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Cancer May Be Back - Thoracic Surgery

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  • Cancer May Be Back - Thoracic Surgery

    After receiving chemo and RPLND for my testicular cancer, there is now a nodule in my lymph node, within my chest that has grown to around 2 CM. My doctor thinks it is most likely teratoma, but I still need to get a blood test, which won't be until Tuesday/ It seems the most likely scenario will be me needing a surgery by a thoracic surgeon. Has anyone ever had this type of surgery before? Does anyone know how it compares to RPLND? I am also wondering on how long the recovery time may be. I have not got all the details yet, but I do know the surgery will be quite invasive, which they will have to crack my chest bone.

  • #2
    Hi there. Sorry to hear about your situation. My son (24) had an eggplant sized mediatstinal tumor removed via sternotomy in November after 12 weeks of chemo and a 4 week hiatus for healing. His experience was far better than we anticipated! He was up the next morning, had his drain removed within 24 hours and home 2 days later. His pain was tolerable and not nearly as bad as he had expected. He said he would do the surgery multiple times over the chemo and it was way easier. He was married less than 4 weeks after the surgery and he was fine. The hardest part for him is the long term healing as that takes a long long time. He feels fine but has to be careful about lifting things, can't lift weights, can't bowl, can't do pushups, has to constantly be reminded to be careful. He hates that part! Hope you have as quick a recovery as he did. Best of luck!

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    • #3
      Interesting. Yes, I think some here have had some. Can you remind us of your pathology originally?
      6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
      6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
      7/7/15: bHCG 56, AFP 42, LDH 322
      7/13/15 - 9/18/15: 4xEP
      10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
      10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
      4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
      4/20/16: RPLND @ IU - teratoma only!
      9/27/2018 all clears up to this date!

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      • #4
        There have been a few on the forum to have thoracic surgery, but not very many. My best guess, due to the size of the incision, and the manhandling of the intestines, that the RPLND recovery is likely worse,but broken bones can be painful & take time to heal, so not really sure.

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

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        • #5
          Wow, we kinda piled on here. Three replies in two minutes...
          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP

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          • #6
            Oh no! If not being at a top TC Center than I would suggest reaching out to one & get a 2nd opinion. What was you post RPNLD pathology and your initial pathology.
            Son Grant
            dx 12/21/16 at age 17

            BEP x3
            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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            • #7
              Hi guys. Initial pathology was 100% embryonal carcinoma. After chemo and the RPLND, it was all either dead tissue or teratoma. My doctor told me that with the RPLND showing teratoma, it increases the likelihood that this nodule in the chest is teratoma. I will have a better idea once I get the results of my blood test, though of course nothing is for certain until the pathology. However, he told me there is a small chance of needing more chemo, depending on the results of the blood test. I am seeing Dr. Vaughn at Penn Medicine, and he is one of the noted TC experts, so I feel comfortable with his opinion. It also does not surprise me I am one of the few who will probably have to go through this. Nothing about this process has gone as expected.

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              • #8
                Yeah, seems reasonable to assume terratoma until bloodwork or pathology shows otherwise. Good luck!
                6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
                6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
                7/7/15: bHCG 56, AFP 42, LDH 322
                7/13/15 - 9/18/15: 4xEP
                10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
                10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
                4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
                4/20/16: RPLND @ IU - teratoma only!
                9/27/2018 all clears up to this date!

                Comment


                • #9
                  Hi JoeM, I had a VATS to remove a nodule in the middle right lobe of my lung after 3XBEP. It took me less than 2 weeks to fully recover and to head back to the gym and spin. The trick is that you MUST follow the breathing exercise on a hourly basis and the exercise is quite challenging. I had a a chest tube for 2 days to drain the fluid but had medication via IV to cope with the pain. It was not bad at all. I was so lucky that the nodule was on the surface of my lung and was easily found; my surgeon took less than 30 minutes to remove. She also broke my rib cage to have the instruments inside me to perform the surgery.

                  Good Luck!!!

                  OBL
                  6/2016 - Right I/O; 35% Yolk Sac, 35% Teratoma, 10%EC, 20% Seminoma with LVI; AFP elevated; CT scan clean
                  7/2016 - markers normal; confirmed Stage 1B; surveillance
                  8/2016 - markers normal
                  9/2016 - markers normal
                  10/2016 - markers normal; CT scan revealed 3mm lung nodule
                  12/2016 - markers normal
                  2/2017- markers normal; CT scan confirmed lung nodule grew to 14mm; confirmed relapse
                  3/2017 - 3xBEP
                  5/2017 - finished 3xBEP
                  6/2017 - markers normal; no size reduction in lung nodule
                  8/2017 - VATS and markers normal; continue to surveillance
                  12/2017 - all clear
                  ​3/2018 - all clear
                  6/2018 - all clear

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                  • #10
                    I received "most" of my tumor marker results today. HCG and LDH both negative. Apparently, the place I went to somehow messed up the AFP test and gave me something else instead. So I will have to get that tomorrow and unfortunately, wait for the result next week. But so far so good on the blood tests! My surgeon said it should be a similar surgery to RPLND, with about a 4 to 6 week recovery, though maybe not quite as bad. I actually found RPLND recovery to be a breeze after the first 24 hours. The scariest thing about this surgery is it comes with many more risks, including a 2% mortality rate. As for the surgery itself, it looks like he will need to cut part of my neck open in order to get to the lymph node. He will also have to crack a rib open and cut a small portion of my chest bone. I am very nervous, but I think I will be fine. My surgeon is one of the best in the country and has even appeared on several news stations.

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