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Advice before Chemotherapy

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  • Advice before Chemotherapy

    Hello all,
    I am 29yrs old Male from India.
    Found notable tiny lump on left testicle on 24.04.21

    In USG and MRI report mentioned as likely to be granulomatus. Three well defined hypoechoic Lesions found with max 1cm

    Initial b-HCG around 3 mIU/mL, AFP 1.2 IU/mL and LDH 196 U/L

    I don't face any kind of pain or any other side effects from start to till date.

    Met with urologist and In semen culture test, growth of Citrobacter koseri was found.

    Treated with antibiotics for 2months.But lump started growing during this course of time.

    Urologist suggested for surgery and ended up with Orchidectomy on 11.07.21

    Pre surgery b-HCG value spiked to 8 mIU/mL and AFP 1.4 IU/mL

    Biopsy report mentioned as Embryonal carcinoma and no invasions. Limited to testis.

    With PET scan,no abnormalities found.

    Oncologist suggesting to go for Chemotherapy. Likely to get started in another couple of days.

    What kind of treatment should I expect?
    Will be there any long time side effects?

    What kind of Do's and Don'ts should I follow this period?

    Kindly guide me through this!!! Thanks in advance
    Last edited by Micky3092; 08-30-21, 12:14 PM.

  • #2
    Welcome, not sure what to say, except adjuvant chemo in cases that are isolated to the testicle seems to be less recommended lately. Not sure how that would apply in your case.
    6-17-2014 - ultrasound: right testis neoplasm likely 6-20-2014 - HCG 43 mIU/mL 6-25-2014 - right radical orchiectomy 6-27-2014 - pathology: 3.6 x 3 x 2.3 cm seminoma, classic type.- pT2, pNX, pMX 8-15-2014 - 1x carboplatin 12-22-2020 - enlarged left supraclavicular node. Large abdominal mass noted during GP examination 12-24-2020 - HCG normal 12-28-2020 - CT: large right side retroperitoneal mass, small cyst lower pole of left kidney, 2.3 cm left supraclavicular cystic lesion 1-13-2021 - biopsy 2 left supraclavicular nodes 1-15-2021 - pathology: metastatic seminoma 1-21-2021 - PET: findings consistent with metastatic disease left clavicular 7mm, posterior mediastinum 1.8cm, right adrenal node 1.6cm, aortocaval node 5 x 5cm 2-8-2021 started 4xEP 3-29-2021 switched to 2xEC after 2xEP

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    • #3
      I am assuming that they are going to do BEP chemotherapy for one round as adjuvant therapy?

      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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      • #4
        There won't be any long term side effects (in most cases)
        As Mike said, it would be BEPx1 (one round) to prevent if any metastasis (non visible) has happened.
        You have a very good prognosis (from what you said) so nothing should be a problem. Keep to what your doctor says. You should be up and runing in 2 months or so
        painless lump rightside over 5 month tumor markers- afp-14.9 hcg-773 06/2018- right i/o path- teratoma/yolk sac/chorio afp down at 2.3 hcg-3303 ct- no lymph involvement, lung mets (stage IIIA) 07/2018- start of 3xBEP +1EP changed to 3xBEP complete response 07/2019- 9 months all clear(bhcg<0.1 or undetectable from 5 months) 10/2019 - ct picked up small nodule on other lung (3mm) blood work normal (one year mark after chemo) 11/2019- afp-0.7 bhcg-2.9 2020 - 2 year all clear 2021 - 3 year all clear

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        • #5
          I am assuming you are stage 1a Embryonal carcinoma. If this is 100% Embryonal, then you have an approximate 45% relapse rate. Surveillance is an option here. Chemotherapy (1 cycle of BEP, not more) is an option. However, most experts recommend surveillance in your case. You may very well be cured already.
          Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

          7/1/2015: felt tiny lump on side of R testicle
          7/30/2015: Ultrasound shows 2 intra-testicular masses.
          7/31/2015: tumor markers normal, CXR clear
          8/5/2015: R orchiectomy
          8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
          8/14/2015: CT abdomen/pelvis clear, Stage 1b
          8/24/2015: started 1 x BEP

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          • #6
            As others have said,with a clear PET scan, surveillance should have been discussed as an option, but I would not expect anything more than 1x BEP if adjuvant chemo is given, any more would be overtreatment from what you've told us. Long term problems from 1xBEP are rare, short term, you will likely feel tired & some have nausea during the long week the following two weeks are just bleo & most feel close to normal pretty quickly after that.
            Jan, 1975: Right I/O, followed by RPLND
            Dec, 2009: Left I/O, followed by 3xBEP

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            • #7
              Thanks guys for your suggestions!
              Doc advised to follow Adjuvant Chemo I cycle (BEP regimen) Currently completed with first cycle
              Before start of Chemo,bHCG
              Last edited by Micky3092; 09-08-21, 03:19 AM.

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