Opinions wanted! Chemo or surveillance?

[Cobree]

Hi Everyone,

Here's the quick run down:

*March 2009 diagnosed TC had I/O of Left Testicle the same day
*Tumor came back as Mixed germ cell: greater than 90% embryonal and less than 5% chario.
*RPLND 3 weeks ago (52 Lymph nodes were removed)
*pathology of the lymph nodes found 2 of the 52 to be cancerous (embryonal, chario, and yolk sac).


The Dr gave two options...either surveillance or 2 rounds: of Chemo. I'm 19 years old so he recommended chemo.

Any opinions? Looking for some guidance.

Thanks!!

[Aegean]

EC can skip the nodes and travels easily through blood and chorio is a nasty bugger. Both choices are valid, but at this point I would get an opinion from a centre of excellence, but since they found live cancer in the lymphs, I would personally want to slam it now.

[Scott]

I second what Aegean said.

[loveumms]

Agree with the above posters.

It really depends on your personality and your ability to follow up. If it was me, I wouldn't be able to stand the thought that the cancer is lurking in my blood just waiting to come back (especially since you have a component of embyonal and chorio - one a lurker of the blood and the other aggressive). Of course, only time would be able to tell if any of the cancer is in your blood but, with embryonal it's much more likely then with teratoma or yolk sac. Plus, embryonal is extremely sensitive to chemo!

Chemo sucks, no matter what. No one is going to tell you it's a walk in the park but, it's probably better to get any remaining cancer cells now compared to if they seed any organ/lymph nodes.

Just make sure you do sperm banking before starting chemo (hopefully you didn't end up with retrograde ejaculation after the surgery or you already did sperm banking). You are so young and even though you may not want kids now, you may in the future and chemo could leave you infertile (30% chance).

Good luck, it's not an easy decision but make sure you do lots of reading and ask lots of questions.

[gilly6993]

chemo....just get it over with....

[RyanSeattle]

I agree to get a second opinion from a center of excellence. The wild card is that you have a tad bit of chorio which is the most aggressive. I would opt for 2 rounds if I were in your position but I would want to get 2nd opinion first. You could email an expert as well and they may point you in the right direction.

[Smartie]

Another vote in the chemo column. I also agree with the idea of contacting a Center of Excellence. I could be wrong, but since you're dealing with choriocarcinoma, I think it's possible they might consider three rounds of chemo.

[Already Bald]

I agree with the recommendations on a second opinion- and even third.
A center of excellance will want to review the slides of both your I/O and RPLND. They will also want to see surgery and CT reports. I would hold judgement on future treatments until you receive the opinions of an expert oncologist.

This doctor that gave you the options- was s/he a urologist?

Best,
Joe