Confirmed mass today....orch. tomorrow.

[djmac]

For the record. I'm getting every 3-4 months, and I'm getting the CXR done every time. My uro insisted on it, oh, and tumor markers...

djm

[Fed]

things are looking really good

Indeed they are. You have pretty much the same diagnosis I had: multifocal seminoma (with the difference that mine was in righty).

Second opinions are very helpful when you don't feel comfortable with the assessment of your doctor. I got a second read on the pathology because the first doctors I saw were very dismissive of my concerns, and they raised more questions than provided answers. It certainly doesn't hurt to have one done (my insurance covered it, so in my case, it was a no-brainer).

Surveillance is a perfectly good choice for your diagnosis. As long as you follow the protocol to the "T" and can handle the anxiety that comes along with every approaching check-up date, you will be fine with this form of treatment. I am surprised, though, that your doc is recommending CTs every 2 months. That's twice the recommended protocol, and CTs do give you a pretty large dose of radiation (certainly not nearly as much as adjuvant radiation, but considerably more than the average chest X-ray). The most common protocol for stage I seminoma is CT and markers every 4 months and chest X-ray every 8 months for years 1-3. Then CT and markers every 6 months and chest X-ray once a year for years 4-7. Finally, once a year thereafter. Details on this can be found at http://tcrc.acor.org/.

Things are good, indeed.

[fuse929]

Hey All,
This is my report: Lobulated and poorly defined 1.6x1cm subcapsular mass approaching but not involving the head of the epididymis. Histologic sections show testicular tissue showing some atrophy and a multifocal neoplasm composed of sheets and groups of gonadoblasts showing central nuclei, prominent occasionally multiple nucleoli and ample clear pale eosinophilic cytoplasm. Mitoses are present but are infrequent. There is an associated lymphocytic host immune response and infiltrate. No evidence of hemorrhage or necrosis within the tumor. A PAS stain, and a properly controlled panel of immunohistochemical stains were performed with the following results: PAS stain shows strong staining of glycogen in the tumor cells, characteristic of seminoma. CD-117 and PLAP are positive in neoplastic cells. NSE is strongly positive. Vitmentin, CD30 and EMA are essentially negative in tumor cells. The histology and staining pattern are consistent with seminoma. There is no involvement of the testicular capsule, rete testis or epididymus: tumor appears to be confined to testicular parenchyma proper.

Diagnoses: Multifocal intratesticular seminoma, left testicle.

Chest, Abdomen and Pelvis are normal (CT). Blood pre and post I/O is normal.

My uro told me this was the earliest he has personally ever seen TC caught, and because of this and the above diagnosis, offered me either surveillance with a CT and Chest x-ray every 2 months for the first year, or a small amount of radiation. I asked what he would do if he was in my shoes, and after about 2 min of quiet thinking he told me he would go with surveillance. I believe I'm going to chose surveillance, and believe me, I will be vigilant with it.

How important do you all think it is to get second opinions? Also, in your opinions and with your experiences, is surveillance an appropriate choice?

Thank you all.......things are looking really good,

Bobby

[Scott]

Glad to hear the good news, Bobby! Keep us posted.

[Mom]

Great news, Bobby! I think you are going to be one of the VERY lucky ones! Dianne

[Fed]

Kick ass, dude! That is great news! With such great results (pending, of course, your radiology and bloodwork), there is a very good chance you are already cured. Best of luck with the remainder of the labs,

[fuse929]

Hey Guys,

Phenomenal news!!! I just had a 2-day-early unexpected call from my uro who told me my path report confirmed a 100% seminoma with no invasion of any type! He said that it looked like there wasn't even any invasion to the retis testis or however you spell it (cover that surrounds the testicle to my knowledge), which I'm told means that it was caught as early as possible. I go tomorrow for blood work and the CT scan just to be sure it's all gone, but right now I feel like a million bucks. Obviously I still have worries and I'm still thinking a second opinion is in order just to be safe, but I feel this is great news and I want to thank everyone for the encouragement and prayers thus far. I'll let you guys know how the CT scan turns out when I get the report.....hopefully by Friday.

Thanks!

Bobby

[fuse929]

Thanks Sharon.......the more research I'm doing on people post I/O relative to TRT the more I'm seeing that it isn't always necessary.....this is very comforting........emotionally and financially haha.

[Russell's Mom]

for us

Russell has been doing great. Still has all his manly features...including the sense of humor and appreciations! Take care, Russell's Mom, Sharon

[fuse929]

Hey guys,

What are the chances an orch. will result in need of testosterone supplements? Do almost all survivors need testosterone, or will only a few? Are there any stats? Have any of you had short or long term side effects of your orch. related to low testosterone symptoms?

Thanks,
Bobby

[Fed]

Fed - thanks for the advice and reassurance! it means a ton, believe me. I see your from Mass.....I'll be up Boston in August for an American Chemical Society conference.

Hey man, I'm just glad I was able to help. I will definitely be in town for the ACS meeting (I might be presenting, as well). We'll have to get together and go out for a drink. I'm sending good vibes so the path comes out as positive as can be.

[Russell's Mom]

thoughts for you

You've got it.....the thoughts and prayers. Being 23, Russell is very much alive on this earth...yet there have been many times lately he would pause and then share that he could "feel" the prayers. He just returned from Guatemala, a thank-you in motion for all who helped and prayed. Sometimes it all goes beyond words for me. None the less, glad to hear you are doing well and will set some special energy your way. Take care, Russell's Mom, Sharon

[huckchef]

Bobby, I'm glad things are going smoother for you. Just rest and things will get better. Let us know when pathology returns on make-up of whatever is in there. Just remember that you could possibly be cured already if it's a tumor.
I live a little north of you in the Jackson metro area. I'll be glad to help you out in anyway I can!
I hope the poodle is not a "lapdog"!!!

My thoughts an prayers,
Brian

[fuse929]

Hey all,

Thanks for all the support! I've been home for about 7 hours now and I feel great. There is hardly any pain....just a slight discomfort......and I haven't needed to take any of the meds yet. The uro told me that the surgery couldn't have gone any better, and he said there is visually no sign of any type of spreading.....which is nice to hear but still anxious for the path. I go back a week from today for the full report. It really means a lot to me to receive all of this advice! The only thing I ask for right now is just a few prayers for a good report. I'm by no means a highly religious person, but I truly feel God was there with me today.......it's the only way to explain my confidence going into the surgery and my excellent condition right now.

Dianne - haha you can relax, I'm from the Poconos

Fed - thanks for the advice and reassurance! it means a ton, believe me. I see your from Mass.....I'll be up Boston in August for an American Chemical Society conference.

Rover - thanks for the encouragement too! haha luckily the roommate with the poodle is a girl......not sure we would have let a guy with a poodle move in! she is being a great nurse.

Thanks,
Bobby

[Mom]

Please don't tell me you are from Downingtown, PA!!! Glad that you had responsive doctors and are well on the way to getting your life back in order. Dianne