It was interesting reading, but count me as skeptical about their conclusions. They discount the effectiveness of Carbo for Stage 1 by citing a study that used it to treat Stage IIA/B. They lead you to believe that the toxicity of Carbo is the same as EP/BEP. They say that the Oliver study isn't sufficient to understand the risk of long-term cardiovascular disease or secondary cancers - this seems a bit unfair considering this wasn't part of the study. Carbo has been in use since 1989 and there is little evidence uncovered of either of these problems.
I do fully agree with their conclusion that from the point of view of patient survival, less treatment is better - hence surveillance is the best choice. That being said, since the survival for all three options for Stage 1 have equal disease specific survival rates, we have the luxury to make a choice based on other factors - like availability of future health care, impact of BEP/EP or stronger radiation later, risk and impact of secondary cancers, stress management, etc....
Note: their argument that Carbo doesn't save you from radiation from all the follow-up CTs is blunted by the new NCCN guidelines which set the total at 3 for both Carbo and RT.
Last edited by K&R; 01-26-12 at 01:58 PM.
2 Feb 2009 - GP, Urologist, ultrasound (all in one day!)
3 Feb 2009 - Right I/O, Stage 1B (pT2) - Seminoma - 4.5cm tumor, LVI+, Rete Testis "appears negative"
Pathology 2nd opinion (MSKCC): Rete Testis involvement confirmed
Treatment 2xCarboplatin: 10 Mar 2009 (800mg)/31 Mar 2009 (860mg)
Surveillance (NCCN protocol 1.2012) - through June 2013 -- All Clear