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Terrified and Overwhelmed
The last 6 months have been a whirlwind of information. My 26 year old son has been diagnoised with State III TC. Below is the information from his scans and pathology report. We are to see Dr. Roth at Vanderbilt on Friday the 26th. Any information or questions which might prepare us for this visit will be welcomed.
Diagnosis: Left Testicle with Non-Seminomatous Germ Cell Tumor, to Include Embryonal and Terato-Carcinoma Elements. Surgical cord margin free of tumor, inked surgical margins free of tumor involvement. Gross Description: Received in a fresh state is a left testicle which includes the attached cord structures. Overall dimensions are 8.4 x 3.8 x 3 cm. A proximal cord section is placed in cassette 1. Ink is applied to the external surface. Approximately 3 cm from the nearest inked margin is a discrete variegated mass which is yellow tan and hemorrhagic in appearance. This mass measures 1.7 cm in greatest dimension. Segments demonstrating the closes inked margin are placed in cassette 5. Sections containing epididymis are placed in cassette 6.
When we went in to see the Oncologist for the first time, he told us that Derick's tumor markers we 60,000. As I have learned more, this is what they tell us. His Alpha Beta Protein was 14,346 and his Beta FCG was 177,000. After 16 weeks of BEP his APB is now 2.8 which we are told is normal but his Beta FCG is 12 which is not normal. They just did a PET Scan because the last MRI's findings were: Scan of the chest, abdomen and pelvis with contrast: A very thin slice axial slices were obtained with the Philips 64 Multi detector Spiral CT Scanner from the thoracic inlet to the pubis symphysis following oral and intravenous contrast administration (Isovue 370, 100 ml). The raw data was then used for axial and coronal reformation at 5mm intervals. Evaluation with lung windows again demonstrates metastatic nodules throughout both lungs too numerous to count. Some of these nodules present on the prior study of 9/21/06 have decreased slightly in size, others have increased slightly in size. There appear to be more nodules decreasing in size than increasing in size. There is no evidence of hilar or mediastinal adenopathy. No focal abnormalities are identified in a normal sized liver. The pancreas, spleen and gallbladder are within normal limits. The large lymph node masses, which have surrounded the aorta on the prior study, have generally been debunked, however, a large number of nodes remain particularly 1 lymph node mass on the left side abutting the medial surface of the kidney measures 4.49 cm. This lymph node mass is slightly smaller than on the prior study. Other lymph node masses show marked decrease in size and generally speaking there is much less riaortic lymph adenopathy than on the prior study. No new lymph node masses are identified. In the pelvis, there is no evidence of iliac adenopathy as such, but a few small shotty lymph nodes are visualized along the iliac chain. The seminal vesicles and prostate gland are within normal limits. No inguinal abnormalities are noted. Large numbers of metastatic pulmonary nodules some of which have deceased in size. A fewer number have increased in size. These changes have all been in the 10-20% range whether increasing or decreasing in size. Decreasing amount of periaortic lymph adenopathy with no new lymph node masses identified. Shotty iliac chain nodes without lymph node masses in the true pelvis.
What we were told from the PET Scan is that there was no lighting up in the Abdomen or Lung area but there was significant lighting up in the Neck region. What that all means, I'm not real sure of but they have since done another MRI of the brain. We do not have those results as of yet. After the PET scan, Dr. Patel told us that Derick has three options. 1) To restart his chemo using the same BEP for two cycles and then repeat his tumor markers 2) To start chemo back up using a different chemo which is what normal protocol who call for or 3) To do a stem cell transplant. Dr. Patel did say that he would like for Derick to get a second opinion at Vanderbilt which is why we are seeing Dr. Roth on Tuesday, January 26th. Dr. Roth has asked that all Pathology slides, records, MRI and PET scan disks be sent to him for review.
At this point I am a mother who is overwhelmed with information and questions. Please help.
Renea
Diagnosis: Left Testicle with Non-Seminomatous Germ Cell Tumor, to Include Embryonal and Terato-Carcinoma Elements. Surgical cord margin free of tumor, inked surgical margins free of tumor involvement. Gross Description: Received in a fresh state is a left testicle which includes the attached cord structures. Overall dimensions are 8.4 x 3.8 x 3 cm. A proximal cord section is placed in cassette 1. Ink is applied to the external surface. Approximately 3 cm from the nearest inked margin is a discrete variegated mass which is yellow tan and hemorrhagic in appearance. This mass measures 1.7 cm in greatest dimension. Segments demonstrating the closes inked margin are placed in cassette 5. Sections containing epididymis are placed in cassette 6.
When we went in to see the Oncologist for the first time, he told us that Derick's tumor markers we 60,000. As I have learned more, this is what they tell us. His Alpha Beta Protein was 14,346 and his Beta FCG was 177,000. After 16 weeks of BEP his APB is now 2.8 which we are told is normal but his Beta FCG is 12 which is not normal. They just did a PET Scan because the last MRI's findings were: Scan of the chest, abdomen and pelvis with contrast: A very thin slice axial slices were obtained with the Philips 64 Multi detector Spiral CT Scanner from the thoracic inlet to the pubis symphysis following oral and intravenous contrast administration (Isovue 370, 100 ml). The raw data was then used for axial and coronal reformation at 5mm intervals. Evaluation with lung windows again demonstrates metastatic nodules throughout both lungs too numerous to count. Some of these nodules present on the prior study of 9/21/06 have decreased slightly in size, others have increased slightly in size. There appear to be more nodules decreasing in size than increasing in size. There is no evidence of hilar or mediastinal adenopathy. No focal abnormalities are identified in a normal sized liver. The pancreas, spleen and gallbladder are within normal limits. The large lymph node masses, which have surrounded the aorta on the prior study, have generally been debunked, however, a large number of nodes remain particularly 1 lymph node mass on the left side abutting the medial surface of the kidney measures 4.49 cm. This lymph node mass is slightly smaller than on the prior study. Other lymph node masses show marked decrease in size and generally speaking there is much less riaortic lymph adenopathy than on the prior study. No new lymph node masses are identified. In the pelvis, there is no evidence of iliac adenopathy as such, but a few small shotty lymph nodes are visualized along the iliac chain. The seminal vesicles and prostate gland are within normal limits. No inguinal abnormalities are noted. Large numbers of metastatic pulmonary nodules some of which have deceased in size. A fewer number have increased in size. These changes have all been in the 10-20% range whether increasing or decreasing in size. Decreasing amount of periaortic lymph adenopathy with no new lymph node masses identified. Shotty iliac chain nodes without lymph node masses in the true pelvis.
What we were told from the PET Scan is that there was no lighting up in the Abdomen or Lung area but there was significant lighting up in the Neck region. What that all means, I'm not real sure of but they have since done another MRI of the brain. We do not have those results as of yet. After the PET scan, Dr. Patel told us that Derick has three options. 1) To restart his chemo using the same BEP for two cycles and then repeat his tumor markers 2) To start chemo back up using a different chemo which is what normal protocol who call for or 3) To do a stem cell transplant. Dr. Patel did say that he would like for Derick to get a second opinion at Vanderbilt which is why we are seeing Dr. Roth on Tuesday, January 26th. Dr. Roth has asked that all Pathology slides, records, MRI and PET scan disks be sent to him for review.
At this point I am a mother who is overwhelmed with information and questions. Please help.
Renea
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