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Pure Seminova - 0.9cm Lymph Node 2 Month Relapse?

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  • Pure Seminova - 0.9cm Lymph Node 2 Month Relapse?

    Hi TC brothers, here I am again. I have recently aired my story, and not to overwhelm everyone with it, here is the post:

    In summary: I had a pure seminoma, no LVI, no tumor markers, unremarkable CT Scan. So Dr. Sheinfeld said protocol is surveillance.

    So today I come back from my 2 month 1st surveillance appointment and the doctor shocks me a little. Says they found a 0.9cm Lymph node in the retroperineal area, and that they want to keep monitoring it with another CT Scan in 3 months. They also say the exact same, 0.9cm lymph node was there in my first CT scan done 2 months ago just before my right I/O.

    So I am left wondering: is the lymph node enlarged because of something else, or is this cancer? Would it have grown in these two months? Given the location, could it be something else? I don't remember having being sick nor anything, outside of, naturally, the I/O surgery and recovery, which was fine. I recently was working out and exercising and I noticed the incision was swollen again (after being fine), so I reduced the exercise routine, but outside of that, I am feeling fine.

    What experience have you guys seen with pure seminoma, no tumor markers, no LVI whatsoever, unremarkable CT scan that, unfortunately, goes on to relapse?

    looking forward for your thoughts - also, if you can, drop a few notes of, in the case 3 months from now the new CT scan shows the lymph node is growing, what the treatment would be?

    Thank you in advance and stay strong.

  • #2
    Based on your post,the node is unchanged from 2 months ago, so no, it did not "grow". It needs to be monitored, but it is smaller than the the size considered to be actionable, so do not be concerned about it at this point.If it hasn't changed in 2 months, it probably won't in another 3.

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


    • #3
      Hi Tango5,

      I had virtually the same stats as you (Pure Seminoma, 2.5cm Tumor Confined, Clear Markers and Scans). Definitely keep up with the surveillance -- they are looking to see if the node exceeds the 1.0cm threshold -- it could feasibly stay the same always, in which case it would not be the TC.

      I actually was all clear for the 1.5 years, and that's when one of my lymph nodes started growing. I just happened to be one of the unlucky 15%. If I remember correctly, Seminoma moves slower than Non-Seminomas. On one scan it was still sub-1cm, but by the next scan 4 months later, it had increased to 2cm.

      If the node is growing, they would most likely recommend that you do 3x BEP or 4x EP chemotherapy. I just finished my 3x BEP in February, and am back on Surveillance. Everybody responds differently -- but if you have to do it -- you will get through it, and the 9 weeks of chemo will soon feel like a momentary bad dream. But like everyone says -- these are one of the "better" cancers to get, due to the high cure rate!

      - Chris
      Last edited by christopherme; 09-07-18, 07:37 PM.


      • #4
        Thanks Dave for the support; and same to you chistopherme. I believe your case (christopherme) is very very similar to what I may have to do. I am wondering how many more cases like this are out there, and also if there are situations where a lymph node is at ~1cm but never grows or even shrinks without chemotherapy?


        • #5
          I was in the same excact spot you were over 5 yrs ago. It started late 2012 grew really slow and i was released back to full duty after 3xBEP, Of course i was as remote as you could get. marshall islands. It took several months for it to get to the point that i had to pack up and come home. But you can read my signature and see what i went thru.
          Jan 2012- U/S mass in Left testicle
          Feb 2012- I/O performed to remove cancer
          Mar 1,2012- pathology pure seminoma
          Mar 7, 2012 PET SCAN stage IIa
          April 2012 Mayo clinic carbolite.
          May 2012 carbolite failed, started BEP x3
          August 7th 2012- BEP complete
          April 2013 CT/PET show relapse
          May 2013 RPLND
          Aug 2013 Relapse again Started VIeP x2
          Oct 2013 HDC AUTOLOGOUS
          Dec 2013 HDC completed CT/PETSCAN 1.1 cm x .8 cm right lower lung lobe
          Feb 2014 confirmed false positive all clear FINALLY !
          Jan 2015 1 year cancer free Pet/CT scan
          Jan 2016 2 years cancer free "Pet/CT scan
          Jan 2017 3 years cancer free "Pet/CT scan
          Jab 2018 4 years cancer free "Pet/CT scan, labs, xrays


          • #6
            Dr. Sheinfeld certainly knows what he is doing but it can be nerve-wracking going with the more conservative surveillance and wait and see approach. A recent abstract looked into those with borderline lymph nodes (i.e. 1-1.5 cm) and with the surveillance approach they were able to avoid treatments in 60% of the guys at the two-year mark. It is a small series but can give you a bit of the idea behind the surveillance and "making sure" treatments are needed approach.

            Oct. 2005 felt lump but waited over 7 months.
            06.15.06 "You have Cancer"
            06.26.06 Left I/O
            06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
            06.30.06 It's Official - Stage I Seminoma
            Founded the Testicular Cancer Society
            6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

            For some reason I do not get notices of private messages on here so please feel free to email me directly at if you would like to chat privately so as to avoid any delays.


            • #7
              Man just try to relax and live life. It’s hard to not worry but u have to try. From reading ur history I wouldn’t call it a relapse even if that node does go beyond the threshold and is idenfirrd as Tc cancer. U haven’t had any treatment other than the I/O so if it does grow that just means u still had small cancer sells floating around in ur blood system. Seminoma is slow growing so it could be possible to still be there. But again it probably isn’t so don’t worry about it. If u find cancer in that node later u will move forward with chemo which will zap ur TC. And seminoma is very sensitive to chemo u will be fine,no sense or point adding stress!

              Now if You had done adjuvant chemo rather than surveillance and that node came to be TC then yes u could say u relapsed. All will be good man. Go live love and laugh man. Keep moving forward.


              • #8
                Hi Tango. I understand what you are going through. I myself had a lucky find with my right testicle having a tumor in Feb of 16. It was confined to the testicle and started active surveillance with MSKCC. 18 months later two lymph nodes popped up on a ct scan that was referred to as the "primary landing zone" . The sizes were 1.6 x 1.4 cm which was previously 0.6 x 0.3 cm & a new node that was 2.5 x .2.4 cm. I did 4xEP and the nodes shrunk to what the report says is a normal size for the smaller node and 0.9 x 0.8 for the larger node. Back to active surveillance. 7 months later two different nodes appeared. One was 1.6 x .1.5 x 1.7 and the other was 1.2 x 0.8 x 0.7. I was offered a clinical trial that Dr. Feldman at MSKCC was heading. I ended up having the standard care of TIP. The one node has completely recovered and the other is now down to 1.0 x 0.7. I to have been told that this is the cancer to have if you are going to have cancer.

                Just wanted to share with you because it's nice to know that others can closely relate to what we are going through. Stay positive, enjoy life and know that you are in good hands.
                2/16 - Right Orch Orchiectomy which turned out to be Germ Cell Tumor PT1
                6/17 - Two Para-Aortic nodes showed on CT Scan. Renal Vein 1.6 x 1.4 / Renal Cava 2.5 x 2.4
                7/17 - Started 4 x EP
                9/17 - Completed 4 x EP
                9/17 - CT Scan both nodes have returned to normal size.
                12/17 - CT Scan both nodes still normal size.
                4/18 - Ct Scan shows Precaval abutting third segment duodenum 1.6 x 1.5 x 1.7 & Retrocaval 1.2 x 0.8 x 0.7
                4/18 - Biopsy confirmed still Germ Cell Tumor
                6/18 - Started TIP Inpatient @ MSKCC
                8/18 - Scan showed nodes now 1.5 x 1.2 cm, previously 1.6 x1.2 cm &
                has nearly resolved, previously 1.6 x 1.4 cm
                Previously measured precaval nodes have both resolved
                9/24 - No recurrent retroperitoneal adenopathy. Residual retrocaval node measures 1.0 x 0.7 cm, unchanged.