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1st time seeing onocologist

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  • 1st time seeing onocologist

    Hello, recently going to go see an onocologist ( waiting on my appointment) . I was last informed by a uriologist of my diagnosis and my surgical pathology, read as: AFP elevation b-hCG elevation , tumor mass 1.3 cm , mixed germ cell tumor ( mature cystic teratoma 65% , embryonal carcinoma 30%, yolk sac tumor 3%, choriocarcinoma 2%) pT1. pNX. S0. I am currently weighing out my options on survillence, rplnd surgery,chemo .What do you guys think, any suggestions before i go meet the onocologist, any valuable information would be appreciated. Thank you
    Last edited by Rich51242; 09-04-17, 11:01 PM.

  • #2
    Without LVI, you have a good chance of being cured already. I'd go with surveillance.
    Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

    7/1/2015: felt tiny lump on side of R testicle
    7/30/2015: Ultrasound shows 2 intra-testicular masses.
    7/31/2015: tumor markers normal, CXR clear
    8/5/2015: R orchiectomy
    8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
    8/14/2015: CT abdomen/pelvis clear, Stage 1b
    8/24/2015: started 1 x BEP

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    • #3
      Not a doctor, but RJKD is, so if he suggests surveillance than that is a good option. With such a large TERATOMA amount in pathlogy RPLND might be an option too.
      17 year old son 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: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

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      • #4
        My Uriologist said i still have 30% relapse , how is it diagnosed that its already LVI ? he explained that this is no way to test or diagnois till RPLD 

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        • #5
          Yeah I am also concerned with a large teratoma the doctor also informed me that chemo wouldnt get rid of teratoma if that was the option

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          • #6
            Originally posted by Rich51242 View Post
            My Uriologist said i still have 30% relapse , how is it diagnosed that its already LVI ? he explained that this is no way to test or diagnois till RPLD 

            30% relapse is generally the number with stage 1a embryonal-predominant disease. Since you have a lower embryonal component, I suspect your relapse rate is slightly lower. To get the most accurate relapse estimate, I would ask Einhorn.

            My last choice would be chemo for you due to the teratoma component. RPLND is a viable option. I tend to favor RPLND more for stage 1b cases as the relapse rate is higher and it's worthwhile to nip the problem in the bud. In your case, RPLND is not a wrong choice at all. It's a big surgery, but it's safe under expert hands.

            Most experts would advise surveillance in your case though. Easy for them to say though.
            Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

            7/1/2015: felt tiny lump on side of R testicle
            7/30/2015: Ultrasound shows 2 intra-testicular masses.
            7/31/2015: tumor markers normal, CXR clear
            8/5/2015: R orchiectomy
            8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
            8/14/2015: CT abdomen/pelvis clear, Stage 1b
            8/24/2015: started 1 x BEP

            Comment


            • #7
              Thanks for all the info and options appreciate it a lot

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              • #8
                I wanted to know aside from the pain and soreness etc; has anyone ever noticed a ball similar to the one on the testicle they removed in another area after the surgery ?? I can tell an almost exact small object but this time to the right of my penis like were my pubes begin and top of the testicle sack trying to explain the best I can as far as location sorry if choice of words or detail not enough has me very worried has been 2,1/2 weeks since my surgery and I barely noticed it by seeing small bump and feeling it. does anyone know about or heard of this?
                Last edited by Rich51242; 09-06-17, 01:47 AM.

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                • #9
                  I'm not sure. Is it on the side where you had the surgery? I still had some swelling 2.5 weeks after my orchiectomy so it may be normal.

                  Either way, if you're concerned about something you should ask your urologist.

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                  • #10
                    Phantom pain. Happens post Orchietomy, even months later! But, if it continues and does not go away seek medical help.
                    17 year old son 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: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                    Comment

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