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My 17 year old starts 3 x BEP this Friday

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  • #91
    You have Grant's cycle 3 to go through first. It helped me to find on this forum that most doctors recommend waiting for appr. 6 weeks after BEPs to do the CT scan. So when our oncologist mentioned 6 weeks at least I was prepared. It was 5 weeks for us, only because our doctor was going to be away.

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    • #92
      JOESMUM~ Thanks for clarifying CT scan possible timeline post chemo.
      17 year old 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: pathlogy Teratoma , 3 large masses removed

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      • #93
        let us know what Grant's oncologist say about the timelines. How is Grant feeling on his last BEP?

        Comment


        • #94
          JOESMUM~ Thanks for asking.Grant finsihed up his last 5 in-patient BEP today! The nurses worked hard to keep his nausea down, day 3 has always been the toughest day every cycle.
          Only 2 Bleos left!!! Concerned since the discharge papers today have his CT Scan on Tuesday, 3/28 which is only 4 days after last Bleo on Friday, 3/24!!!

          HELP: I need to go back and read posts about about after Chemo CT Scans, but 4 days seems too soon.
          Please help direct me to the "norm" for post Chemo CT Scans.


          Grant's tumor markers dropped even more after 2nd BEP round, and are now normal!!!
          17 year old 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: pathlogy Teratoma , 3 large masses removed

          Comment


          • #95
            I looked into a lot of posts on this forum about that topic as mine was only 6 days after my last bleo. The most common time frame is about 4-6 weeks post chemo in order for the chemo to have its full effect.

            Mine was 6 days as they were still concerned about doing 3 cycles over 4, so wanted an early indication.

            If I were you I would ask your oncologist why it's so soon after the last bleo, and say you've read it's done roughly a month after chemo normally. They might have a reason for doing it earlier.

            Realistically, if your sons scan showed that a node or two were still enlarged slightly, they would most likely re-scan him a few weeks later to see if they've shrunk a bit before any further treatment, which is just using up more scans so worth questioning your oncologist.
            24 year old diagnosed 6/11/16
            Pre/o markers 9/11/16 - HCG 15, AFP 210, LDH 539
            Pre/o CT Clear
            Non-seminoma (80% embryonal carcinoma, 10% yolk sac tumour, 5% chorea carcinoma, 5% seminoma)
            Post-op markers - 14/12/16 - HCG 35, AFP 1050, LDH 430
            Post-op CT with one enlarged lymph node - 1.5x1cm
            Borderline stage 2B/3B
            BEPx3 started 15/12/16 (Borderline BEPx4 - Advise of Dr. E to only do 3 rounds)
            CT and markers clear - in remission - 28/2/16

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            • #96
              NISH~ Thanks. I will ask why. Today when the Oncologist stopped by before my son was discharged she mentioned the possibility of surgery if the nodes have not shrunk. That is why I came here to confirm the normal time frame. I know I read a few posts, like one of yours, that most people waited at least a month post chemo. Also, recall that nodes continue to shrink for a bit post chemo.
              Again, this Oncologist is great, just not one who has treated many males with TC as a Pedi Oncologist. Thanks again for your input!!!!
              17 year old 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: pathlogy Teratoma , 3 large masses removed

              Comment


              • #97
                Congrats, Trekga, blood markers are a great indicator!! Two more Bleos and you're done!!

                Comment


                • #98
                  JOE~ Thanks! Grant must be tired from the effects of the last doses of E&C, he fell asleep at 8:30 pm EST!
                  17 year old 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: pathlogy Teratoma , 3 large masses removed

                  Comment


                  • #99
                    Originally posted by Trekga View Post
                    NISH~ Thanks. I will ask why. Today when the Oncologist stopped by before my son was discharged she mentioned the possibility of surgery if the nodes have not shrunk. That is why I came here to confirm the normal time frame. I know I read a few posts, like one of yours, that most people waited at least a month post chemo. Also, recall that nodes continue to shrink for a bit post chemo.
                    Again, this Oncologist is great, just not one who has treated many males with TC as a Pedi Oncologist. Thanks again for your input!!!!

                    Yh they seem to always mention the possibility of surgery, they did to me also, I suppose as it is always a possibility. But I really hope Grant doesn't require it and hopefully that's the news we'll get in a few weeks!
                    24 year old diagnosed 6/11/16
                    Pre/o markers 9/11/16 - HCG 15, AFP 210, LDH 539
                    Pre/o CT Clear
                    Non-seminoma (80% embryonal carcinoma, 10% yolk sac tumour, 5% chorea carcinoma, 5% seminoma)
                    Post-op markers - 14/12/16 - HCG 35, AFP 1050, LDH 430
                    Post-op CT with one enlarged lymph node - 1.5x1cm
                    Borderline stage 2B/3B
                    BEPx3 started 15/12/16 (Borderline BEPx4 - Advise of Dr. E to only do 3 rounds)
                    CT and markers clear - in remission - 28/2/16

                    Comment


                    • All hospital stays are done! this is a HUGE milestone, well done to you and Grant! two weeks to go for two more Bleos and you are back to normal - hopefully. I have seen various posts with some people requesting CT scans earlier, some having them in 4-6 weeks time, sounds like there is no generic rules. As the guys said above, go with what your Onco suggested and be prepared to do another CT scan if required. Always the safest bet I think. Hopefully the op will not be needed but good to be prepared just in case.

                      Comment


                      • JOESMUM~ Yes, grateful that Grant has gotten through the hardest part, he hopes to never have to have Cisplatin again! Thanks for taking time to always respond. Hope all is well with your son.

                        Asking again for more responses:
                        Is 4 days post last Bleo too soon to have CT Scan? I thought I read several weeks post BEP?
                        Grant had normal CT scan pre-r/o, but CT Scan post r/o (increasing markers) showed 3 nodes over 2.5, none larger than 3.6.
                        Tumor Markers normalized AFTER 2nd round of BEP. Grant still has 2 Bleos left in this 3rd cycle.



                        17 year old 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: pathlogy Teratoma , 3 large masses removed

                        Comment


                        • Originally posted by Trekga View Post
                          Is 4 days post last Bleo too soon to have CT Scan? I thought I read several weeks post BEP?
                          .
                          It is not too soon to have the scan, it is, however, too soon to prescribe further treatment based on that scan. Any good onc knows that the nodes will continue to shrink for a month or so post treatment. No harm in scanning earlier (except for the radiation)as long as the doc understands it does not predict the need for further treatment accurately.

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

                          Comment


                          • DAVE~ I know my son's Oncologist has little experience w/Testicular Germ Cell, being a Pedi Onc at a Children's Hospital. I just do not want him having repeat CT Scans. He has already had 2 since December 2016! Does the primary pathology makeup matter, for example Grant had some Teratoma in his, though it does not say what type? That is what his ONC mentioned, that there might possibly be some...I would defnitely get an expert opinion before ANY surgery!
                            17 year old 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: pathlogy Teratoma , 3 large masses removed

                            Comment


                            • Since he had one node at 3.5cm, the odds are good that it will not be down to normal by the 28th, but an earl test can show that it has shrunk , which might be good to know earlier rather than find out a month later that it has not shrunk. I would discuss this with the oncologist . Certainly we don't want him glowing in the dark, but sometimes there are valid reasons for repeated scans.Let his doc know your concerns & work out a plan together.

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

                              Comment


                              • Great point from Dave. Once you know that Grant's lymph nodes have shrunk, you will feel so much better as you will know that BEPs have worked. And early check means that they are on top of things...

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