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stage 1 seminoma protocol

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  • stage 1 seminoma protocol

    On a recent follow up visit to my Onc and Urologist I was given the normal blood workup as well as physical exam. I was having a discussion with my Urologist about follow ups because he wanted to do an abdominal CT scan. I told him that I haven't found any info to support this being necessary since I was stage 1 seminoma and underwent RT to ab and pelvic area. He did some checking and agreed. However, when I questioned him about ordering the chest X ray he said the guidelines state that normally a physical exam and blood work are all that is necessary. I talked with my Onc about this since I didn't agree and he told me that if I wanted a chest X ray they would be happy to order it, but he felt that since the guidelines for follow up had changed recently ( did they?) that I was just subjecting myself to more radiation than I needed to since chest X rays normally aren't clear or detailed enough with this type of Cancer to be of much help. This is the first I've heard or this. I would have thought the chest X ray was more helpful than the blood work since my blood work has been normal before, during and after the orch and radiation. Any thoughts on this? Thanks.

    diagnosed 28 June 06. Orchiectomy 29 June 06. Stage 1 Seminoma with no evidence of spread or Vasc invasion. Finished adjuvant RT (27Gy) to abdominal and pelvic area August 28th, 2006.

  • #2

    You might want to check out the link below:

    These are practice guidelines in the US for oncology.

    They recommend a chest x-ray at the same schedule as the blood work. This is important since seminoma, in many cases, does not produce tumor markers. You can always print the recommendations and take them to your next appointment, for discussion. Or better yet call the doctor's office.

    These are the 2007 version guidelines, and there were some changes, but eliminating a chest x-ray for seminoma follow-up was not one of them.

    Best wishes.
    Right I/O 4/22/1988
    RPLND 6/20/1988
    Left I/O 9/17/2003

    Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.


    • #3
      You may also what to check out this journal article if you have access. If you don't have access, the authors will usually e-mail you a copy of the work if you ask them personally.

      Cancer. 2007 Apr 16;
      Evidence-based guidelines for following stage 1 seminoma.
      Martin JM, Panzarella T, Zwahlen DR, Chung P, Warde P.
      Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
      4/26/07 - mass confirmed w/ no elevated markers
      4/27/07 - left I/O
      5/2/07 - Dx: 100% seminoma stage 1A
      Surveillance: CT/blood (6 month cycle)
      4/27/13 - 6 years cancer free!