Residue Tumour

[ivannabanana]

Hi i was wondering if anyone could help me here.... My husband and i went for the result of hys Ct scan, the first one after finishing hys 4xBEP...The Doctor told us that the largest of the tumours situated just behind the kidney on hys right side has shrunk to 6cm, the one in hys chest has shrunk to 3 cm and he has one in hys lower pelvic reagion but he neva mention the size of it..... We have to go back to the Hospital 2 weeks today as they are going to discuss wot kind of treatment he will now get.... He mentioned radiotherapy and an operation and also more chemotherapy .... Will thys operation be called an rplnd that i have seen written so many tymes on thys forum? Wot kind of chemo kan he get? has thys happen to anyone else? My hubbys tumour was quite large altho dimensions have neva been gyven to us but the size of small melon has been referred to....im just so worried..... please any info would be great....regards Yvonne x

[Lori]

Sounds like the surgery would be an RPLND to remove the one near his kidney and the one in the pelvic region. The chest tumor removal could potentially be done at the same time as the RPLND but depends. My husband had tumors in his chest and neck removed at one time with two different surgeons - each experts in their field. Then the RPLND was conducted by an expert on RPLND. However, I met another patient who had the RPLND and chest surgery together, again with two diff surgeons. It sounds awfully scary, but my husband did pretty well during both surgeries. Recovering of the RPLND has been harder than the chest surgery but after a week he was up and around. Good luck!

[Scott]

I would have expected that with seminoma they'd hold off on additional treatment after chemotherapy to see first if the residual masses are absorbed by the body. I highly recommend getting a testicular cancer expert's opinion.

[Scott]

There's a relevant section in this article:

Postchemotherapy Seminoma
Patients with higher volume retroperitoneal seminoma or widely metastatic seminoma are treated with cisplatin-based chemotherapy similar to patients with nonseminoma. Unlike patients with nonseminoma, however, teratoma is never associated with pure seminoma. Therefore, the issue of whether to resect postchemotherapy masses after chemotherapeutic treatment for pure seminoma is controversial. Generally, patients with residual masses after chemotherapeutic treatment of seminoma are managed expectantly, with only a small percentage of patients recurring in the area of the mass. Also, standard second-line chemotherapy in seminoma is curative at the 50% level, and most patients who experience growth of a postchemotherapy mass after induction chemotherapy are usually given second-line chemotherapy. Therefore, surgical resection is reserved for patients who fail second-line chemotherapy and have a localized mass. Alternatively, some centers advocate surgical resection of postchemotherapy masses in pure seminoma if the mass is greater than 3 cm in diameter. This issue of whether to resect postchemotherapy masses in seminoma remains controversial, and management should be individualized. The use of positron emission tomography scanning in this situation is also controversial.

[Scott]

Also, see page 8 of the NCCN guidelines. They recommend a PET scan, with surveillance if the results are negative and other treatment options (biopsy, second-line chemotherapy, radiation therapy) if positive.

[ivannabanana]

Thanx for the quick replies....The doc we spoke to neva mention to us about the body absorbing the residue tumour, but i thynk that he may not have wanted to say to much and put ideas in our heads before he had spoke to the othe consultants.... Our team of Consultants are all vert good and they make you feel confident... Jeff White is my husband's consultant he is exellent in hys field, eveyone you speak to about hym all have good thyngs to say of hym...Ive neva had negative feedback about hym which i thynk says it all.... All the advice i get on here is brilliant and is very much appreciated, i just have tymes when i get a bit low and mymind goes into overdrive..... thanx again, Yvonne