(Likely) TC caught very early, what should I expect from I/O + aftermath

[canadian]

So I *likely* have TC. 6 small lesions, none bigger than 1 cm, not really palpable. Ultrasound shows they have increased vascularity. I wrote about it here: http://www.tc-cancer.com/forum/showt...this-is-benign

The urologist emphasized that this has been caught very early. The lesions were first detected two years ago, and took that long to double in size. The scan was done for an unrelated reason.

There is, of course, an outside chance that these are something benign such as a Leydig cell tumour, or some rarer condition. But let's go on the assumption that it's cancer, likely a type of seminoma.

My tumour markers are negative. I'm guessing nothing has spread (though I know seminoma doesn't usually raise markers).

1. What's recovery from the orchidectomy like. How long do I stay in the hospital, and how long until I can return to normal activities such as weightlifting.
2. Where is the incision made, and does it leave a scar? I ask because I'm prone to hypertrophic scarring, so I'll have to take extra care to minimize any that forms.
3. For TC caught early, what's standard procedure for treating it after the orchidectomy? I've read about scans to check for spread, but also read those can't be determinative. For those of you who had TC caught early, were you able to forego radiation/chemo?

Thanks for your help!

[DoubleZero]

Hi Canadian,
Lots of questions, I'll see what I can answer...
The I/O surgery can take place as a day-case, I stayed in hospital overnight, but I know (a lot of) others who were in and out the same day. Normal activities, in general it's a "listen to your body" answer. You'll need to be careful for a few days to watch the swelling and so forth and reduce the size of any haematoma that occurs. I was out shovelling snow from the drive within a few days of my operation.

The incision is made at the top of your pubic region and below your stomach. It's a relatively shallow incision (they don't go into the stomach wall, or muscles) and the scar is around 3+ inches or so.

You have a few "choices" of what happens next. If you have TC (pathology will determine that), then depending on its type (seminoma, embyonal...) will notionally determine its aggressiveness. But the main thing is whether you have any evidence of metastasis (blood markers and ct scan results). If you have no evidence of spread you are most likely to be offered surveillance, though you could be offered a single short of Carbo or 1 x BEP as a "safe guard" against a relapse. Most people (though it's your choice) seem to go for surveillance only to start with (why put your body through more trauma if it's not needed?)

Regardless of whether it has mets or not, or whether you have one shot of chemo, the prognosis is usually very good. So you should do okay...

[willb]

So I *likely* have TC. 6 small lesions, none bigger than 1 cm, not really palpable. Ultrasound shows they have increased vascularity. I wrote about it here: http://www.tc-cancer.com/forum/showt...this-is-benign

The urologist emphasized that this has been caught very early. The lesions were first detected two years ago, and took that long to double in size. The scan was done for an unrelated reason.

There is, of course, an outside chance that these are something benign such as a Leydig cell tumour, or some rarer condition. But let's go on the assumption that it's cancer, likely a type of seminoma.

My tumour markers are negative. I'm guessing nothing has spread (though I know seminoma doesn't usually raise markers).

1. What's recovery from the orchidectomy like. How long do I stay in the hospital, and how long until I can return to normal activities such as weightlifting.
2. Where is the incision made, and does it leave a scar? I ask because I'm prone to hypertrophic scarring, so I'll have to take extra care to minimize any that forms.
3. For TC caught early, what's standard procedure for treating it after the orchidectomy? I've read about scans to check for spread, but also read those can't be determinative. For those of you who had TC caught early, were you able to forego radiation/chemo?

Thanks for your help!

Canadian, I can try to answer a couple of questions. I had my orchiectomy in Toronto today and it was just over an hour in length. They watch you in recovery, check your dressing, heart function, and give you a variety painkillers depending on the severity of your pain. Mine was quite bad when I woke up, but it has really subsided. My procedure was early in the morning and I was out before noon. So it's day surgery, much like a hernia operation I'm told. Not sure if this is standard everywhere.

Not sure about physical activity, I'll probably find out at my follow-up next week, but it's hard enough to bend over as it is. Also not sure about scarring because of the dressing, which is in two parts. The last of it comes off in 7 days.

I'm told surveillance will likely be my treatment for a few years, since my tumor markers, abdominal/pelvic CT, and chest x-ray were okay.

In my opinion, the anxiety and shock were much worse than the actual surgery.

Best of luck,

Will

Edit: the pain definitely hits you the next day... wouldn't recommend any weightlifting for a while.

[Davepet]

2. Where is the incision made, and does it leave a scar?

I think all your questions have been answered except the scar one, yes, I'
m unaware if any surgery that does not leave a scar, this one certainly does, after a year it's pretty hard to see, but it's there if you look.
Dave