Full Report

[Alucard]

Hi,

I don't have a lot of experience on this so I'll post here what my reports said before surgery to compare with the ones I'll have in 3 days. I think I need some help "translating" these things.. and if any of you want to know anything about my case I'll answer your questions

CHEST + ABDOMEN CT

Chest CT Scan:

With I.V.dynamic contrast.
Multiple bilateral different sizes pulmonary nodules scattered in both lung fields, one of them is located adjacent to the superior vena cava and appears lobulated.
The largest one is located in the subpleural region of the right lower lobe.
Most of them show hypodense center.
No hilar or other mediastinal mass lession is seen.
Features represent pulmonary metastases from known primary.

Abdomen CT Scan:

The examination is performed with oral and I.V. dynamic contrast, the liver is also scanned without I.V. contrast.
The liver and spleen appear enlarged, but without evidence of focal lesion.
No definite intra-abdominal lymph node enlargement is seen.
Both kidneys and pancreas appear nornmal.
No ascites is seen.

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Blood test:

Alpha-Fetoprotein Protein: 23.23
HCG - Serum: 111280

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Ultrasound report:

Testicular U/S:

The right testicle: Almost replaced by a huge mixed echogenic masss associated with central necrosis appearances most likely inkeeping with malignant lesion.
The left testicle: Appears morphologically normal, no cystic or solid is seen, normal echogenicity.

-No significant hydrocele is demonstrated.

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Chest X-Ray:

Heart size is normal.
Multiple cannon-ball metastases in both lungs are seen. (how did they know they were metastases if they didn't know about TC?).

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That's about it.. all those tests were done before the orchiectomy..I'll keep updating this thread when I get new reports.

-Al

[dadmo]

Al:
Good job getting that report. I'm not one of this sites experts on reading reports so I won't say much other then it looks like your treatment protocol is correct. Do you know what the original tumor was composed of? It should be in one of your reports, the reason I'm asking is with the amount of lung involvment you have I'm surprised (good thing) that the nodes aren't affected. My guess is you had mostly Embryonal Carcinoma.
I don't know if you ever read Armstrongs book but he had golf ball size tumors in his lungs (no node involvement either) and his treatment took care of it so there is no reason to suspect that you shouldn't be cured too. Good Luck.

[Scott]

I agree with dadmo. Your report says in essence that you had a large testicular tumor and obvious spread to the lungs, apparently skipping the retroperitoneal lymph nodes. Your orchiectomy and chemotherapy should cure you.

Did you have specific questions about something in the report?

[Alucard]

Hi,

No definite intra-abdominal lymph node enlargement is seen.

But there could be, right?

Plus I'm not sure if this is normal but I have a headache that started 5 days ago and won't go away.. I don't know if I'm allowed to take any medication.. I think I'm going to the centre now.

I just came out of the shower and a lot of my hair is falling, I mean a LOT.. I started chemo 3 weeks ago (4/4/2006) and it just started.. this is ok right?

[Alucard]

By the way I'll have 4xBEP and not 3 as I said before.

[Scott]

There could be, but if there is, the chemotherapy will take care of it.

[Alucard]

Okay, last one: Will I need RPLND? I've reading about it and I'm kind of terrified.

-Al

[Scott]

I'd be surprised if you do, with no apparent retroperitoneal lymph node metastasis. Was there any teratoma in your pathology report?

[Alucard]

Um, no, I don't think so. I listed all my reports here.

I don't know a lot of people here and the doctors don't say much so I'm kind of lost.. I'll try to get more info on tuesday.

Thanks,

-Al

[Jens]

Hi Al.

I'm sorry you fell somewhat lost towards you condition.
But don't worry! We will get you through this!!!

Necrosis in the tumor and spreading directly to the lungs is consistet with Embryonal carcinoma (EC), as Dadmo said.
EC is an aggressive form - which is why it's so sensitive to chemo!

4 x BEP is standard treatment for a condition like yours - and it will cure you! Allthoug I only needed 3 series (because it was in my belly and not in the lungs) it's still the same mix.
And it cured me, along with so many others, as will it cure YOU!

Hair loss after 3 weeks is normal. Shave it all of now. It will come back in a couple of month - very soft and curly.

Headaches, nausia etc. is normal. Make sure you get enough anti-nausia medication. Zofran, prednisolon, vogalene, etc...
Paracetamol is good for headaches. You should be fine taking what you need.

Hang in there buddy!

Best wishes
Jens

[Alucard]

Jens,

Thanks a lot for the info, it's very appreciated. I'm glad you got though it and now I don't feel so terribly lost as before. I'll ask my doctor about everything this tuesday.

-Al

[Alucard]

Bleh, they delayed my bleomycin again. I'll try again this tuesday.

[Scott]

While a few days are probably OK, the TCRC's chemotherapy page notes that delays shouldn't be necessary. See the section about 3/4 of the way down that begins with the bullet "Delays During Chemotherapy."

[Davie]

I can only give you the benefit of what my consultant told me before the start of chemotherapy.

He said that very little would delay any chemotherapy treatment. When I went into to have my bleomycin shot last week, my white count was very low to the point where I could easily catch an infection, and should I catch an infection I may have difficulty fighthing it.

I was told bleomycin does not effect the white count and continued as normal. They prescribed me antibiotics to take as a precautionary measure.

There was a guy on my ward who developed pneumonia frm the bleomycin and after intensive IV antibiotics resumed his schedule a few days later.

This is the only experience of my hospital, but it appreas to take a hell of a lot to happen before any chemotherapy is delayed.

Davie

[Alucard]

I can only give you the benefit of what my consultant told me before the start of chemotherapy.

He said that very little would delay any chemotherapy treatment. When I went into to have my bleomycin shot last week, my white count was very low to the point where I could easily catch an infection, and should I catch an infection I may have difficulty fighthing it.

I was told bleomycin does not effect the white count and continued as normal. They prescribed me antibiotics to take as a precautionary measure.

There was a guy on my ward who developed pneumonia frm the bleomycin and after intensive IV antibiotics resumed his schedule a few days later.

This is the only experience of my hospital, but it appreas to take a hell of a lot to happen before any chemotherapy is delayed.

Davie

I'll talk to my doctor this tuesday to understand why is he doing this.

By the way I got the output of my blood samples today (CBC), here:

11/04/2006
(I had bleomycin this day)

WBC: 5.2
RBC: 5.1
Hb: 14.1
PCV: 41
MCV: 79
MCH: 28
MCHC: 35
Platelets: 489
Neutrophilis: 70
Lymphocytes: 25
Monocytes: 5


18/4/2006

WBC: 2.0
RBC: 4.46
Hb: 12.3
PCV: 34.8
MCV: 78.2
MCH: 27.5
MCHC: 35.2
Platelets: 350
Neutrophilis: 40
Lymphocytes: 45
Monocytes: 15
I can't find the last report right now but I'll post it here as soon as I find it.

By the way I met someone today who saw my exams and said I have anemia but not much (I think.. couldn't understand the language).

That's about it,

-Al