New Member... Help Me Out

[T-Bone682]

Hi everyone,

My name is Tyler, and I was diagnosed with a pure seminoma in my right testicle in March 2007. It was deemed that it was caught early, and therefore only an orchiectomy was done with surveilance to follow. I had my first all-clear in June 2007 and the doctor said everything looked great, so we'd wait 6 months until the next check-up. My doctor was great, and I trust everything he did for me, but within that six months he moved out of state. In that time, I moved as well and because of this shuffle, I've neglected to go for follow-ups since that time. I'm now 2 1/2 years removed from my surgery, and my wife and I recently found out that we're having a baby in April. That is something that I never would've though possible in 2007, and we're so grateful. I recently thought about going to get a follow-up, but don't even know where to start. I've also regressed into that "fearful unknown" mode and started thinking... what if it has spread and it's already too late.

What are the chances that it has spread after all this time and I don't know about it? Has anyone else had the same experience as me? I feel like I'm back to square one.

Thanks for your input.

[RyanSeattle]

Tyler,
The chances that it may have spead our somewhere between 10-20%. The reason for surveillance is to avoid further treatment and if it comes back to treat and cure it. Now normally you should be getting ct scans every 6 months(?) After 2 years. Your first step should be to make an appointment asap with a oncologist or urologist. Then they would be able to schedule a CT scan. If you have relapsed then you still have a very high cure rate. Just do your future child a favor and take care of this. I personally think its going to turn out fine but its not worth the risk. Good Luck!

[sam.k]

My Friend,
Just read my signature below and you will understand that follows negligence for TC is simply wrong wrong wrong wrong ....

Go to see a doctor ASAP and don't skip your surveillance anymore ,
Yes Seminoma is so curable.. but this thing can kill you if you disparage it..

Best Wishes,
Sam

[NightTrain]

besides...... after you have a ct scan and get the 'all clear' you will have peace of mind. You have enough to worry about with a kid on the way. Congrats!

[T-Bone682]

Originally Posted by sam.k

My Friend,
Just read my signature below and you will understand that follows negligence for TC is simply wrong wrong wrong wrong ....

Go to see a doctor ASAP and don't skip your surveillance anymore ,
Yes Seminoma is so curable.. but this thing can kill you if you disparage it..

Best Wishes,
Sam

Sam,

Were you symptomatic? What made you decide to go get checked out again?

[sam.k]

Originally Posted by T-Bone682

Sam,

Were you symptomatic? What made you decide to go get checked out again?

What made me decide to go get checked out again is a sharp renal pain,.. but this pain saved my life thank God,

Cancer is a quiet beast.. I had a pain in stage IIC, some people get Stage III without any pain at all.. that's why you should stick to your surveillance schedule.


Best Wishes,
Sam

[Paul54]

Hey, Tyler. Congrats to you and your wife on the baby, and to 2.5 years survivorship.

Depending on your exact initial staging (IA or IB), your long-term relapse-free outlook just on surveillance has probably ramped up to 85-95%. In the small chance you have relapsed, the long-term prognosis after treatment for seminoma is still around 99%. But there is no better time to get back on the surveillance path than now. You may have to see your family doctor first for a referral, and you may be due to a routine physical exam anyway. But surveillance would best be managed by an oncologist, or an oncology/cancer center. Ask around for someone with decent experience with TC.

Best wishes, and good health to all.

[T-Bone682]

Thanks for your help all... Does anyone know a good route of finding a reputable Urologist in my area?

Also, what does RPLND mean? (Sorry, newbie )

[Fed]

Originally Posted by T-Bone682

Thanks for your help all... Does anyone know a good route of finding a reputable Urologist in my area?

The Philadelphia area does have some reputable urologists, and others from there could chime in. Also, my best friend, who is a surgical urologist trained by Joel Sheinfeld at Sloan-Kettering, has his practice in Hershey. Drop me a PM if you want his information.

Originally Posted by T-Bone682

Also, what does RPLND mean? (Sorry, newbie )

RPLND stands for Retroperitoneal lymph node dissection. It is a surgery used to remove the lymph nodes that are behind your abdominal organs. The RPLND is used for staging or to remove scar tissue and tumors in the lymph nodes, and is typically only done in cases of non-seminoma.

[Paul54]

Tyler,
First step is finding a good family physician, who would be best at referring you to a urologist. We have several members in PA, although I don't know who is close to Reading.

RPLND is retroperitoneal lymph node dissection, or surgical removal of the lymph nodes which would be the usual first stop for cancer cells that escaped the testes. RPLND is almost never done for seminoma since it is very sensitive to chemo. See http://en.wikipedia.org/wiki/Rplnd , for example.

[T-Bone682]

I see... thanks for your help guys. Any leads to family doctors in my area would be appreciated. I'll start the ball rolling on this. It's scary though. Does it ever happen that a diagnosed pure seminoma recurs elsewhere as a different cancer? Or shouldn't I be worried about that?

[Fed]

Just dropped you a PM.

Originally Posted by T-Bone682

Does it ever happen that a diagnosed pure seminoma recurs elsewhere as a different cancer? Or shouldn't I be worried about that?

Seminoma will always recur as seminoma, and it has a fairly predictable and sluggish pathway of spread: testicle to retroperitoneal lymph nodes to lung/mediastinum to liver/brain/bone. On extremely rare instances, the mets will skip sites.

[Elliott]

TBone read my signature or husbands blog, survelliance is everything.


FeD-Could having radiation change the pathology of the cancer like chemo can?

[Fed]

Originally Posted by Elliott

FeD-Could having radiation change the pathology of the cancer like chemo can?

Actually this statement is a bit imprecise. It is not that chemotherapy changes the pathology of the cancer. Chemotherapy, like radiation, works by damaging DNA. By virtue of their rapid rates of division, cancer cells are typically vulnerable to chemotherapy and/or radiation. Sometimes, though, there's some collateral damage in which normal cells are affected. If the affected normal cells are conferred a survival advantage, then they may eventually turn into cancer. This is why, for example, people that have had chemotherapy are at a higher risk of developing leukemia in the long run as a secondary cancer compared to the normal population. The same holds for radiation, where people that have had such treatment are at a greater risk of developing sarcomas as secondary cancers. In summary, cancer treatments don't turn the original cancer into something else; but rather, they increase the long term risk of developing a secondary cancer caused by the treatment itself.