gynecomastia????

[jram303]

hey guys, I first hope that all of you are doing well with everything in life.When i am not in here,you are all with me in mind and spirit.I have a question. I finished my chemo about 5 months ago, and about a month ago i noticed i had some semi tender nipples with hard lumps on both sides. Gynecomastia i guess it is called, well it scared the crap out of me today when i actually looked up what it is. I had my blood tested in april and all was clear, i again had my bloodwork tested may 5th and everything still looked great. Is this something that can be a hormonal side effect of all that we have to go through? I really hope that it is and not the latter.I am pretty positive i didnt have this upon presentation of the cancer, I can recollect it just popping up one day, jeez that could have been around two months ago.I think this symptom is only associated with the bhcg tumor marker, and an elevated afp or ldh would not produce this side effect/condition. My tumor make up was roughly 77 percent yolk sac, with near equal parts seminoma and EC. My bhcg started at 995 before chemo, and was normalized by the first round.So it then took another 3 doses. Just curious guys, what do you think? Thanks in advance for your constant help everyone.I was told my my nurse liasson that she will call me back tomorrow, but we all know what waiting in the dark like that can be like.

[Paul54]

I had somewhat the same symptoms in the months before I was diagnosed, along with persistent low-grade back pain, and a sort of "hormonily" feeling. My markers were never raised and I had no mets in my back or anywhere else. All of that disappeared within days of my I/O. The only explanation that made any sense was that my testosterone levels were declining due to righty crashing. I suggest you get your testosterone levels checked and consider another ultrasound.

[dadmo]

My son had issues with Gynecomastia but they cleared up rather quickly after his cancer was removed. I wouldn't worry too much but a full hormone panel might be in order.

[gilly6993]

gyno is caused by estrogen....most of the time by an increase in testosterone which is converted to estrogen and binds the receptors in the nipple area...I would get soem blood work done....sometimes meds can be helpful to prevent the conversion, nolvadex and arimidex are a couple of common ones....if it doesn't clear up you will need a surgery to remove the glands....doubt it would get to that point though....

[Aegletes]

As Gilly mentioned, this may be hormonal and associated with elevated conversion of testosterone into estradiol (E2). A complete hormone panel can be run and include the sensitive assay for E2 (as opposed to the broader assay used for women). Elevated E2 levels, if they are indeed the culprit here, would also result in difficult achieving or maintaining an erection as well as changes in libido.

[jram303]

hmm this is interesting. I had my testosterone checked two weeks ago with my tumor markers which were normal, my testosterone was at 10.5 so it is on the lower side of normal. I read a study of 18 post treatment patients who developed gyneo 2-9 months after the end of treatment (I am 5 months out). All had normal bhcg, with lower normal level testosterone. Apparently cytotoxic treatment effects the spermatogenisis and leydig cells which in turn causes an increase in oedestral and other hormones. Apparently these guys all cleared up in a duration of 4.8 months.

This sounds identical to mine. I was more concerned about the possibility of relapse than anything. Still haven't heard from my onc. They said if I needed to do anything they would call. Do you guys think I should persue this a little more? I have noticed my beard is thinner and I get emotional easy sometimes. I also have some back pain ( running underneath the outside of my left shoulder blade more towards my side). Could the temporary overproduction of oestridal be the culprit for this you think. Thanks alot guys.

[j2k2dad]

Your experience sounds similar to mine. I finished 3xBEP in late October '09. In late December, I noticed my left nipple was really tender, with a hard, marble-sized lump behind. Over the next 2 months, the lump grew, tenderness worsened, and my right nipple started to do the same. After lots of worrying and stressing out between visits to my oncologist, referral to an endocrinologist, detailed bloodwork, an MRI and even a biopsy of the lump on the left... final conclusion- bilateral gynecomastia. I was just growing little man-boobs due to low testosterone (not critically low, but right at the low end of "normal" range). Other symptoms were low libido and very slow/thin growth of facial and body hair.
I have been on AndroGel (daily 5g packet of 1% testosterone rubbed on my upper chest/shoulder area) for almost 2 months. The gynecomastia has completely reversed. The libido and hair growth issues have continued, though. I just had a blood draw 2 days ago for my follow up appt with the endocrinologist next week.
I suspect that you are on the same path as me, just a few weeks behind.
Hope this helps,
John

[jram303]

Wow John. I would say that sums me up right there. I have been such a nervous wreck about this. I gotta say, I never expected to squeeze my nipple and have stuff come out of it. Did your endo happen to say if this could lead to permanent damage if left untreated? I have read about some guys that just cleared up in most cases 4 to 8 months down the line. I am a lucky guy, I end up with two of the most uncommon side effects of chemo there is haha. Thanks for your post man, it took alot off my shoulders. Oncs office said it's not their deal, nothing cancer wise and to take it to the family doc. Unfortunetly I don't have insurance ( working on Canadian citizenship isn't easy) and seeing my 17000 dollar combined doctor bills almost made me puke. If you happen to know if doc said it is imperative to remedy this quickly that would be great. Thanks alot man.

Joe

[j2k2dad]

Sorry to take so long to reply!
Doc (endocrinologist) did tell me it may not reverse, even with the testosterone treatment. She said there was no way to tell if it would continue/stop/reverse if I did not take the testosterone, but that due to my low blood values I was a candidate for testosterone replacement.
You mentioned that you are getting fluid from your nipple- that is something that I did not have. I don't know if that is of concern or not- it's above my pay grade.
Hopefully someone else can chime in on it- but I would recommend you get it checked out by a doctor.
John

[jram303]

Yea. I am not getting Any fluid at all if I don't mess with them. Only If I squeeze them for a little bit then I get a small amount of fluid from them like a drop or two. I don't know what to do. My bhcg is normal , I had it checked on Saturday morning. My oncologist said that this doesn't have to do with active tc to make an appointment with my gp. Do you think this could be a bad sign?

[j2k2dad]

Joe,
I don't know if it's a bad sign or not. Just that I never got fluid from my little man-boobies, but i never squeezed them much, either. Something about I'd go blind if I did that, or grow hair on my palms, or something
I think it would be worth seeing your GP about, if for nothing else than to put your mind at ease!
Hang in there!
John