Gosh whats next....

[gingerboy]

Hi Gang....Bless everyone on this website...I am 40 with type 2 diabetes and hypertension both under good control with meds, diet and exercise...

Ive had quite a month....

I have some questions for you guys....(and gals)

June 7- annual physical...Dr. feels that my testicle is hard
June 8- Urologist confirms Cancer
June 9- orchiectomy (left) with prosthetic placement

June 12-huge hematoma and excruciating pain
Emergency-pumped with morphine and pain medications prescribed

June 29- pathology report given to me by urologist

Seminoma-large tumour 6.2cm x 4.3cm x 3.5 cm
Into rete testis but no where else
CT scan and Xray clear
Tumour markers within normal limits
T1 Nx Mx S0

Referral to cancer centre....Urologist feels that they will recommend surveillance...

Questions....
1. My tumour was large and went into rete testis...I understand that this is higher risk and my chance of relapse is 30% instead of the usual few percent....
2. Is precautionary chemo or radiation a good idea...I have cardiac risk factors and am worried about the toxicity...
3. I still have mild pain in my affected scrotum(is this normal 3 weeks post surgery)...my hematoma has gone down drastically...just a little one now
4. I've been feeling depressed and worried off and on...I guess thats not a question...

Appreciatively
Gingerboy

Any advice would be helpful

[TC Destroyer]

Hi gingerboy, I am sorry to hear about your troubles and diagnosis. In your staging I personally would opt for surveillance, why subject your frail body to unnecessary chemo. If you stick to your schedule, you will catch any new growths at a very early stage. If you have a relapse, then I would discuss chemo or surgery with your medical team.

I completely understand being worried, but you need to pat yourself on the back for catching it at such an early stage. I hate to say it, but reality is things could have been a lot worse. If you had vascular invasion chemo or surgery would be your choices not surveillance.

Celebrate your early victory, walk with you head high and stay positive.

Feel free to ask more questions or vent at your leisure.

John

[Aegean]

Hey Ginger,

Sorry you had to find us, and the TC. I would agree with TC-Destroyer above. You do have 2 factors that increase likely recurrence, that being the size of the tumor and the rete testes involvement. All that being said, you have an approx. 70% chance that the operation alone cured you. Given your other ailments, you may want to discuss your options(Radiation, Carboplatin, Surveillance) with a medical oncologist. Surveillance is a definite option at Stage 1B and a recurrence would most likely be treated with radiation.

Either way, your prognosis is excellent.

[Paul54]

Sorry to have to welcome you. As noted, your prognosis is good and you have options. I'm going to take a contrarian stand and suggest you seriously consider one or two doses of carboplatin to get that "cure" rate from 70%-ish up to 95%-ish. That's what I would have done when I had the chance if I had known more. I also have a concern about cardiac issues, having had a stent installed to widen a narrow cardiac artery. I worry about the effects of a full course of chem in the event of relapse. Carbo has effects that are usually described as more like a bad case of the flu. I would save the radiation for dealing with something else where you have less choice later in life (hopefully won't need it at all).

Having said all that, I've been on surveillance for almost 3 years, and so far, so good. Life is back to normal, except I spend more time staying fit, definitely a good change. You will recovery from the I/O before you know it, and those annoying pains and hematoma will disappear. Sure, it's OK to worry now, but that also declines and you will get back to whatever you want to do. And you can worry about the really scary things in life, like raising kids, paying taxes, and saving for retirement

Let us know how it goes.

[chrisg551390]

I went down the same route as Paul54, i.e seminoma stage 1B and had single dose carboplatin three weeks ago.
It makes you feel rough for a while but if a softie like me can manage it anyone can.
I'm very cautious by nature so this attitude to risk made me avoid surveillance.
My oncologist was keen for me to go down the carboplatin route due to invasion of lymphatics and rete testis although obviously the final decision was mine.

[gingerboy]

Originally Posted by Aegean

Hey Ginger,

Sorry you had to find us, and the TC. I would agree with TC-Destroyer above. You do have 2 factors that increase likely recurrence, that being the size of the tumor and the rete testes involvement. All that being said, you have an approx. 70% chance that the operation alone cured you. Given your other ailments, you may want to discuss your options(Radiation, Carboplatin, Surveillance) with a medical oncologist. Surveillance is a definite option at Stage 1B and a recurrence would most likely be treated with radiation.

Either way, your prognosis is excellent.

Hi thank you kindly for your response but my understanding is I am 1A as the rete testis dont count for 1B- am I wrong? but for some reason 1A would make me feel better...

Gingerboy

[gingerboy]

Originally Posted by chrisg551390

I went down the same route as Paul54, i.e seminoma stage 1B and had single dose carboplatin three weeks ago.
It makes you feel rough for a while but if a softie like me can manage it anyone can.
I'm very cautious by nature so this attitude to risk made me avoid surveillance.
My oncologist was keen for me to go down the carboplatin route due to invasion of lymphatics and rete testis although obviously the final decision was mine.

Im going to ask a stupid question as I have not met with oncologist yet...
When you say single dose carboplatin...does that mean one day or one week or one what lol....
What effect did you have and to your knowledge does it increase your cardiac risk

Thank you,
Gingerboy

[chrisg551390]

There are no stupid questions.
The single dose meant going along for a few hours and having a drip in the back of my hand. The infusion lasted about one hour.
The effects have lasted for three and half weeks so far. There are some threads on this in the chemotherapy section.
The worse bit was for the first five days (nausea / hangover /flu feeling). Now I just feel really tired.
My understanding is that in my case invasion of the lymphatics makes it 1B (T2), although invasion of the rete testis increases risk of relapse it currently doesn't change the staging.
I don't know about cardiac risk, best ask your oncologist.