General question regarding treatment

[cmpst52]

As I mentioned in the other forum, my tests this week came back "we have no idea what's wrong with you, but it's not testicular cancer," and my older brother is a sixth-year survivor. (I won't repeat details here, in the interest of bandwidth.)

Here's what interests me: if I’m understanding correctly, from the treatment discussion I've seen on the web (here and elsewhere), is that for early stage non-seminoma, they typically use surveillance or RPLND as your two options. My brother, in 2000, was instead given the choice or surveillance or two immediate rounds of chemo. From my admittedly novice understanding, this seems somewhat unorthodox. I don't recall that there was any discussion of RPLND.

Perhaps his case was atypical, or considered not-so-early-stage, or something, but how often are people given the surveillance vs. chemo choice, instead of the RPLND option? Anyone heard of this?

[jdbob]

In the NCCN (National Comprehensive Cancer Network) clinical practice guidelines for Testicular Cancer the closest thing I can find is:

Nonseminoma Stage 1B:
RPLND or
Adjuvent Chemo 2 cycles or
Surviellance (only if T2, compliant patient)

[Scott]

This comes up pretty frequently. For the case against 2xBEP, go to this TCRC page, and scroll to the section that begins, "Some countries in Europe (particularly the UK and Germany) plus a few sites in the US are now recommending 2 cycles of adjuvant chemo for patients with high risk stage I nonseminoma."

[cmpst52]

Thanks, I appreciate the input. I discussed this with him over the weekend. They did offer him an RPLND, but he chose the chemo instead. I suppose when given the choice, everyone will make their own decision.