Results and Options

[Mat]

Well I attended the Royal Marsden (London) toda to get my results for the first time since my I/O on 17th Dec 07.

Been told that both CT and Chest scans are clear.

My AFP is back to normal 7 (from 31 pre-surgery)and my BhCG is normal below 2 (from 58 pre-surgery).

Now i have to make a choice on what todo.

Ive been offered surveillance which consits of in the first year blood markers every month, chest x-ray every other month and CT twice.

2nd year blood and chest x-ray every three months and CT once

3rd year only blood and chest x-ray 3 times during the year

And during the 4th and 5th year blood and chest twice a year.

My other option is to have chemo which would involve 2 cycles of BEP.
Instead of spending days 1-5 having chemo i would only spend days 1-3 then days 8 and 15. I wouldn't be having the full dose of chemo either.

Any thoughts are welcome.

Mat

[dadmo]

This is a very personel choice but for me I would choose surveillance and save the chemo for when I'm certain it's needed. If your markers came down and there is no evidence of spread the chance that you are cured is about 80% which means that you have an 80% chance of being over treated. Even if you should need chemo later on it won't change your overall chances of beating the disease.

[Fed]

Hey Mat,

I agree with dadmo on this one. You can save the ammo in the event of a relapse, and even if you do, 3xBEP is likely to give a cure. Just make sure you keep will all the labwork. Your tumor produced markers, so that will help in picking things up quickly. What was the composition of your tumor?

[petep]

another surveillance vote from me...

good job staying on top of this....and if you do choose surveillance, keep those appointments...

pete

[Manny]

Mat - did they tell you what stage TC you have, the make-up of your tumor, and if if you had vascular invasion? My urologist did not recommend surveillance for me even though my markers normalized 4 weeks after I/O and my CT Scans were clean before and after I/O.

He said that since I had vascular invasion, and some teratoma he recommended a more agressive approach to treatment. I went to Sloan for a second opinion and they agreed. Can you share some other data from your pathology report?

[jaybird]

Because your tumor was confined to the testical (no vascular invasion) and your afp went down I would say surveillance is a good option.

[Mat]

Sorry but i forgot to ask the make up of the tumour but i have another appoitment next friday to disccuss what i will do next, so i will get a copy of the report then.

When i did go before christmas they had part of the pathology report which stated that the tumour was confined to the testicle, and i was told today that there was no sign of spread.

Once i get the make up of the tumour i will post it. I will try to call on monday.

Thanks for all the advice

Mat

[Fish]

I personally always favor surveillence, saving treatment for when it is definitely needed, but as Dadmo said, it is a personal decision. Some guys hate the idea of the wait and see, whereas other are not bothered too much. Any option you choose will get you where you want to be.

Best wishes

[jaybird]

I personally always favor surveillence, saving treatment for when it is definitely needed, but as Dadmo said, it is a personal decision. Some guys hate the idea of the wait and see, whereas other are not bothered too much. Any option you choose will get you where you want to be.

Best wishes

I think its all about understanding the odds of recurrence. If CT Scans are clean and there is no sign of vascular invasion then your odds are in your favor for cure. However, in my humble opinion, if someone has vascular invasion with a makeup of embrynol cell then I think rplnd becomes a great choice, even if ct scans are clean. I can understand why someone would not want to be too aggressive and over treat but I also think it is important to tackle cancer when there is the least amount in your body as possible.

We sure are lucky that we all have options that achieve the same cure rate.

[dadmo]

My concern for overtreatment is mostly with chemo and not so much with an RPLND.

[jaybird]

My concern for overtreatment is mostly with chemo and not so much with an RPLND.

I agree 100%. That's what make the rplnd so valuable.

[Fish]

I definitely agree with you guys about the RPLND. I was so happy when my lymph nodes came back clear, I felt the RPLND was well worth it to get that information. One caveat to RPLND is that embryonal cell will somtimes spread via the bloodstream bypassing the retroperitoneal lymph nodes.

[Mat]

Thanks for all the replys.

Ive decided to have the 2 rounds of BEP as a precaution. This will now start 2 weeks today (25th Jan 08).

Another good sign is that my blood markers have dropped again.

On 27th Dec 07 AFP was 7 and BHCG was <2
On 4th Jan 08 AFP was 4 and BHCG was <2.

Sorry but i still can give the full make up of the tumour. This is because the Royal Marsden in central London was on fire last week (this is the cancer specialist hospital in the UK) and im at another site but the LAB is at the one that was on fire and its not safe yet to go back in. Should get it in the next few days though.

Cheers Mat

[Fish]

Glad you came to a decision. It's not an easy choice.

I hope everything goes smoothly with the BEP.

I'm sure you'll get a lot of good advice and tips from some of the folks who have been down that road.

Best wishes

[Margaret]

Mat...glad to hear the markers are going down, but I am sorry you have to endure any chemo. The good news is you are being aggressive about getting treatment. Good for you!!

If you need any tips or helpful advice about BEP, let us know.

[dadmo]

Mat:
Congratulations on making that decision. Don't try and second guess yourself, you picked a perfectly reasonable path now just stick to it.

[Davie]

Hi Mat,

I too was treated at the Royal Marsden in Sutton under Prof. Horwich/Dearnaley, and your certainly in good hands. I didn't have the difficult choice you've had to make, but now you've made it, at least your confident that in the worst case you're nipping anything in the bud, and it will give you peace of mind.

I'm back in the Marsden next Friday (18th) for a 3 month check up (I'm 20 months post-chemo), so if you're also in for the regular Friday TC clinic, tap me on the shoulder and say hello! My photo is in the photo thread on the ballroom tab.

Anyway, best of luck.

Davie.

[fuse929]

Good luck with everything Mat! Keep us posted.