Surgery Tommorow

[djmac]

Newbe,

What you describe is perfectly normal (and scary). No, you do want to lose both... but as was mentioned, this is a rare occurance. And statistics are tricky, I've read 1-3% chances of a contralateral TC, and I've read as much as 5-6% chance. The reality is that whatever the percentage is, that statistic is VERY misleading. It turns out that it's more like 100% of a small percentage of TC survivors will get TC in their remaining testicle, while 100% of the remaining 95-99% will NEVER have to worry about a second TC. This is because the events that lead to TC happen early in embryonic development, and it's a matter of luck if the defective migrating cells populate one or the other, or both testicles. Worst case scenario is that they populate NEITHER and end up being outside the gonads and forming a difficult to detect and treat extragonadal germ cell tumor (EGCT).

Unfortunately, unless you live in Europe or are willing to undergo a biopsy of your remaining testicle to test for carcinoma in situ (CIS) then you really have no way of knowing if your testis is prone to a second tumor. (Note that if you do have CIS your chances of developing a second tumor approach 100% and if you do not have CIS then your chances of developing a second tumor are essentially nil...and this does not rule out the possibility of EGCT). So in the United Stateas, this leaves us with surveillance for the second testis and the remote possibility of EGCT as a second TC presentation, which is fine.

There are ways you can play with the statistics to see what your real chances of a second TC MAY be. For example, if you have a sonographically normal testis (i.e. no microlithiasis) AND you have a normal testis volume (no atrophy), AND you have normospermia (or at least more than 1/2 normal, since you're only working with one) AND you don't have a history of cryporchid or anything like that, your chances for 2nd TC are actually MUCH lower, whereas if you have all 3 major prognostic risk factors (i.e. atrophy, microlithiasis, oligo/azoospermia) then your chances of getting a 2nd TC can be >30%. So ask yourself, are you fertile? Is your sperm count normal (or near normal?). Sonographically, do you have absence of microlithiasis and a normal sized testes? If you answer yes to all of these, I would keep the fear of a second TC in perspective... you're much more likely to recur from your first one (if you are on surveillance) then you are of getting a second TC. And with a 6mm tumor, I'd keep the worry of relapse in check as well. I think you're going to be fine!

By the way, my pain (well, slight discomfort really) and swelling of the epididymis sent me to the uro yesterday. Had an ultrasound, everything is fine. Best of luck to you!

[Already Bald]

Well its been three weeks since my surgery I was diagnosed with "very early stage I seminoma" no vi or anything ct was all clear and now I am debating on weather to go on survelliance or have radiation therapy... however, what is bothering me is last couple days i started getting discomfort in the last remaining testicle...I dont want to lose this one too!!! I have no idea if this is normal I am assuming it is not and just really upset that i may have TC in the remaining one i thought i was on the road to recovery but not sure what to do now I havent mentioned it to any of my doctors yet because i am pretty sure I am going to have to lose number two...does anyone know is there anything they can do to salvage the last remaining one(if it turns out to be tc again)?????any words of advice will help...And i hope everyone here is doing well I truly would not had the courage to go through this without each and every one of you GOD BLESS!

Hi Newbie,
Sorry to hear that you do have confirmed TC, however your future looks great. Try not to stress over the pain you are feeling in the remaining testicle- I had the same symptoms.. I think part of it was my testicle starting to take on additional "work"- and also my constant self exams about 3 weeks post IO. You will be seeing your doctor frequently in the coming months- so lay off the self exams for now- and take an Advil or Motrim (one is all you will probably need) to help reduce the achiness.
Be sure to metion it to your doctor, but just know that this is typical, and lasted a few weeks for me.
You will liveSTRONGER ever day!
Best,

[Karen]

newbie,
So glad to hear you're stage 1 seminoma. Mention discomfort to your doc but chances are it's post op discomfort still. Remember that if you are going to start RT you need to make a decision soon since you're 3 weeks post I/O already. You may very well be cured already .

[Scott]

I don't know off the top of my head what the odds are for having contralateral TC, but I'm sure it is posted elsewhere in the Forum.

Here's one study that offers, "The cumulative risks of metachronous contralateral testicular cancer 20–25 years after initial diagnosis of testicular cancer range from 2.4% to 5.2%."

[Fed]

Great to hear from you again!
What you are describing sounds like par for the course. You just went through surgery, and as a consequence, there will be inherent pain every now and then. I would imagine that by now you have had your post-op appointment with your urologist; but if not, or if the pain becomes unbearable, don't hesitate to contact him again.
Based on your summary of the path report, you are likely staged at pT1, so as long as you are good about keeping appointments religiously every 4 months for the next 3 years and you can handle the anxiety at each of your visits, surveillance would be a good pick for you. The anxiety does decrease gradually (just ask Scott, the master of surveillance )
As far as getting TCx2, that is a very rare instance. TC itself is rare. I don't know off the top of my head what the odds are for having contralateral TC, but I'm sure it is posted elsewhere in the Forum. My suggestion would be that when you are less sore from surgery, you may want to begin doing self-exams every now and then (just don't over-do it!).
Good to hear that the path came out great. Best,

[Scott]

...what is bothering me is last couple days i started getting discomfort in the last remaining testicle...I dont want to lose this one too!!!

While you should, of course, talk to your doctor about it, the sensation you describe is very common. I had it myself.

[newbe]

Hello ALL

Well its been three weeks since my surgery I was diagnosed with "very early stage I seminoma" no vi or anything ct was all clear and now I am debating on weather to go on survelliance or have radiation therapy... however, what is bothering me is last couple days i started getting discomfort in the last remaining testicle...I dont want to lose this one too!!! I have no idea if this is normal I am assuming it is not and just really upset that i may have TC in the remaining one i thought i was on the road to recovery but not sure what to do now I havent mentioned it to any of my doctors yet because i am pretty sure I am going to have to lose number two...does anyone know is there anything they can do to salvage the last remaining one(if it turns out to be tc again)?????any words of advice will help...And i hope everyone here is doing well I truly would not had the courage to go through this without each and every one of you GOD BLESS!

[Sans rt1]

Take it easy and heal. You went through some major surgery and you will be sore for a while. You will also have some phantom pains and wierd sensations in the area of the incision and down where it used to be. These are normal. I remember mine seemed to get a little worse a couple of days after the surgery - swelling, bruising, and soreness, but then got better every day after that.

We will keep our fingers crossed that it was not cancer, but if it is rest assured you caught it very early and you are on the road to a cure - in fact you might be cured already just by the surgery!

[dadmo]

Don't get too concerned if you feel a lump in there. I will be a blood clot and will go away on it's own.

[Karen]

Yes, that is normal. This is where they deliver the testis through to the incision to be removed. For me this was also one of the last areas to completely heal. The sensation varied from pain to burning to chafing to rubbing. You may experience numbness along that area, feels strange at first but welcome compared to any pain.

-chris

My husband has most of his discomfort when the shaved areas grew back in and were rubbing against sensitive parts . Try to take yourself off the vicodin as soon as you can...it'll really slow down the motility of your digestive system and you don't want to strain. Phantom pains, numbness at the incision, a ridge or bump under the incision are common.

[newbe]

just a quick question it is the second day after surgery, removal of the right testicle my question is...is that it feels like I am experiencing a little pain from the right side of my scrotum where my testicle used to be up to the incesion is this normal...I mean normal feeling pain in the scrotum...anyone else experience pain there? it has been over four hours since my last Vicodin...

[Karen]

newbe,
Glad the surgery's done with! You caught it early and you will be just fine! It's always a good idea to get copies of your labs and path report too. You've just gone a long way towards a cure...congrats!

[Fed]

Great to hear you are on the mend. Take it easy for the next couple of days. You'll be feeling better in no time. Looking forward to hearing good news on the path,

[Already Bald]

my urologist told me he will have the report in about a week to find out what it was and what stage it is

Try not to stress aout over the next week or so- just remember that your doc said you will be fine no matter what the path is.

[Scott]

Glad to hear you're doing well. We'll look forward to hearing what the pathology report shows.