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RPLND vs 3 BEP Opinions please

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  • RPLND vs 3 BEP Opinions please

    Hello,

    Just joined and was hoping to get some opinions. I'm currently trying to decided between RPLND and 3xBEP below is my story

    1/14/21 - Lump noticed, misdiagnosed from GP as an infection
    2/25/21 - Right I/O, AFP 13.9, HCG 19.8, LDL - normal.... pathology indicates 75%EC, 10% Teratoma, 15% Yolk sac
    3/3/21 - CT scan clear, one spot on liver of interest
    4/12/21 - MRI clears liver, shows 2 lymph nodes, 1 common iliac 1.0cm and 1 paracoval 0.8cm. Blood shows all markers normal (AFP <2.6, HCG < 2.4, LDL normal)
    4/16/21 - Chest CT scan clear

    Interestingly enough my local hospital called the nodes 1.9 x 1.3 x 1.2cm and 1.3 x 1.2 x 0.9cm respectively and the Mayo called them 1.0 and 0.8cm. Anyone else have second opinions be this far off?

    Mayo initially recommended 3x BEP prior to their radiologist reviewing the MRI scan and once they reviewed it they think the nodes are borderline and are recommending RPLND. Is it worth asking them to wait a month and remeasure?


  • #2
    Which Mayo? The one in Rochester, MN?

    It might not be unreasonable to wait but it may increase the risk for needing BEPx3 and for RPLND to be off the table. If your markers rise then RPLND should probably not be an option either.

    Mike
    Oct. 2005 felt lump but waited over 7 months.
    06.15.06 "You have Cancer"
    06.26.06 Left I/O
    06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
    06.30.06 It's Official - Stage I Seminoma
    Surveillance...
    Founded the Testicular Cancer Society
    6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

    For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

    Comment


    • #3
      Yes, Rochester Mayo.

      Comment


      • #4
        OK, so I am assuming that you saw Dr. Brad Leibovich for the RPLND consultation? If so, and he feel that RPLND is feasible, then I would trust his judgement but you an ask about re-assessing but may lose the option for RPLND if they increase in size or your markers rise.

        Mike
        Oct. 2005 felt lump but waited over 7 months.
        06.15.06 "You have Cancer"
        06.26.06 Left I/O
        06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
        06.30.06 It's Official - Stage I Seminoma
        Surveillance...
        Founded the Testicular Cancer Society
        6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

        For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

        Comment


        • #5
          Ended up getting the RPLND with Dr. Leibovich last week on May 11th. Pathology came back that I only had the 2 nodes with cancer cells, 1 with 40%EC 60% immature teratoma and 1 90% immature teratoma 10% EC. Sounds like I made the right decision!

          Comment

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