Check up Question

[keysi]

Hello there I know it's been a while since I have not posted anything but I always read your posts,, I have one question , my fiancé is getting his first check up next month already.... ( I can’t believe it's been six months since his orchiectomy)... and I want to know what type of tests he is supposed to get, I know CT scan is one.. But can you tell me what other standard tests he should be getting?? Thank You very much… Ahh by the way… he is a Stage IA classical Seminoma.. RT finished on June 2006 Thanks!!

[rjs]

In addition to the CT Scan, he will probably get Chest X-Rays and bloodwork done. Of course, they will also do a physical examination and ask if there are any lingering effects from surgery or the radiation. It should be fairly easy and routine.

All the best.

-rs

[IowaBrian]

Yep: chest xray and blood work every month and ct scan ever 3 to 4 months and the month of the Ct they might not do the xray in my case they don't.
They also do full exam and check to make sure no other lumps on the lone survivor and if all is well see you at the next visit.

[Karen]

keysi,
My husband is a stage 1 seminoma, post-RT and his schedule for the first 4 years is:

every 3 months: physical and bloodwork (he gets markers and a complete metabolic profile done for soem reason)
every 6 months CAT (abdominal and pelvic since his radiation was para-aortic)
every 12 months: Chest X-ray

The every month schedule is for those who did not get RT and went the surveillance route.

[keysi]

Thank You very much for your replies,, I am very nervous because is the first CT sca he is going to get after his RT but I guess it's normal... any advices from co-survivors for not getting anxious? I don't want show him that I am worried....Thank YOu!!

[huckchef]

things will be good!!! those visits never get any easier and the anxiety always shows its face, for me anyway! just keep the scheduled appointments and don't miss any!
my thoughts and prayers
brian.

[Scott]

Note that the TCRC says CT scans after radiation therapy are unnecessary, and tumor markers and a chest x-ray should be sufficient.

CT scans are not to be taken lightly. They provide a reasonably large dose of radiation, and they should not be used if they are not needed. Our surveillance protocols do not call for abdominal CT scans post RPLND or post radiation. Studies have shown that the odds of a recurrence in the retroperitoneum are very small following these therapies, and these odds do not justify the use of a CT scan.

[keysi]

Thank You all!! and Thank you Scott for the reminder! I did not know that

[tlh]

Scott,

I just read this thread. Thanks for the info. I was starting to get a little anxious thinking my doc wasn't doing all he was supposed to for follow-up. I was stage 1 seminoma and received adjuvant rad (para-aortic and pelvic which if you have read my other threads can see I still have a few lingering side-effects) . I was concerned because I have a check-up next week (4 months since orchiectomy and 6 weeks post-rad) and noticed he didn't order a ct scan. Now I think I understand why. Thanks for the info.

[Sans rt1]

According to the NCCN, which recently published revised followup protocol for Stage 1 seminoma, a yearly pelvic CT should be added for those that had para-aortic rather than dogleg RT. In my research, I found references to a significant percentage (still it is a low number) of reoccurences post para-aortic RT occur in the pelvic lymph nodes that were not treated - and this would not be detected by chest X-ray until it is fairly advanced - but even then it would be highly treatable with chemo - but a more rigerous chemo than if it had been caught earlier.

So, it you had the para-aortic rather than dogleg, question your oncologist if your followup for the first few years does not include a yearly pelvic CT scan.

Here is the address to the NCCN guidelines:

http://www.nccn.org/professionals/physician_gls/PDF/testicular.pdf