great idea to open up the scans with your surgeon and study them together. Sometimes, radiologist see small nodules but ignore them because they cannot confidently say it is a tumor. Your surgeon may have a different take on it.

                      My HDC chemo was the following:

                      Background High-dose chemotherapy (HDC) using sequential cycles of carboplatin/etoposide is curative for relapsed germ-cell tumors (GCT). However, outcomes of high-risk patients in advanced relapse remain poor. We previously developed a new HDC regimen combining infusional gemcitabine with docetaxel/melphalan/carboplatin (GemDMC), with preliminary high activity in refractory GCT. Given the high vascular endothelial growth factor expression in metastatic GCT and the synergy between bevacizumab and chemotherapy, we studied concurrent bevacizumab and sequential HDC using GemDMC and ifosfamide/carboplatin/etoposide (ICE) in patients with poor-risk relapsed or refractory disease.
                      Patients and methods Eligibility criteria included intermediate/high-risk relapse (Beyer Model), serum creatinine ≤1.8 mg/dl and adequate pulmonary/cardiac/hepatic function. Patients received sequential HDC cycles with bevacizumab preceding GemDMC (cycle 1) and ICE (cycle 2). The trial was powered to distinguish a target 50% 2-year relapse-free survival (RFS) from an expected 25% 2-year RFS in this population.
                      Jan '11 - Stage IIIc, Mets in lungs and liver, abdo 7*7, pulmonary embolism
                      Right I/O AFP 13,000, bHCG 110, Scrotal Hematoma, IVC Filter
                      4*BEP AFP 20 end of 4*BEP
                      May '11 - RPLND @ Indiana U - inferior vena cava dissected, necrosis, AFP<5
                      Surveillance (blood & X rays) and all clear for 24 months
                      April '13 - AFP 26 , went up to 46 in a week, Negative CT Scan, Ultrasound and head MRI
                      4xTIP - almost normal AFP, but started rising again
                      2 x HDC with Autologous Stem Cell Transplant - AFP almost normal but started rising again
                      Lost kidneys, damaged liver, chirhosis, ascites 2 liters per day, dialysis 3 times per week, disabled
                      2 Lung Wedge Resections -

                      Comment


                      • #12
                        Some more tests have been done now. A brain CT shows no mets, but the markers keep rising. Nothing new was found on a testicular ultrasound, so the chance of a hidden tumor in the testicles appears very slim. I hope now that an isolated spot shows up on the PET/CT, which would hopefully make surgery an option.

                        Tarc, I understand your point of view on the chemo. For me however, as I have a mediastinal primary, the cure rate of standard HDC is very dismal at only 10-15%. I would like to have a better chance, but I know that doesn't come without high risks.
                        Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
                        Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
                        Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
                        March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
                        April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
                        July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
                        Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
                        Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
                        March-April 2017: cisplatin, gemcitabine. PD.
                        May 2017: pazopanib. PD.
                        June 2017: imatinib.

                        Comment


                        • #13
                          I understand. It sounds like there is a small tumor somewhere growing. What are your markers now? Have they been highly correlated to your tumor burden so far? Maybe, a CT (don't do PET, it doesn't work) will show a small nodule in a few weeks/a month. You may want to attack that with surgery. You may also want to ask the surgeon to take a whole lobe or half of it to make sure margins are clean. They need to hear this from you. Otherwise, they will just cut out a small piece with the tumor. Explore all your surgery options before you decide on HDC. Note that I wasn't suggesting that standard HDC will cure you alone, but it may be enough to kill newly spread very small amounts. Plus surgery before and after standard HDC, you may perhaps get back on your feet. Hopefully, you will!
                          Jan '11 - Stage IIIc, Mets in lungs and liver, abdo 7*7, pulmonary embolism
                          Right I/O AFP 13,000, bHCG 110, Scrotal Hematoma, IVC Filter
                          4*BEP AFP 20 end of 4*BEP
                          May '11 - RPLND @ Indiana U - inferior vena cava dissected, necrosis, AFP<5
                          Surveillance (blood & X rays) and all clear for 24 months
                          April '13 - AFP 26 , went up to 46 in a week, Negative CT Scan, Ultrasound and head MRI
                          4xTIP - almost normal AFP, but started rising again
                          2 x HDC with Autologous Stem Cell Transplant - AFP almost normal but started rising again
                          Lost kidneys, damaged liver, chirhosis, ascites 2 liters per day, dialysis 3 times per week, disabled
                          2 Lung Wedge Resections -

                          Comment


                          • #14
                            I don't know my current markers, I will make sure to ask. My markers have not really been proportional to tumor size due to the teratoma components. The respected mass was fairly large. Regardless of which chemo I choose, I realize a multimodal approach including surgery will be my best chance.

                            Could you elaborate on why PET doesn't work? After all I will do a PET CT, so the PET will only add information. Even if this information is useless, there will still be a CT backbone.
                            Sep. 2015: Diagnosed with large primary mediastinal GCT and lung met.
                            Sep.-Nov. 2015: 1xPEI/VIP, 1xBEP, 2xTIP, markers normal after chemo.
                            Jan. 2016: Surgery to remove residual mass. Pathology shows immature and mature teratoma.
                            March 2016: Markers rising. PET/CT shows 4 active mediastinal lymph nodes.
                            April-July 2016: 4xGAMMA (dactinomycin, HD methotrexate, oxaliplatin, paclitaxel).
                            July 2016: SBRT mediastinum, markers rising. PET/CT shows tumors in mediastinum, pleura and abdomen.
                            Aug.-Oct. 2016: HDC, 2xEC, markers normal, almost all tumors resolved.
                            Jan. 2017: Markers rising. PET/CT shows activity in mediastinum, pleura, abdomen. Oral etoposide and SBRT on active tumors. PD.
                            March-April 2017: cisplatin, gemcitabine. PD.
                            May 2017: pazopanib. PD.
                            June 2017: imatinib.

                            Comment


                            • #15
                              Generally speaking PET scans are only helpful with seminomas. PET relies on the fact that fast growing cells will take up the sugar based radioactive "dye" faster than normal cells. so they "light up" in the scan. Teratoma is too slow growing, so if that is all they found, I'm surprised they are even considering chemo, since my understanding is that chemo does not work on teratoma because it is slow growing. I could be wrong.

                              Dave
                              Last edited by Davepet; 03-22-16, 04:22 PM.
                              Jan, 1975: Right I/O, followed by RPLND
                              Dec, 2009: Left I/O, followed by 3xBEP

                              Comment

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