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  • Input please.

    My 20 y/o son was diagnosed w/ left testicular cancer 1/2019 at which time he had a left oophorectomy. Pathology showed embroyanal 60 percent/yolk sac 38 percent and choriocarcinoma 2 percent. Tumor Markers Went To Normal Level And Oncologist Put My Son on Surveillance.
    10/4/19 CT Abd Pelvis Showed New Left Periaortic Retroperitoneal Lymphenopathy the largest lymph node 2.5x2.4x2.5 cm. 10/4 beta hcg 62/afp 184.7 LDH 202
    BEP x3. Last dose 12/16/19.
    12/30/19 CT Chest/Abd/Pelvis Showed Significant Interval Decrease In Size Of Previously Enlarged Retroperitoneal/Para-aortic lymph node 1.2 cm x 0.9 cm x 0.6 cm. Other Smaller Left Retroperitoneal lymph nodes persist if not slightly smaller as well.
    12/2/19 all tumor markers normal.
    My Son's appt. is on Monday. This Sitting and waiting is hard. I Don't Know What The Next Steps Will Be. If It's Surgery I Know We Need A Very Specialized Surgeon That Has Done Many Retro Peritoneal Lymph Node Dissections. We Are From Metro Detroit? Any Recommendations Regarding Info Above And What I Should Do? My Nieces Husband Had A Lymph Node Dissection w/ Dr. Foster. But I Read Today That He Retired.
    Thanks In Advance

  • #2
    With the node still being larger than 1 cm I would anticipate him needing an RPLND. Unless, an expert surgeon, as mentioned, thinks waiting and re-imaging makes sense in case the chemo is still shrinking the node. But with multiple nodes that may not even matter and they may say RPLND is necessary. Dr. Foster is retired but Dr. Clint Cary is at IU now to take his place and Clint is phenomenal. I would go to IU if it were me. You could also look at Cleveland Clinic (Dr. Klein or perhaps Dr. Michael Gong). Dr. Andrew Stephenson was at Cleveland Clinic but just moved to Rush in Chicago so I suppose that is another option.

    Mike
    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
    Surveillance...
    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 mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

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    • #3
      Hi Skater,
      The sitting and waiting is hard - I hear you on that! There are a lot of us sitting and waiting with you, and hoping that you get the information and guidance you need to get through this.
      Painless lump 5/18/2017
      Orchidectomy June 2017 (4.5cm, rete testis involvement)
      Chemo Summer 2017 (2x7AUC carboplatin)
      No evidence of relapse since, but plenty of anxiety about it.

      I'm also an epidemiologist, and a professor at a medical school (with NO training in oncology), oh, and gay, too.

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      • #4
        They will probably recommend to rescan in a couple of weeks as the biggest node is now borderline and could shrink further.

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        • #5
          With the imaging just 2 weeks post chemo, they may just wait a bit more & re-scan. My doc did & it is now undetectable.
          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP

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          • #6
            Matt saw the dr today. Recommended surveillance. Next month tumor markers redrawn. Cat scan 2 months from the 12/30 cat scan.

            Nurse practitioner was treating Matt for pneumonia bc a consolidation was shown on cat scan. The dr thinks it’s more likely an effect from bleomycin. He’ll get a pft and possibly start on an inhaler.

            Thanks for all you input.

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            • #7
              Sounds like a reasonable plan to me. Keep us posted as you find out more.
              Jan, 1975: Right I/O, followed by RPLND
              Dec, 2009: Left I/O, followed by 3xBEP

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