RPLND soon

[BSewards]

well, my observation didnt last long. Had righty removed mid June, I have beem doing my follow up treatment at Princess Margaratt (toronto) with Dr.Jewitt. Just got the word on Friday that one of my nodes is 1.3 cm and I will have to undergo the surgery. I am so freaked right now. I know if I need to do it, Dr.Jewitt is the right guy in Canada.

Any advice on how to get ready for it and how to ease the recovery process would be sooooooo welcomed. Thanks to all in advance.

Brad

[millerjnm]

Brad,
Sorry to hear you have to go through this surgery. Not sure there is any way to prepare for it, just keep thinking that it is needed to be Cancer free! As you are recovering make sure you get up and walk as soon, and as much as possible. People kept telling me that prior to my surgery........I didn't listen and my recovery took longer. Good luck and keep us posted.

[Geoff]

Brad, not sure there is much you can do to get ready, but here are some thoughts (just based on my surgery which was last week). Once it is scheduled you'll probably just want it over with. Don't bother worrying or thinkig about it because it needs to be done and you will get through it. When you go, bring a good book or something funny to relax you hefore the surgery.

Bring a pillow with you. After the surgery it will help to brace your abdominal area with it if you have to cough, clear your throat or anything else. It somewhat lessens the discomfort. I also used it between my body ad seatbelt on the way home. Have someone around with you the first few days you are home. Getting up and sitting can put a lot of strain on your abs, so help from someone can keep you feeling well. Also, you may need to recline when you sleep for a while when you get home. I tried to sleep flat my first night home and sitting up afterwards was miserable. You probably won't be able to eat a decent sized meal for at least a few days. Finally, be nice to the nurses, they control your access to pain meds and everything and you'll be happier if they are happier.

I'm sure others have some better advice, but this is what i can think of for now. Just remember that you get better every day and it will heal, and you'll be back to yourself in a couple of months.

[S P]

Not going to lie or sugarcoat anything, the RPLND surgery is probably the toughest thing I've had to get through in my entire life, although I went into it already pretty beat up from EPx4 chemo and was already semi-deconditioned muscle wise. The best way to do it is prior to chemo, if that's what's appropriate for your case. Yup, get up and start walking around ASAP. It will absolutely suck for a few days afterwards, but soon you'll round a corner and will be on the upward swing, and a couple weeks after that you ought to be able to get around and do just about anything you need to do, although you'll probably have some physical restrictions for a month or longer.

[BarclayBanister]

Wouldn't they go straight to chemo in a case like this?

[CW406]

Wouldn't they go straight to chemo in a case like this?

The statement "one of my nodes is 1.3 cm and I will have to undergo the surgery" struck me as a non sequitur. I do understand that surgery is an option with stage II NSGCT but the only situation in which I would think surgery would be mandated would be in the case of an extremely high percentage teratoma pathology. Is that the case here? Otherwise I would think they would go to chemo as well...

[BSewards]

The more i read the more confused I get. Why the sergury??

WIll the RPLND cure me?? or just prove that the my enlarged node was cancer....and then I go into Chemo anyway.

I dont want to do either....but I sure dont want to do both...if i can go right to Chemo and that will cure the problem.

Dr.Jewett did say that 3 cylces of BEP was an option but because only one node was enlarged (grew from mylast CT) that he wants to do the surgery to keep me away from Chemo.

Will be calling in the morning for another visit with him.

[BSewards]

The statement "one of my nodes is 1.3 cm and I will have to undergo the surgery" struck me as a non sequitur. I do understand that surgery is an option with stage II NSGCT but the only situation in which I would think surgery would be mandated would be in the case of an extremely high percentage teratoma pathology. Is that the case here? Otherwise I would think they would go to chemo as well...

sorry I didnt answer your question...Path report was 95% EC and 5% sem, confined to tetis with no V/I

[CW406]

Gosh, I mean with 95% EC I would be kinda concerned doing the RPLND. EC can skip the nodes and end up in the lungs. Obviously if they did the RPLND and the pathology came back negative then that would be that. But if it came back as malignant then it does seem to enter into a grey area - some people give 2XBEP I believe after such findings while in some other cases they seem to go on with surveillance. So you could avoid chemo. I understand that Dr. Jewett is a surgeon by trade, and you're in Canada, so those things could be steering the decision (regional and personal preferences), but it does seem a bit odd. Anecdotally, it seems like here in the states and on this forum when people show nodal enlargement while on surveillance they usually go straight to chemo barring any unique circumstances. I know there are others on this board who have been seen by Dr. Jewett so maybe they have input.

[BSewards]

Dr.Jewett already responded to my email last night. Clearly, he stated that he expects the RPLND to be cureative. and allow me to avoid Chemo.

[Aegean]

I understand that Dr. Jewett is a surgeon by trade, and you're in Canada, so those things could be steering the decision (regional and personal preferences),

Jewitt is recognized by Dr. E. as being the best in Canada. Much like Dr. E, he also responds to questions extremely quickly. As to treatment decisions, he is always open to a frank discussion and his team of oncologists are also among the best in Canada. I would ask to speak to one of them and get an understanding of the plan.

[S P]

Per the NIH gudelines, primary RPLND surgery is indeed a good option for Stage IIA nonseminomas. Primary chemo is preferred for IIB/IIC.

http://www.cancer.gov/cancertopics/p...e6#Section_145

Yes, EC can grow and spread rapidly and skip the retroperitoneum also. Fed was telling me about another case here where someone went with a primary RPLND but relapsed and ended up needing chemo anyways. Certainly something worth discussing with your doctor. For IIA, pathological findings from the RPLND might be benign which means you're probabaly already cured, in which case you can save chemo for later if needed. Don't want to over-treat. For IIB/C it's more of a sure thing that you're going to need systemic therapy so you go with chemo first and try to see if you can possibly avoid the pain of going through an RPLND surgery.

[S P]

The more i read the more confused I get. Why the sergury??

WIll the RPLND cure me?? or just prove that the my enlarged node was cancer....and then I go into Chemo anyway.

I dont want to do either....but I sure dont want to do both...if i can go right to Chemo and that will cure the problem.

Dr.Jewett did say that 3 cylces of BEP was an option but because only one node was enlarged (grew from mylast CT) that he wants to do the surgery to keep me away from Chemo.

Will be calling in the morning for another visit with him.

heh, I feel your pain. It's literally a matter of picking your poisons. Primary RPLND, if it does indeed cure you, also has the advantage of avoiding you of all of the long-term health risks associated with chemo. Just gotta research as much as possible, ask you doctors lots of questions and really put them on the spot, and in the end do what you feel is best.

[BSewards]

update time,

RPLND done 7 days ago at Toronto General by Dr. Jewett.

Came home on Saturday, didnt think I was ready but home they sent me. And best thing hey could of done. As all other posts I have ever read the first few days are the worst thing I have ever been through. Fist 24 hours were not bad...but was very drugged. The worst for me was a migrane I got that lasted 48 hours....nothing they did could stop the pain. That was my low point. Also the day they took out the epidural and cathedar, very painful days for me.

Now 7 days after seems that lower back pain is my main issue now....I have had small bm and gas is slowly leaving me, swelling is coming down nicely in my belly. Just having issue with sleeping b/c of the low back pain....but that shall too pass!!!!

I want to thank everyone on this site...you all have been so nice and helpful from my first post in june when I started my battle with this horrible disease.

Brad.

[S P]

Glad you made it through it. Keep us posted on pathological findings.

[CancerSux]

Glad you made it home and are on the road to recovery!

Heal well,
Tracy

[Fed]

Looking forward to hearing good news from the pathology findings.

[julesTO]

Wow - I can't believe how quickly you were scheduled for surgery. Very glad for you! This most definitely was NOT our experience with Jewett or Princess Margaret, unfortunately.

All the best for a speedy recovery.

[DARDEVIL]

Great you made it !
keep us informed on the pathology report.

Take care