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Joining the club! Orchiectomy scheduled for next week

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  • Joining the club! Orchiectomy scheduled for next week

    So lefty started feeling a little large and hard about a month ago. I didn't think a LOT of it, so I put off going to the doctor.

    The last week of 2005 though, I got this sharp pain, and I went to my PCP for help. He shot me up with pain drugs, and told me to go to the ER immediately because it was torsion or orchitis. I went to the ER, had the ultrasound done, and they tell me it's a TUMOR!

    I've been to a urologist, who has confirmed that he believes it to be a tumor as well. My AFP is 25.5 and my HCG is 389 (I'm not sure what this means really?)

    In any case, I am scheduled for a left radical orchiectomy for next week. I've read lots about what to expect, but it seems some people are able to get up and move around the next day, while others are bed-ridden for a while.

    I've read almost everything I can get my hands on, and it's really a lot to try to digest, but I think it's really cool that this forum exists so we can help each other out.

    If anyone has any insights on the AFP and HCG numbers, and/or would be willing to share their post-orchiectomy experience, i'd be most appreciative.

    Thanks guys, and good luck to all of you!!!

    John
    Last edited by papajdub; 03-08-06, 04:23 AM.

  • #2
    Hi,

    Having elevated AFP and/or HCG is an indicator that there is TC present within your body. Your readings arnt massivly elevated (some people have HCG into the 000s) but are up enough to show cancer is present. If after the orchiectomy these numbers drop down to 'normal' levels (from memory under 10 AFP, under 5 HCG) thats normally a decent indicator that the only cancer was in the testicle (although not a guarentee). If they rise it's a sign that the cancer has spread beyond the initial site - not good news, but still highly curable.

    After the surgery Id expect them to book you in for a CT scan (chest and abdomin) to check for spread of the cancer, and blood tests to check the markers. Based on these, and the pathology results from the tumour removed they will decide if you need further treatment.

    Ref the orchiectomy, I had mine as day surgery, and was out of the hospital about 2 hours after the op finished. Very stiff walking for a few days, but certainly not confined to bed. I think I was driving again about 7 days after the surgery, although I wouldnt have wanted to make a big trip! I booked 2 weeks off work for having it done, and I remember feeling guilty in the second week as I was probably fit enough to go in (Ive got a nice lazy desk job - real work would have been harder )

    I hope that helps - feel free to ask any other questions you have!

    Good luck,

    Steve
    Left I/O March 05, nonseminoma;
    Relapse July 05, single lymph node 3cm;
    2 x BEP Aug / Sept 05, node grown to 4.7cm;
    2 x VeIP Sept / Oct, node grown to 6.7cm, markers normalised;
    RPLND Dec 05, no active cancer;
    back on surveillance

    Comment


    • #3
      John,

      Sorry to hear you'll be joining our club - it's a great club, but the entry fee is pretty steep. But welcome!

      Steve already filled you in about HCG and AFP, so I only have a single observation to make: Since your AFP-numbers are elevated this would mean, barring some other unlikely non-TC reason for that specific elevation, that the tumor is non-seminoma, since seminomas do not raise the AFP tumor marker. As mentioned, your HCG-levels are elevated but definitely not drastically. If I remember correctly, Lance Armstrongs HCG-levels were around 92,000 at the peak.

      You can read up on the different types of TC, tumor markers etc at TCRC, which is a great site.. although I'm guessing you already found it?

      I think it took me about a week before I had more or less recovered from my orchiectomy and was able to go to work. If I had to do something other than office work, I would have waited longer.

      As for the operation itself, I was up and moving (and left the hospital) the next day. But to be honest it hurt like hell the days after the operation.. but I think people have pretty different experiences with it.. I guess people heal at different rates. Other than having pain for the first few days, it really isn't that bad IMO, but it's normal to feel numb for a long time after the surgery.

      If the doctors haven't already - it would be a good idea to get a test of your testosterone levels before the surgery. That would give your doctors a baseline of your pre-op levels, just in case testosterone levels become an issue down the line. Only about 18% of TC patients require testosterone supplements after the operation, but better safe than sorry..

      If you have any other questions, please ask away!
      Last edited by Rune; 01-12-06, 05:56 AM.
      Sincerely,
      Rune

      Right I/O, 11/27-2003 | Nonseminoma (embryonal carcinoma, teratoma) | Surveillance

      Ride to Live!

      Comment


      • #4
        Originally posted by Rune
        Steve already filled you in about HCG and AFP, so I only have a single observation to make: Since your AFP-numbers are elevated this would mean, barring some other unlikely non-TC reason for that specific elevation, that the tumor is non-seminoma, since seminomas do not raise the AFP tumor marker.
        You probably already know that one thing that means is that radiation therapy won't be a treatment option, so you should read up on surveillance, retroperitoneal lymph node dissection (RPLND), and chemotherapy. I'll bet you caught it early. Keep us informed as you find out more.
        Scott, [email protected]
        right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since


        Your donation funds Livestrong services for people facing cancer now. Please sponsor my ride!

        Comment


        • #5
          welcome to the club! as like the other post, sorry the initiation fee is going to be as planned!!! i promise you it want be all that bad. just be informed as much as possble when asking questions. this site is great for that. i was not as fortunate to find this place until after my last surgery. it really has helped!!(thanks to everyone)
          if you have a spouse, i would mention to be, as open as possible with them because they, as well as you, will be going through alot mentally and physically in the next few months. as for the surgery it wasnt bad at all for me. the first surgery i had a full removal on righty and partial on lefty and that made a little it more sore than usual but my full I/O of the partial lefty in august went pretty smooth. do get testosterone levels checked because there could be issues later down the road. best of luck and you'll be in my thoughts and prayers! Brian
          diagnosed 01/15/2005 bi-lateral seminoma stage IIa,4cm lymph node, right I/O & partial left I/O mar/2005, 18 days of radiation, remaining left I/O- aug/2005, surveillance, Wife did IVF oct/2005, DAD OF BABY GIRL born 08-02-2006!!! testosterone implants May 2008

          Comment


          • #6
            Hi John:

            Good luck with your surgery. I've been through it twice. In 1988, I stayed in the hospital overnight and in 2003, it was outpatient. It is somewhat painful, but the pain meds usually get you to a level that's tolerable. My doc told me not to drive for 1 week after surgery. Also don't get too alarmed it your scrotum and penis are a bit swollen and/or black and blue for a few days. I had this after both surgeries and it took about 3-4 days to go away. Of course pain/swelling/bruising should always decrease over time. If anything seems to get worse, don't hesitate to call your doctor.

            I'm sure you'll do fine. Nothing more to add about the tumor markers, yours don't seem too high compared to some other folks, interestingly, mine were never elevated, but that can happen also.

            Best wishes,

            Jim
            Fish
            TC1
            Right I/O 4/22/1988
            RPLND 6/20/1988
            TC2
            Left I/O 9/17/2003
            Surveillance

            Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

            Comment


            • #7
              Haven't had the left Orchiectomy yet (next Tuesday), but I did get the results from my CT scan.

              Chest and pelvic scans came back clean, and here are the remarks on the abdominal scan:

              Retroperitoneum: There is a 9 mm apparent lymph node to the left of the abdominal aorta, several centimeters below the left renal artery. This is only 9 mm. No other enlarged lymph nodes are seen.

              Impression: Solitary 9 mm retroperitoneal lymph node on the left. This is solitary and under 1 cm. Followup CT imaging would be recommended to recheck the retroperitoneum in view of the history of testicular mass.
              I haven't had a chance to talk to my Urologist about these results yet (appointment later this week), but can anyone shed some light on whether "9 mm" is indicative of needing an RPLND? Or can Chemo take care of it? Or is it possibly something other than a spread of the tumor?

              Thanks! -- And thank you all for your responses and support!

              John

              Comment


              • #8
                9mm is not that big and there's a good chance the enlargement is caused by something else than cancer. From what I can read from the report, they are recommending keeping an eye on the development of the lymph node by CT-scans for just that reason.

                If it should turn out to be cancer, your options depend on the contents of the tumor which won't be known until the orchiectomy and the pathology report is done with. If there's continued increase in the size of the node and they think it's cancer, they will most likely offer either chemo or RPLND (again, based on the tumor type). Most patient who choose chemo do not need an RPLND afterwards.

                Try to take one thing at a time. It's very possible that the node is just "flaring up" due to some local infection or something like that and you need to concentrate on getting the orchiectomy over with now.

                Hope this helps.
                Sincerely,
                Rune

                Right I/O, 11/27-2003 | Nonseminoma (embryonal carcinoma, teratoma) | Surveillance

                Ride to Live!

                Comment


                • #9
                  I had my orchiectomy on Tuesday. It was mixed germ-call cancer, still waiting on the pathology report. I was awake during the procedure, they gave me an epidural, and I didn't feel a thing. The post-op pain isn't nearly as bad as I thought it would be. It hurt like hell once the epidural started to wear off (yay for morphine), but now I'm up and walking around and it's not that bad at all (although, I *am* on percocet!)



                  The doctor tells me I'll need chemo though ... so I'm waiting to see him at my appointment next week to see what that looks like.

                  Thanks to everyone for the advice and well wishes, you're the best.

                  John

                  Comment


                  • #10
                    Awake?

                    You were awake during the procedure? Is there some reason they did an epidural vs. traditional anesthesia? I don't know if I could have handled seeing what was going on. Good for you. Hang in there and continue to be strong. Recovery from the surgery takes a little while, so give your body the benefit of the doubt and take it easy.

                    (I see you are from Orlando also. Another one of us in the "club")
                    Diagnosed 5-5-05 (Stage 1 - Seminoma) / Oriechtomy 5-9-05 / Adjuvant Radiation July 2005

                    Comment


                    • #11
                      Originally posted by rjs
                      You were awake during the procedure? Is there some reason they did an epidural vs. traditional anesthesia? I don't know if I could have handled seeing what was going on. Good for you. Hang in there and continue to be strong. Recovery from the surgery takes a little while, so give your body the benefit of the doubt and take it easy.

                      (I see you are from Orlando also. Another one of us in the "club")
                      Well, I have a complicated airway situation, and it was either they give me an epidural, or they give me an awake intubation (shove a tube down my throat while I'm awake). My doctor (Dr. Woods, in Altamonte), was totally fine with doing the procedure under local, and it worked out well. I didn't see a thing, they draped a sheet up so I didn't have to look, AND I was under some mild sedation, so I wasn't really "bothered" by anything at all.

                      It's actually kind of funny, I said to him at one point "hey doc, how's it going?" and he said "You're already done!" I didn't even know they had cut me open yet, it was amazing.

                      Comment


                      • #12
                        Wow, thats amazing that you were awake for that!! yikes!

                        So the doctor already told you that you'll need chemo!? Hmm, thats interesting. I would think he would check the path report and your tumor markers before making such a suggestion?

                        Hope your feeling okay. You'll be up and about in no time.

                        -Kevin
                        Diagnosed 10/03/03
                        I/O 10/15/03
                        RPLND 1/21/04
                        Completed the Boston Marathon 4/19/05
                        Completed the Boston Marathon 4/17/06
                        Baby Riley born on 3/29/09

                        2012 Livestrong Challenge Web page

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                        • #13
                          Awake !!!! WOW!!!! First time Iv'e heard of that.... I think I would have passed out from anxiety or fear of having lefty removed.... Hope your feeling better and this surgery alone cures you from TC my fellow Floridian!!!!!!! DON
                          Moffitt Cancer Institute
                          CANCER SUCKS
                          Diagnosed/Left I/O 9/18/2004--Non-Seminoma/Stage IIIC--3X B.E.P chemo--3X T.I.P. Salvage chemo---Abdominal [email protected] 34cmX 24.5cmX 17.5cm---4/19/2005 --RPLND/Left Kidney,8 1/2lb Abdominal tumor,42 nodes removed---7/16/2005 Remission/Surveillance---Severe Peripheral Neuropathy--

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                          • #14
                            When I had my IO I was given the choice between local and general anesthesia, I chose general.
                            I/O Aug 04 (nonseminoma), bilateral RPLND Sep 04, Surveillance

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                            • #15
                              Originally posted by Don
                              Awake !!!! WOW!!!! First time Iv'e heard of that.... I think I would have passed out from anxiety or fear of having lefty removed.... Hope your feeling better and this surgery alone cures you from TC my fellow Floridian!!!!!!! DON
                              I was under some pretty heavy sedatives, and I had a sheet up so i couldn't see what was going on. I think back and wonder to myself why I didn't "care so much" or "freak out", and I'm pretty sure it's because of the sedatives, they just calmed and relaxed me to where I just didn't care.

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