Pathology report

[swan]

HI all ,
I just got back from the doc,s got bloods taken as i am seeing the urologist on fri. after having I/O last monday.
The doc gave me my markers pre surgery, and the pathology report.
MARKERS
HCG 15 <5
AFP 58 <11

Patholgy report
There is a lot there so i will just write the conclusion if any one wants to know specifics just ask !

CONCLUSION Right testis
A. Mixed malignant giant cell tumour , measuring 17mm in maximum diameter comprising predominantly embryonic carcinoma with a minor component of immature teratoma also present.(ie. so called ''teratocarcinoma'').
B. The tumour abuts but does not infiltrate into or through the tunica vaginalis.
C. Lymphatic invasion (into subscapsularlymphatic channels ) is identified.
D. No tomour present in the rete testis, epididymas or spermatic cord.
E. The adjacent testis shows reduced spermatogenesis but no intratubular germ cell neoplasia or other pathology present.

So what do you guys think ?
I am seeing the urologist fri. but he called 2 days ago to tell me that they had not got it all and he would probably refer me to an oncoligist , and i would need some chemo .
Your opinions would be great.
Regards swan.

[nzsteve]

Hi,

Im guessing that the "Lymphatic invasion (into subscapsularlymphatic channels ) is identified" part is why he's saying youll need some chemo, although its not something my path report talked about, so I dont know for sure.

The results from your new blood test will be important - hopefully the markers are dropping, which would be a good sign. They should also schedule you a CT scan if it hasnt been done to check for spread. I'd expect you to be refered to a a medical oncologist, who will disscuss the options of surveillance, chemo or RPLND with you based on the CT and the blood markers.

As far as I understand it, if your markers normalise and CT is clear surveillance is an option in most cases if you are going to be a compliant patient and keep your appointments.

Good luck,

Steve

[nzsteve]

Just saw on your older thread youve had a CT and it was clear, (which as you know is good!), so ignore my comment about getting one scheduled.

Steve

[Fish]

Hi:

From my understanding, lymphatic or vascular invasion is a risk ractor for spread. Nither condition gurantees spread of cancer cells. There have been cases of NO lymphatic invasion and NO vascualar invasion where the cancer has still spread. This is all really an odds game, and I don't mean to be filppant by using the word game, its a very serious game, with some men getting TOO much treatment too soon, and others possibly not getting enough. Look at the odds for Stage 1 seminoma - perhaps 80% are cured by orciechtomy alone, yet there is a very strong bias in the US toward adjuvant ratiaotion. This meas a significant % of seminoma patients revieve useless and potentially damaging radiation therapy I agreed to have an RPLND after my first TC because tests indicated enlarged nodes. After the pathology came back negative, I told my doc no more treatment unless he could point to a CT or blood test and show me the need for treatment. AFter my second TC, I told the oncologist the same thing -- not treatment unless he proves to me there is cancer present that needs to be treated.

Sorry to ramble on, but, in my humble opinion, the medical community is often too quick to iniatiate unecessary treatment for stage 1 TC.

Beacause TC is one of the most treatable cancers, we need to give serious consideration to the surveillence option. Doctors might simply might have to spend a litte more time "screening" patients to decide the best risk and most compliant people to put into a surveillence program.

I firmly believe in "do no harm"
Jim