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Suggested exams and treatment options after orchiectomy.

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  • Suggested exams and treatment options after orchiectomy.

    Hi forum!
    it has been a valuable source of info, since in Greece there is very little info on the subject.
    So, my boyfriend was diagnosed May 9 with a tumor 6,5cm in right testicle. The bloodwork showed b HCG normal, LDH normal and AFP 253 -while a second one before the surgery showed AFP 280. Chest x ray showed clear, ct of upper and lower belly showed clear.
    15/5/2019 he did the R/O orchiectomy operation, and the pathology report was out Monday, showing germ cell mixed tumor, 60% yolk sac and 40% classic seminoma. The tumor has invaded all testis except the spermatic cord. The pathology was made in a private hospital, where he did the operation, which is actually specialized in births and pregnancies. THe other exams where made at a private clinic which does not hit me as trusty. _None of these specialize in cancer, less in testicular cancer._
    No evaluation of the stage of the cancer was made. I don't know whether he's a stage Ia, Ib or whatever.
    He was referred by the urologist to an oncologist he knows, who ordered no more exams -he has not done no MRI anywhere, no pet scan and no bloodwork after his operation- and I am not very sure his lymphatic adenes where properly checked for tumor invasion. The oncologist suggested 2xbep starting Monday.
    I am pleading him to do more tests and take a second opinion because from what I read in the forum, most of the people had many more tests before deciding their treatment options, while I've read here that for a stage I non seminoma 1xbep is enough. on the other hand I really think he should run more tests because as I see things, first goal is a complete killing of the cancer and elimination of the risk of recurrence, and second goal is the treatment to be less toxic possible, without, of course, taking any risks.
    Here in Greece there is a public academic hospital specializing in cancer which I think he should visit before deciding. He is afraid of displeasing his oncologist but the way I see things this is a very important decision and this first oncologist should not be displeased if he asked for some time to take second opinions.
    What is your opinion the way you see things? does he need more tests or these sound enough to you? Does he risk anything if we don't start Monday and wait for more opinions? Should BEP start real quick or a month's waiting time does not play important role? thank you all for helping me out, because I really feel he is being irrational taking fast decisions in a very important subject, because if he does 2 bep when 3 is needed then in a recurrence he is gonna have a hard hard time, while on the other hand if 1 is needed and he does 3 or 2, he will have very brutal side effects and the possibility of another cancer in the future -or so I've read.
    since maybe my emotional involvement stand in the way of clear thinking on the particular subject, please help me see whether I am exaggerating or whether we should indeed take more time and especially if the tests sound enough to you guys. Thanks for your time,
    cheers,
    Maria
    Last edited by Maria; 05-29-19, 02:38 PM.

  • Davepet
    replied
    For stage 1 non seminoma., often the I/O operation is the only cure needed. Doing chemo at this point may be too much, but there isn't enough data to know. What *is* known is that if he goes on surveillance & has a relapse, his chance of a cure with 3xbep are close to 100%, it''ll just be a rougher ride. It is easier to make choices when it it a life or death situation that when it is a chemo /no chemo thing& no one knows if it's actually needed tough call....

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