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I had the scan result which shows 2 mildly enlarged interaortocaval with largest measuring 9mm in short axis, which were not present there. usually the right testicle cancer cells moves to the interaortocaval nodes. How can one know if they are cancer or no ? Pet scan or biopsy will show that ? The blood tests were all ok, maybe because if they are cancerous there is not much secretion. I have an appointment next week with oncologist. What you think they will advise ? And what are your recommendations ? Dr Einhorn reply was:
It is difficult to provide advice long distance, but if your testis cancer was on the right side and an experienced radiologist felt this was a NEW lymph node between the aorta and inferior vena cava, it is PROBABLY from seminoma. Options would be to repeat CT in 6-8 weeks, since it is less than a cm in size and if further increase treat it as a metastatic lymph node, or to proceed with treatment now. I would never recommend chemo here and options now ( or in 6 weeks ) would either be radiotherapy or RPLND. Here in the U.S.we have recently been evaluating RPLND rather than radiation with the hope and expectation it would be as effective and not associated with any of the rare late complication from abdominal radiation therapy.
In europe they usually do not perform RPLND, but I am scared from radiotheraphy long term secondarly malignancies. What's your advise guys about all this ?
My brain is running all over.
09/2016 - 3cm no vascular invasion seminoma in right - orchiectomy + surveillance + normal blood work
12/2016 - ct scan clear + normal blood work
03/2017 - ct scan clear + normal blood work
06/2017 - only blood work - normal
09/2017 - mildly enlarged 2 interaorotocaval lymph nodes with the largest measuring 9mm in short axis diameter - the rest all clear
It is difficult to provide advice long distance, but if your testis cancer was on the right side and an experienced radiologist felt this was a NEW lymph node between the aorta and inferior vena cava, it is PROBABLY from seminoma. Options would be to repeat CT in 6-8 weeks, since it is less than a cm in size and if further increase treat it as a metastatic lymph node, or to proceed with treatment now. I would never recommend chemo here and options now ( or in 6 weeks ) would either be radiotherapy or RPLND. Here in the U.S.we have recently been evaluating RPLND rather than radiation with the hope and expectation it would be as effective and not associated with any of the rare late complication from abdominal radiation therapy.
In europe they usually do not perform RPLND, but I am scared from radiotheraphy long term secondarly malignancies. What's your advise guys about all this ?
My brain is running all over.
09/2016 - 3cm no vascular invasion seminoma in right - orchiectomy + surveillance + normal blood work
12/2016 - ct scan clear + normal blood work
03/2017 - ct scan clear + normal blood work
06/2017 - only blood work - normal
09/2017 - mildly enlarged 2 interaorotocaval lymph nodes with the largest measuring 9mm in short axis diameter - the rest all clear
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