salvage chemo/ tandem stem cell transplant

[cellblock]

Has Anyone Had A Stem Cell Transplant?

My Boyfriend Has To Have A Tandem One In The Middle Of February.
He Was Diagnosed W/ Testitcular Cancer 6/2005, Had Orchiectomy, Tumor Markers Were Still Elevated, Had 3xbep, Tumor Markers Still Elevated, Has Gone Through 2 Rounds Of Vip, There Not Sure If He Has To Have The 3rd Rd Of Vip Or Just Go Straight To High Dose Therapy And Have A Stem Cell Transplant After That And Then Another One The End Of March. He Is Going Through Apherisis Right Now Where They Take The Stem Cells And Freeze Them For The Transplant. He Did Have A 3" Mass In His Abdomen After The Bep, But So Far It Has Been Shrinking.

He Is 31 Years Old And Has 80% Embryonal And 20% Yolk Sac.


Has Anyone Gone Through A Transplant? If So, Please Write Me So I Can Get Some Advice Of What To Expect.

Thank You!

Jennifer In Arizona

[jdunn]

Hi Jennifer in AZ,
First of all, welcome to this forum. Although I can't answer your questions I just wanted to say hello and I'm sure you will get responses from other members here who will be able to help you. I'm sorry that your boyfriend is going through a tough time right now. Life will get better I promise. My son is a tc cancer survivor. Take care
Jane Dunn in AZ too.

[cellblock]

Thanks Jane! How often does your son go back to have his blood markers checked/ pet scans?

[Jens]

Hi Jennifer.
I'm sure you know that your boyfriends situation is very serious.
High dose chemotherapy with stem cell transplant is a very aggressive therapy that only a few TC patients need to go through, but those who do have a very good chance of getting cured.
I haven't had it but it's well described in the litterature.
It will render the body in a weakened state, it's my understanding that the side effects are like the "normal chemo" ones, just somewhat worse. That really means that it will be a very though time to get through - you boyfriend will become quite sick - but it will pass and you get to receive your reward for taking care of him.
The professional staff around him will do their medical job, you have to deal with the emotional side. Know that we are here to help.
And tell cellblock to be strong.
Hang in there and keep us posted.

Best wishes
Jens

[Kman99]

Jennifer..

I haven't had a transplant either, but thought I'd post a few websites with info on recurrent cancers found on the internet. You may have already done this, but I hope it's helpful in some way.

Can I ask where he is being treated?

I'm very sorry for what your boyfriend and you are going through!

http://www.cancer.gov/clinicaltrials/findtrials

http://patient.cancerconsultants.com/

Q. What are the complications from these high dose treatments?
A. Primarily, low blood counts, which may lead to anemia, bleeding, and infection. Transfusion of blood and blood components, such as platelets, are usually successful in treating anemia and bleeding. Infection, even with the most appropriate antibiotics, can be difficult to treat. Given these complications, it is very important to shorten the period of low blood counts, which regularly follows high-dose chemotherapy. There is also the risk of other organ damage to the liver, lungs or kidneys. (Stem cell transplantation is a way to help recover from these complications.)

Q. Does the stem cell transplant protect patients from these complications?
A. No, not entirely. Until the transplanted blood stem cells start producing new blood cells, usually 10-14 days, patients have low blood counts and are at risk for these complications.

Q. What are the side effects of transplantation?
A. Some patients experience mild nausea and/or vomiting. Other side effects may include cough, shortness of breath, flushing, and stomach cramps.

[cellblock]

thanks for the info. He was being treated in northern az, now he is being treated at the the Mayo Clinic in scottsdale, az, they're supposed to be one of the best.
He goes for a pet scan tomorrow, then we meet w/ the transplant dr wed, and the following week he will most likely start the high dose chemo/ transplant. then another transplant sometime the end of march.

His Dr originally did not do scans nor blood work in between the 3x bep rounds. I assumed it was because they did nlt give accurate readings. however, I have found that is not the case. THe Mayo seems to be on top of it as far as that is concerned.

[Shory]

Cellblock, How elevated are his markers, which one afp or b-hcg?

How much has the abdomen tumor shrink? is there any possibility that perhaps his tumor is full of fluid? I tell you this, because if it is, there might be a chance that the fluid inside the mass is leaking out and elevating markers.

Let us know.

[cellblock]

his afp and ldh are both normal, after the 1st round of chemo 3x bep, the hcg was 419, which should be 0, by the time he started the vip chemo, the hcg was 5000, now after the fist cycle of vip hcg is 519, he just had another pet scan and blood test today, we'll get the results wed. after the 1st cycle of chemo 3xbep he had a 3" mass in the abdomen, after the 1st cycle of vip, the dr said it had shrunk quite a bit, and there was a cyst there also, and it looked like mainly necrotic tissue which is good. as to how much more I'll know later in the week. the fact that it is shrinking though is good, because his dr originally said his tumor was chemo resistant. thanks for the input, I'll let you know more after we go down wed to get the results.

[Shory]

Alright if he has a cyst, then that is something that the doctor should think of before doing a Stem Cell Transplant. If the mass that he has is mainly a Cyst, then there is high possibility that the elevation of this markers are a false positive, this is because the liquid inside the cyst which is charged of B-HCG or AFP and that is leaking to the plasma is elevating markers.

Please print these articles and give them to your doctor:

http://www.ncbi.nlm.nih.gov/entrez/...st_uids=1706441

http://www.ncbi.nlm.nih.gov/entrez/...t_uids=14665869

http://www.ncbi.nlm.nih.gov/entrez/...t_uids=15316321

The right approach should be then, taking the cyst out with an RPLND and then wait and see if the markers go down. I had 4 cycles of TIP with out probably needing them, before the salvage chemo my markers when up to 800 and then after the mass came out the markers normalized until today!!!

Good Luck!

[Shory]

If the links I gave you don´t send you anywhere try looking at this post where I also mention them.

http://www.tc-cancer.com/forum/showthread.php?t=1775

Again Good Luck!

[Javier Rodrigue]

whats up with the pet?

did you the pet? show activity in the node? when you have results let us know....
still fighting...

[cellblock]

yes, we got the results the b-hcg is down to 176 which is the lowest it has ever been, and the mass in the abdomen is still shrinking. The outer layer of the mass still lights up on the pet scand but the inside is necrotic tissue. they are going to forgo the last cycle of vip and go straight to the high dose chemo for 5 days and then stem cell transplant, he goes in next wed, feb 15th. the Dr said he sill be in the hospital 12-14 days after the transplant and then will have to go for blood work everyday afterwards for a couple of weeks. Once his blood counts are relatively normal within a month he repeats the transplant. the first time he had the bepx3 the bhcg at the end of cycle 3 was 418. So I think it is good news.

[Scott]

I'm glad to hear the treatment is working well and wish you both the best during this stressful time. Here's to better days ahead!

[kollerjones]

kollerjones

My husband is in the middle of a tandem stem cell transplant - meaning the second of two. He made it through the first one pretty well. Only one day of puking and about the same level of tiredness as he had with prior treatments. No infections or illnesses in the 5 weeks inbetween - biggest concern because of compromised immune system.

He had the typical chemo round (BEP) immediately following the oriechtomy about 2 1/2 years ago. He was stage III nonseminoma. Cancer recurred six weeks following BEP treatments and he had 12 more weeks of TIP therapy. About six weeks after TIP he had an RPLND to remove remaining tumors. Most of what they took out was teratoma. 12 inches of his vena cava was replaced (bypass) at the same time because he had tumors growing up the inside of the vein into his heart! (isn't that weird) He was clean for just over two years when it came back October 05. Tumors left in his lungs (thought too risky to remove - about an inch from heart in center of lung) originally thought to be teratoma doubled in size - as well as some new spots on his lungs. He had the first stem cell transplant Jan/Feb 06. Just dropped him off for the second one yesterday. He's being treated at the Cleveland Clinic.

Based on the history you described with your boyfriend, he is not totally refractive but does have a resistance to chemo. In my husband's case, the tumors would shrink and even sometimes go away (at least to the eye) and then come back or grow new ones. While the stem cell transplant process is no picnic, the process was not nearly as intimidating as we originally thought. He honestly tolerated it very well. Second one promises to be worse though - at least that's what they tell us. My husband remained only partially responsive to the first transplant. Two tumors shrunk, but the two biggest ones remained the same size and density. They said he will likely need to consider surgery to remove anything that's left. Again - if the Cleveland Clinic physicians think they can risk it.

My husband had a collapsed lung from one of the tumors on the outside of the lung bursting (required lung surgery to remove the damaged portion), and has developed mild emphysema from the BEP treatments. On top of that, he has a parkinsonism. (meaning Parkinson's sypmtoms but they are not sure its Parkinson's) There is a lot on the web to read. Keep your self informed. While information can be sobering, there is still hope.

I tried to get everything in there. Let me know if you have any questions. He's started the High Dose Chemo today. Gets the transplant Monday or Tuesday. He's 39. I'm at home with the kids (ages 2 and 5) and about 2 hours away from the clinic. I talk to him daily. We visit on weekends. I work full time. My hubby has pretty much been off work since this all started.

Sorry to be brief but the kids are in the tub!

Best to you and your boyfriend!

[Scott]

Wow, kollerjones, your husband been through -- is still going through -- the ringer! I know this has to be hard on you and your kids, too.

I'm glad you're here and wish you the best of luck. Your attitude is great!