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How long After chemo does lymph node continue to shrink?

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  • How long After chemo does lymph node continue to shrink?

    2019 my son had left orchiectomy. Pathology showed 60 percent embryonal carcinoma, 38 percent yolk sack tumor, 2 percent Choriocarcinoma.

    10/4/19 cat scan showed 2.5 cm x 2.4 cm x 2.5 cm left periairtic retroperitoneak lyphadenopathy along w/ inferior 1.5x 1.1 cm as well as a number of small lymph nodes extending infeeiorly to left periaortif region.

    10/4/19 beta 62 and afp 184.7

    Last bepx3 12/16/19 12/2/19 hcg less 1 and afp 2.4

    Cat scan 12/30/18 showed 2.6 cm x 2.4 cm x 2.5 cm enlarged retro peritoneal/para aortic lymph node now measures 1.2 cm x 0.9 cm x0.6 cm. There is smaller left para-aortic lymph nodes which are stable or perhaps even smaller as compared to his earlier exam. His local oncologist recommended surveillance as did dr einhorn when I emailed him.

    My question. How long after ct does lymph node shrink? His dr 1st said cat scan 3 month after. I said 3 months skeptically than the dr said ok 2 months. I don’t know if it’s best to make cat scan appt 2 months post chemo vs prior ct scan. Also does anyone know likelihood of reoccurrence.

    My son has bipolar. He’s emotionally having a difficult time now. (Since cat scan result)I think he was hoping for lymph nodes not to be enlarged at all post chemo. (As i would also wish) He wants to get on w/ his life. He’s scared of the challenges cognitively w/ bipolar and now the unknown w/ reoccurrence.

  • #2
    Hi Askater, what did the doc say about the node that is now 1.2 x 0.9 x 0.6?
    It may no longer be considered "enlarged" when it is that small. I'm not an oncologist, but I thought nodes under 1-1.5cm were not considered to be enlarged. The serum tumor marker response is very encouraging as well.

    Your local doc and Dr. Einhorn aren't suggesting surveillance because there's "nothing better" to do - quite the opposite! They are recommending surveillance because "doing something" has some risks, and the odds are that your son is already "done for life" with his cancer treatments.

    Adjusting to the news of having cancer can be rough for everyone. It is also a challenge to get used to the uncertainty about whether it is gone, not quite gone but held in check, or recurrent.
    Your son's bipolar diagnosis could make the transition more challenging, but not necessarily. Your son has already learned some tough lessons because he has bipolar, and he has learned how to overcome many forms of adversity just to get to this point - these are skills he can bring to bear on adjusting to the cancer diagnosis as well.

    I know it sounds lame to say "time heals all", but time helps. I had a very hard time adjusting to being diagnosed - to the point where I had to cut down to 50% time at work, I didn't have any energy left over to socialize - I could barely get myself up and down stairs after coming home from work when I did go to work, and sometimes I'd have to spend the whole next day in bed just to recover from teaching one class. It took me a year to get back on my feet, and it wasn't until 2 years after the diagnosis where I really bounced back and was able to go back to work full time and fill my social calendar. It can vary a lot from one person to another, from weeks, to months, to a year or two.
    So, besides just waiting around for your mind and body to get back together, you can take some active steps to help the process along, including frequent intense exercise, forcing yourself to reach out to friends, and getting outside to take a walk every day.

    Thank you for being a strong advocate for your son, I'm glad that you're in his corner and fighting for him.
    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.


    • #3
      Thanks for response. You are so strong billandtuna.

      My son has a great psych dr. He talks about suicide.

      But we have help from
      A great mental health group.


      • #4
        I had my last bleo on 4/6/10. 1st PET scan on 4/20/10 and it also showed a slightly enlarged node. My scan on 7/6/10 didn't show

        anything at all & it stayed that way until my last scan.
        Jan, 1975: Right I/O, followed by RPLND
        Dec, 2009: Left I/O, followed by 3xBEP


        • #5
          Originally posted by Askater112 View Post
          Cat scan 12/30/18 showed 2.6 cm x 2.4 cm x 2.5 cm enlarged retro peritoneal/para aortic lymph node now measures 1.2 cm x 0.9 cm x0.6 cm.
          If you look three-dimensional, this node is 24x times smaller than before, and that is a significant shrinkage. My amateur opinion is that nodes that were metastatic continue to be a little encreased after chemo for a long time, because they are still full of dead cancerous tissue, they are like a fresh scar and it takes time for them to become fully normal.
          45yo, left I/O 07/30/2018, T1 pure seminoma, surveillance...