help with something confusing me

[shelly]

I have been researching for two straight days, learning, reading, learning, thinking, crying, learning and thinking more. There is something that strikes me as odd.

I have read that sometimes people have chemo, and then still need an rplnd for residual masses. I have also read that people have the surgery and due to findings in the nodes, still need a round or two of chemo. How in the world do you decide which one to do first, if you may end up needing both depending on the outcome of the other? I am aware that sometimes rplnd is not an option at first because of tumor markers or CT results...assuming there is nothing certain, only possibilities, and one journey may end up resulting in the other, this is an absolutely tortuous decision one has to make.

Shelly

[mstlyn]

I have been researching for two straight days, learning, reading, learning, thinking, crying, learning and thinking more. There is something that strikes me as odd.

I have read that sometimes people have chemo, and then still need an rplnd for residual masses. I have also read that people have the surgery and due to findings in the nodes, still need a round or two of chemo. How in the world do you decide which one to do first, if you may end up needing both depending on the outcome of the other? I am aware that sometimes rplnd is not an option at first because of tumor markers or CT results...assuming there is nothing certain, only possibilities, and one journey may end up resulting in the other, this is an absolutely tortuous decision one has to make.

Shelly

Hi Shelly,

These questions are on my mind a lot too. I have been reading, and reading, and reading and I still do not know what is best. This same conversation is in one of the other links on the board tonight.

It seems that doctors do not always agree about this too, and that doesn't help matters.

Sorry I can't help with your question. I just thought I would let you know that you are not alone.

Tammy

[kmom49]

Rplnd

Hi Shelly and Tammy

The way it was explained to "us"; my son was diagnosed in 2003, was that IF there's a question as to which should come first, the RPLND should be considered first, due to the fact that if chemo is chosen and then the RPLND is still needed, it makes for a more difficult surgery because the chemo makes the nodes "sticky"/"gluey" which in turn makes the surgery more difficult. I have seen it go both ways from different posts here and in our experience the RPLND was the only full-proof option which my son chose and he/we were fortunate that no nodes were affected. He had Stage I. It's a tough surgery no matter what but my son is doing great today. So this is just from our experience. I'm sure you'll hear reasons for completely avoiding RPLND here, but in our situation, the way it was explained, it was kind of a no-brainer. Just my thoughts on it. Hope it helps a bit.

Kathy

[Mom]

It's not the treatment you should be concerned about, it is the doctor who is making the recommendation. Make sure you are with a TC expert, even they disagree sometimes but at least they are making their recommendation based on what they believe is best for the patient so it will not be a wrong decision. Just make it and don't look back. Cancer is insidious and some TC tumors even more so because of their aggressiveness. Don't agonize over this issue.

[kmom49]

Rplnd

Yes, I meant to say that as well - you MUST have a TC expert who has lots of experience with that surgery.

[Vinny]

The good news is, you don't have to make this decision in a vacuum. Have your local oncologist consult with IU, MSK, Oregon, whoever. Check the TCRC Expert List then make the oncologist fax information over and talk to an expert so that you can have the best and brightest collaborating in the treatment plan.

Good luck!
Frank