Announcement

Announcement Module
Collapse
No announcement yet.

When/if to have RPLND?

Page Title Module
Move Remove Collapse
X
Conversation Detail Module
Collapse
  • Filter
  • Time
  • Show
Clear All
new posts

  • When/if to have RPLND?

    Hi all -- I don't post often but I read a lot, and I find this board extremely helpful. Thanks so much to everyone here! I'm writing with a clarifying question. My husband, dx pure seminoma stage 2B, just completed 4EP. CAT scan indicated considerable shrinking of the tumors of the lymph nodes, but something is still on the scan -- I don't have the report in front of me but I think the biggest now is between 1 and 2 cms. The doctor said next step was a PET scan in six weeks which would tell us whether or not the spots we are seeing contain active cancer. But from reviewing the conversations on this board it seems like for many the only way to know if there was still active cancer post-chemo was to have an RPLND. I definitely trust the doctor (at MSK) but I guess I just wanted input from this wise group as well. When will the PET scan tell you whether you have additional treatment, and when does someone need to move forward with more surgery with an RPLND to really be sure? My husband's tumor markers were never elevated, so that's not really something we can use to judge growth.

    Thanks!

  • #2
    Pure seminona should lite up like a xmas tree with a pet/ct. The theory is the radioactive isotope is glucose based. Cancer cells will ping alot hotter than normal cells. That in a nut shell is a PET/CT.
    The 6 weeks out is to ensure thst what ever damage is or will be done by the chemo to good and bad cells will have repaired and or healed by then.
    They dont normally i say normally do prlnd for pure seminona, but in my case they did for my relapse. So if he has and i say a big if. Then his case should go to a tumor board meeting and they will either say yea or nah on the RPLND. Lot of factors that they consider. They may just have him go right to more chemo.
    There has been discussion on here about clincal trials for semiona and rplnd.
    I know its easier said than done to think postive, but he is more than likely cured, but if it was like mine stuborn as hell to cure. You still have alot of tools to curing him.
    Last edited by eodtech2001; 09-26-18, 09:07 PM.
    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

    Comment


    • #3
      Thank you so much for this explanation. It's very helpful. Can I ask you, how did they confirm your false positive in Feb 2014? I ask because the doctor said false positives are pretty common on the PET scan.

      Comment


      • #4
        I had literally finished HDC like 4 or 5 days prior to the pet/ct. Emailed Dr Einhorn and he said no way have them re check it no sooner than 6 weeks out. So sure enough 6 weeks later had another Pet/Ct and everything was normal. Normal as in no. Active cancer.
        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

        Comment


        • #5
          According to the NCCN guidelines (2017, page 10), any post chemo mass less than 3CM should go to surveillance if markers are normal. They do not even recommend PET/CT unless there are masses over 3CM. Personally, I would want the PET/CT just to be sure, but I wouldn't be anxious about the results.

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

          Comment

          Working...
          X