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  • 3d cycle of EP is delayed by a week ...

    It is my first message, but from the start, I’d like to thank all the participants. It was a great help mentally for me, reading your posts, although by myself, not out the woods yet, but trying to be optimistic, and keeping my faith. Being diagnosed with TC, and going through treatment is not a “walk in a park” as one of you said.
    I was diagnosed with Seminoma, Classic type, having conglomerate left para-aortic nodal mass measuring 3.1 x 2.6 x 4.9 cm – assigned IIB.
    Started 4 X EP at MSK New Jersey location on 1/30.
    I’m 47 years old, and according to doctors, that would be a border age (50) when they really need to give a day 6 Neulasta injection. They did it on my 1st cycle, but omitted on 2nd (my wbc count remained high all the way till the begging of 2nd cycle). So, now, before starting the 3d cycle, We discovered that my Absolute Neutrophil Count (ANC) is 0.5, and 3d treatment is postponed till the next week, meanwhile I was given 2 shots of Neupogen.

    I am wandering if anybody went through these types of cycle’s delays, and how big of a deal it is?
    Would it generally impact the overall efficacy of the treatment?

    Thanks a lot

  • #2
    ANDREI~ My son almost had his 2nd cycle of BEP x3 delayed due to low ANC/Neutrophil, but I contacted Dr. Einhorn who in turn called my son's Oncologist. At IU they usually go ahead, and proceed with cycle unless a fever presents. So my son went ahead with 2nd cycle, and he is just finishing up his 3rd cycle of BEP.
    I hope someone chimes in regarding EP. Good luck
    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
    Tumor markers at start of Cycle 1 1/27/17 HCG 899.68 AFP 50.6
    Tumor markers at start of Cycle 2 on 2/17/17 HCG 5.96 AFP 10.2
    Tumor markers start of Cycle 3 on 3/10/17 HCG .6 AFP 3.2
    POST Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm


    • #3
      Trekga, thanks a lot for support. By all means, finishing chemo is a nice milestone to clear. Good luck.


      • #4
        From what i've read i'd avoid any delays in the chemo as much as possible. I can't comment on your specific counts as I can't remember if there is a low threshold, but hopefully someone else can.
        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


        • #5
          Everything I've read says they should not have delayed treatment. I've never seen a study that documents how delaying treatment affects outcome, but the experts do not recommend it. I would insist on getting that shot from now on.

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