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Second RPLND

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  • Second RPLND

    so my husband has been in remission ten years. he went in to see a sports doctor because he fell a couple years ago. he went in last year. did therapy.. went back because the pain was still there. he has nerve damage. they want to do a steriod injection in his spine. however, the MRI also showed two concerning lymphnodes that were too big.. so recommened CTSCAn with contrast. Hubby can't have contrast so did it without contrast. now.. they want to do another RPLND because the cancer seems to have come back in the same lymphnodes where it was before. Still kind of in shock. and his doctor who did his previous RPLND in 2009 said he shouldn't be cut open again. because that was the second time he was cut open as he had his appendix out a long time ago.. So tomorrow we find out whether or not they will do it or should do it.

    left orchiectomy, surveillance, retroperitoneal lymph node dissection (RPLND), chemotherapy: 4xBEP, second-line chemotherapy: VeIP, autologous stem cell transplant.. journey started 2008 remission 2010
    Diagnosed Mixed Germ Cell tumor Carcinoma and classic seminoma StageIIC 6*8cmbulky June 26-08
    Left I/O June 26-08 4*BEP July-08-Sept-08
    Mets to Abdomin/chest,
    Stage III, , 6*8 cm Jul 08
    Markers normalized Nov08, residual tumor 3*2cm in abd. 13mm in chest. Spinal Stenosis,Neuropathy RPLND feb 09
    Found all three: Cancer, teratoma and scar tissue
    10/09 B-HCG up to 39.90, recurrent TC, 2*VIP 12/09, TI started 05/11/2010, stem cell infusion 5/18/2010 day of rebirth
    08/10 all clear

  • #2
    I'd suspect teratoma. Anything else would have grown and metastasized elsewhere in that period of time I think. So surgical resection seems like the way to go? I'd consult some other centers of excellence for this level of case, it isn't something most doctors have probably encountered.
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15: begin 4xEP, end 9/18/15
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    10/22/19: all clears up to this date!

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    • #3
      I tend to agree with biwi Cancer can't come back to the "same" nodes since they would have been removed during the 1st RPLND.
      Jan, 1975: Right I/O, followed by RPLND
      Dec, 2009: Left I/O, followed by 3xBEP

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      • #4
        I am praying for him. I have read all your story and I wish you all the best. Keep us posted and do you have more details? What are the sizes of the "nodes"?

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        • #5
          I don't think there's anything there but a teratoma..Betahcg would rise in the smallest Cancer Focus..

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          • #6
            Originally posted by omerkulum View Post
            I don't think there's anything there but a teratoma..Betahcg would rise in the smallest Cancer Focus..
            Not true, I had 5cm mass in my lung, embryonal carcinoma and no markers what so ever.

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            • #7
              The absence of markers is NOT useful at all, unless they were elevated & came down. Only the presence of markers really tells us anything.
              Jan, 1975: Right I/O, followed by RPLND
              Dec, 2009: Left I/O, followed by 3xBEP

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              • #8
                I agree with the reaching out to an experienced center like Indiana University, to get their thoughts. Here is a nice list of experts: http://thetcrc.org/experts.html
                Not much details to go on but if this is a late relapse, then surgical intervention if possible, may be the preferred method up front. I would think a biopsy and any other differential diagnosis may be needed as well before jumping into treatments.

                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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