Update....

[dk1003]

This is what I have as far as Labs and CT scans and the Path report, we are still waiting for Mayo to send back their opinion for the biopsy.

Pre op:
LDH 182
AFPTM 88.0
BHCGTM <2

CT ABD/PELVIS: Small nodes in the peripancreatic head region and porta largest measuring 1.4cm.
3.5cm. mass compressing the IVC consistent with nodal mass.
Small left periaortic nodes even though increased in number measure under 4mm.
Mesenteric nodes present measuring is large and is 1.2cm.

There are nodes present in both groins measuring 1.6cm. on the right, 1.5 cm. on the left.
The nodes in the external iliac chain are small 7mm or less in size.

CXR: Negative

CT CHEST: Negative

PRELIMINARY SURGICAL PATH. REPORT: (Waiting for final results from Mayo Clinic)

A. Rt. testicle
"Immature teratoma with foci suggestive of seminoma and embryonal carcinoma. Tumor involves the epididymis. The external testicular capsule is free of tumor invasion. Line of resection of spermatic cord is free of the tumor. Tumor focally involves the epididymis.
B. Proximal portion of cord, Rt.
"Fragments of spermatic cord. No pathological diagnosis. No tumor seen."

His oncologist wants to begin chemotherapy with the following drugs:

1. VP-16
2. Bleomycin
3. Cisplatin

Would this be the proper treatment for the findings? What about RPLND? (Before or after chemotherapy? or at all.) Is this something you would feel comfortable with? Should I get a second opinion?

They are waiting for the results from Mayo before starting chemo. Is that normal?

[Scott]

Sounds right. 3xBEP (bleomycin, etoposide, and cisplatin) is a standard protocol; VP-16 is another name for etoposide. Hang in there -- this is a proven cure.

[dadmo]

dk1003:
That sounds right. The VP-16 is really the E in BEP and the Cisplatin
is really the P so the mix is fine. My preferance with no lung involvement is to go 4Xep but that needs to be discussed with your doctor. Just make sure you have his lung fucntion checked prior to the BEP.