second opinion?

[Alex_G]

Hello all,

I was diagnosed with TC. Based on ultrasound and blood work my doctor said that it’s seminoma.
I still cannot believe it. Is it only the ultrasound that they base diagnose on?
4 week ago I woke up and felt pain in my left. It was larger than usual and very painful to touch. I scheduled an appointment with my doctor but it took me 2 weeks to get there. By that time pain was almost gone and testicle size back to usual.
They made me go to ultrasound and my doctor called me told me that they found multiple
swellings and I need a surgery.
Is that a procedure? Do I need to go to another doctor for second opinion? If doctors make their decisions based on ultrasound only then it doesn’t make any sense to go to another doctor?

What next?
Sorry for my English – it’s not my native language.

[Kman99]

The way you say multiple swellings is a bit unclear. Did the ultrasound reveal a solid mass? Do you know what your blood work says (your tumor marker levels)?

An ultrasound is used to detect tumors, not to specifically diagnose TC, certainly not seminoma vs non seminoma. To make that determination, a sample of the tissue must be removed and sent to a pathologist. If there is a tumor, the normal procedure for this is an inguinal orchiectomy, which is the removal of the testicle - http://tcrc.acor.org/orch.html

My initial impression is that you need to see another doctor or at least ask your current doc some specific questions.

Let us know if you have more questions.

[Alex_G]

I’m sorry for being unclear.
Actually my doctor didn’t show me ultrasound results –I assume that it was probably multiple tumors.
I have my blood result however.
Alpha-1-feto-marker 2.1
HCG marker low lever <2

[Kman99]

I think you should get more specifics from the ultrasound first, but if you really do have multiple solid masses, you should have the surgery as soon as possible to remove that testicle.

Your tumor markers appear to be in normal ranges to me, but that doesn't mean you don't have TC, so do the best you can to see someone (preferrably a doc with TC experience) soon.

[Alex_G]

May be someone knows answer to this question
In age of 7-8 I had surgery for undescended testicle. It was brought down and it much smaller in size. Is it still functional? Will it produce hormones etc?
My doctor told me that he is not sure but he checked and told me that there is a good blood flow there.

Any idea?

[dadmo]

An undescended testicle is more likely to have cancer then one that descended on it's own. Is the one that was undescended the one you have a problem with? Kman is right about a biopsy being needed to determine what form of tc you have. If your markers are normal and you are older you may have seminoma but you can't tell from just blood work. Your doctor needs to get this right otherwise he may prescribe the wrong treatment.

[Alex_G]

Unfortunately for me I’m having problem with normal one. Undescended is fine.
I’m just curious is undescended still functional? I had surgery to bring it down in age of 7.

[dadmo]

I can't answer that one but you should certainly consider banking sperm.

[Alex_G]

What about testosterone? Is it also testical job?

[Kman99]

I too don't know whether your undescended testicle is functioning normally. You really need to ask a qualified doc these questions. Have your doc test sperm count and testosterone levels to make sure it is working normally.

More importantly, you need to get better answers on your other testicle too and find out about the tumors/swelling. You will want to have that one removed, regardless of the undescended one, if there are really solid masses.

[Alex_G]

I have the surgery scheduled for next Wednesday.
What the next steps are going to be? CT scan after that? I thought they should do CT scan before surgery. I’m kind of confused here.

[Kman99]

Alex,

Here's an excellent website that gets into details on what to expect - http://tcrc.acor.org/index.html

[Karen]

Alex,
Can you tell us what part of the world you live in? There may be others here from the same area that can guide you to more expert doctors for you to be treated by. You do need the surgery as soon as possible, but your diagnosis and treatment are very important so you want to go to an oncologist that is very experienced in this area.

[Kman99]

Good idea Karen. I'm concerned about Alex's doc already diagnosing TC, a seminoma no less, by the use of an ultrasound.

[Alex_G]

I live in USA Chicago area.
Here is my short story.
4 weeks ago I felt a pain in testical area. In 2 weeks I visited my urologist. He sent me to ultrasound and blood work. Ultrasound results – multiple tumors (I’m not sure about exact wording I can get copy from a doctor). Blood work comes up clean.
My doctor told me that it looks like seminoma and I need surgery asap. I’m in higher risk zone because in my childhood I had undescended testical surgery.

Please let me know if that’s the procedure.