Path Report

[Beth]

Non-seminomas
Mixed Germ Cell Tumor (Embryonal Carcinoma<--(75%) and Teratoma).
Vascular/Lymphatic Invasion: Present
More to post later...have to go out for a few hours
Something else about rare tumor cells being immunoreactive with HCG and AFP and intratubular germ cell neoplasm...

He says surgery and then chemo unless the borderline masses in the lymph nodes have grown in 3 weeks. In which case he says chemo then surgery..

I am still expecting to be called and told it's a mistake, but now seeing it in writing, I guess I am in normal denial.

[dadmo]

Beth:
I hate to jump the gun here but have you consulted with an expert? If the cancer has spread and it's Embryonal Carcinoma chemo should be first.

[Beth]

We have scheduled 2nd opinions next week, plus we have to talk to an oncologist and a surgeon. Our doctor recommended Dr Richie (or some name similar) from Harvard to do the surgery.

So does that mean chemo, surgery then more chemo? Or chemo and then surgery, and no other chemo?



be back later if I don't reply right away...

Beth

[dadmo]

What is usually done when Embryonal Carcinoma spreads is to give either 3xBEP or 4xEP (my son had 4xEP) and then if required an RPLND.

[dadmo]

Embryonal Carcinoma can skip the lymph nodes so removing them first isn't always a cure.

[Fed]

Hey Beth,

Dadmo is right. With embryonal and the potential of spread, chemo is usually the first step (Dana-Farber does 3xBEP). Depending on the outcome of the chemo, an RPLND would be recommended if there are residual retroperitoneal masses. The surgeon you have been referred to (Jerome Richie) is the chief of urology at Brigham and Women's Hospital in Boston. My best friend from college is a urological surgeon, and although he received most of his training from Joel Sheinfeld at Sloan (arguably the world master of the RPLND), he has scrubbed in the past with Richie, and he's really good, likely in the top 5.

You said you have a second opinion scheduled for next week. Will you be coming to DFCI? Let me know, and if you want, we can meet up and I can help you get around. I believe I gave you my contact info, but if not, drop me a PM, and I'll send it your way. Rest assured that with prompt action, Jason will be out of the woods in due course. Let me know if you need anything.

[Scott]

Did you get the tumor marker levels from before surgery? Another factor will be what those markers do. If they don't return to normal, chemotherapy is a definite. Hang in there, Beth.

[Karen]

Beth,
Denial is normal. Now get mad, and kill the ba$&ard!!! The % of EC is high, and vascular invasion is present, so you need to be aggressive. Please consult an expert and if you are at DFCI please take Fed up on his offer...he is a sweetie and will make sure you get where you need to be and provide support. Lean on us all, you and Jason WILL get through this!!!!

[mstlyn]

Beth:
I hate to jump the gun here but have you consulted with an expert? If the cancer has spread and it's Embryonal Carcinoma chemo should be first.

Anthony was diagnosed with EC and Yolk Sac w/vascular invasion .. one enlarged node in the retroperitoneal area. Chemo was a must before anything else.
He had RPLND 2 months after chemo-

I have been told all along that when it comes to EC, it can skip the nodes and go straight to the lungs, so when there is vascular invasion, chemo is recommended first.

[Chris'Mom]

Hang in there Beth...it is always so hard at the very beginnning...you feel numb...like your world will never be the same. Get him treatment...gather all your info...and he will be fine....stay in touch...everyone here will help you thru it....Mary Ellen