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  • The urologist called wants to remove lymph nodes

    The urologist called and said the all the test CT scan came back clear. But now he wants to remove the lymph nodes anyway. he said that DH is at high risk for his lymph nodes to develop cancer later on and it is not good to try and remove them later if he does develop cancer in his lymph nodes. so we would be better off removing them now. has anyone else had this done?

  • #2
    Rose, It is called an RPLND, there is a lot of information about the surgery on this site. Many of the men here have had it done including my husband. You will need a very good doctor to do the surgery since there are not many doctors with a lot of experience doing RPLND's. Did your urologist tell you who he wanted to perform the surgery?

    I will post some links so you can be reading up. http://www.tc-cancer.com/rplnd.html
    Co-survivor with husband Boyce, Diagnosed 7-11-06, orchiectomy right testicle on 7-12-06- Stage 3A: Mixed germ cell tumor with inguinal seminomatous and kartotypic carcinoma. One tumor over 10 cm, second tumor 4 cm, Chemo 4xBEP: Bi-lateral RPLND Dec 2006, nerve sparing but left sterile.
    Current DVT
    Current testosterone replacement therapy, Testim.

    "You must abandon the life you planned, to live the life that was meant for you" ~wisdom I have learned from my family on this forum

    Comment


    • #3
      Rose, you guys definitely need to see an Oncologist for follow up.... I could be mistaken, and other people in this site will know more than me, but it seems to me that with a clear CT, there must be some other reason weighing heavily on the Urologist's mind to recommend RPLND right off the bat.......
      "Faith is being sure of what we hope for and certain of what we do not see". Heb 11:1

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      • #4
        Originally posted by CharlieFL
        Rose, you guys definitely need to see an Oncologist for follow up.... I could be mistaken, and other people in this site will know more than me, but it seems to me that with a clear CT, there must be some other reason weighing heavily on the Urologist's mind to recommend RPLND right off the bat.......
        I agree with Charlie, getting another opinion from an oncologist is always a wise choice. Even if they both agree on treatment, then at least you will have peace of mind. This a fight for his life and of course, not the time to take any chances.

        But if you do have any questions/concerns about the RPLND, there is so much information on this forum and lots of people to support you.
        Co-survivor with husband Boyce, Diagnosed 7-11-06, orchiectomy right testicle on 7-12-06- Stage 3A: Mixed germ cell tumor with inguinal seminomatous and kartotypic carcinoma. One tumor over 10 cm, second tumor 4 cm, Chemo 4xBEP: Bi-lateral RPLND Dec 2006, nerve sparing but left sterile.
        Current DVT
        Current testosterone replacement therapy, Testim.

        "You must abandon the life you planned, to live the life that was meant for you" ~wisdom I have learned from my family on this forum

        Comment


        • #5
          One thing to possibly consider and talk about with your medical team is the time frame of the RPLND. If you go ahead with the RPLND now, there is a good chance that fertility will be saved through what is known as a nerve sparing RPLND. On the other hand, the RPLND is a big ass surgery which may be overkill if the CT was clear and the pathology was promising (I don't know your particular pathology). An important thing to remember is that if you choose surveillance and the cancer comes back, it is much more difficult to do a nerve sparing RPLND post-chemo. Not impossible, but more difficult.

          Bobby
          4/26/07 - mass confirmed w/ no elevated markers
          4/27/07 - left I/O
          5/2/07 - Dx: 100% seminoma stage 1A
          Surveillance: CT/blood (6 month cycle)
          4/27/13 - 6 years cancer free!

          Comment


          • #6
            I agree with bobby, there are so many ways to tackle this issue and many pros and cons. If your doctor wants the RPLND, always get a second opinion. The RPLND is a big surgery but it can also be life saving and in many cases allow your husband to avoid Chemo (which has many long term effects). The RPLND is also easier to perform before Chemo and I always hesitate on waiting and doing the "watch and see if the cancer grows" approach...but I am always going to favor the more agressive treatment. Once they see cancer growing in his nodes, they may want to do chemo first and then follow it up with an RPLND. Getting more than one opinion will help you make the tough choices.
            Co-survivor with husband Boyce, Diagnosed 7-11-06, orchiectomy right testicle on 7-12-06- Stage 3A: Mixed germ cell tumor with inguinal seminomatous and kartotypic carcinoma. One tumor over 10 cm, second tumor 4 cm, Chemo 4xBEP: Bi-lateral RPLND Dec 2006, nerve sparing but left sterile.
            Current DVT
            Current testosterone replacement therapy, Testim.

            "You must abandon the life you planned, to live the life that was meant for you" ~wisdom I have learned from my family on this forum

            Comment


            • #7
              Get a couple of opinions. My urologist was for a RPLND, my oncologist was against it and he was in contact with Dr. Eihorn in Indiana. So I got everything together and went to John Hopkins in Baltimore to a specialist in laproscopic RPLND's. He said no-go on the RPLND. So I had 3 against and 1 for a RPLND. I still worry about the choice, but it has been almost 4 years since I decided not to. Tim
              Stage 3 seminoma w/intratubular Germ/ embryonal carcinoma in lymph/ pulmonary metastases
              I/O 7/2/03
              BEPx4
              Surveillance since 10/31/03

              Comment


              • #8
                Thank you to all that replied. I have been finding a lot of great info on here. Margaret thank you for the link. It was very helpful.

                Well I finally talked to the urologist(my DH did not ask enough questions). He said that it is a stage 1 nonseminoma.

                Comment


                • #9
                  You'll want a copy of the pathology report, which will offer more details that are helpful in making an informed treatment decision, including the cancer cell types and whether there is lymphatic or vascular invastion. Do you have blood test results from before surgery, and if markers were elevated, have they returned to normal? If RPLND turns out to be the choice, be sure the surgeon performing it has plenty of experience.
                  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


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                  • #10
                    Hi Rose: To rule out spread to other areas of the body, Andy had all sorts of scans and tests performed after his initial orchiectomy. He had a CT scan, a PET scan, a brain MRI, and all of these turned out clear. He was also Stage I Nonseminoma but there were a lot of factors to consider when he decided to have the RPLND surgery done to remove the lymph nodes. I'm not quite sure if you have posted the type of tumor on another thread, but the make-up of Andy's tumor is what eventually brought us to have the surgery. Rest-assured if this is the course of action that you must take, there are many on this site who have successfully undergone this surgery and I know you will find comfort in that.

                    Here's a link that may be of help to you...


                    (At the bottom in red, you will find some excellent articles for additional information)
                    Maria
                    *Hubby Andy diagnosed 02/13/07, Left IO 02/16/07 *Stage 1A Non-Seminoma (65% Immature Teratoma / 35% Embryonal Carcinoma) *RPLND 04/27/07 Lymph Nodes-ALL CLEAR
                    *Complications from Chylous Ascites so Laparotomy 05/03/07 *No food for 10 weeks, TPN only *07/18/07 Removed drains, tubes, picc line *CT Scan 07/31/07-ALL CLEAR
                    *CT Scan 02/12/08-ALL CLEAR *Hydrocele surgery 06/19/08 *CT Scan 9/30/08 and 03/06/09 shows <cm left lung nodule - under surveillance

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                    • #11
                      I do have the results of the first blood test, but I have no idea what I am looking at, or what it means. Thankfully we have 3 great children and I had my tubes tied, no more children for us. DH talked to the doctor when he first called and barely remembers the conversation. I called back and he only had a min. to talk so I could not ask a lot of questions. After the surgery the doctor said that he would like us to get a second opinion and that he would refer us to a TC specialist for it but would have to look into whom to refer us to. We have an appointment on Thursday to discuss the options and to find out who we will see next. So I can ask questions then. Any suggestions on what to ask? I keep writing things down as I think of them but any suggestions would be great. I can't think of everything at the moment, I have fibromyalgia and I am in the middle of a bad flair, so lots of fibrofog, and all this stress has made my pain a lot worse. Also round about how long of a recovery time for rplnd.

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                      • #12
                        We can help interpret the blood test report if you care to post it.

                        Click here to find links to good lists of questions at the Testicular Cancer Resource Center.

                        I'd plan on four to six weeks, more or less, for RPLND recovery.
                        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!

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