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Stage 1 non-seminoma surveillance v. chemo

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  • Stage 1 non-seminoma surveillance v. chemo

    I have just had a radical orchietomy. I was diagnosed with stage one embryonal cell carcinoma. My tumor markers before the surgery were normal. A CT scan before the surgery showed no invasion of the lymph nodes. The pathology report following the surgery said my margins were clear. There were some cancer cells found in the spermatic cord. The tumor was 2cm. I am 47 yrs old. I have been presented with the option of either surveillance or two rounds of BEP chemo treatment. I would appreciate your thoughts and experiences regard which way to go, or which way you have gone if in a similar circumstance.


  • #2
    I would have taken the surveillance, but there was no such option in my case.
    They may very well have removed everything with the I/O and you may not even need any further treatment. Chemo is your safety net, in case some cancer cells slipped by afterall.

    Stage IIa, non-seminoma (90% embryno / 10% teratoma); I/O 12/22/04, 3 x BEP, RPLND 05/12/05


    • #3
      Welcome, Jeffrey! In my opinion, you're better off going with surveillance, saving chemotherapy in case of recurrence. Be sure to read the section of the TCRC's chemotherapy page that begins "Some countries in Europe..."
      right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since

      Your donation funds Livestrong services for people facing cancer now. Please sponsor my ride!


      • #4
        I have about the same thing you have and I am watching and doing the monthly doctor visits. I had vascular showing so my chances are about 50-50 as to if it will show up again. The doctor told me if you are willing to do the monthly visits and the self exams then you can watch and wait. If not then he suggested chemo. All three of my doctors think surveillance is the right choice right now. The cure rate is about the same but you have the chance to not have to do chemo which is big since chemo isn't the best thing for the body.
        Both are good choices just depends if you want to play the waiting game and go to the doctor every month for blood test and xray then ct scan every 3 months or just do the chemo now.
        Good Luck
        5-1-2006 Right IO - Stage 1 Nonseminoma Embryonal and Yolk sac - Surveillance Baby on the way Born 7-20-07


        • #5
          I was in a similar situation with pure embryonal, no markers, but I did have vascular invasion. The docs tried talking me in to 2 cycles of BEP, but I insisted on surveillance. I guess you have the comfort of knowing that it is still very treatable, even if it does come you didn't have a lot to lose if you go the surveillance route if you can handle the anxiety.

          It come back for me and I am now in the middle of 3 x BEP. I guess the main trade off is you may end up getting 3 cycles if it returns, rather than 2.

          All the very best



          • #6
            I want to thank those of you who replied. Your thoughts and input are greatly appreciated. I have been leaning toward surviellance, and your words further incline me to that direction. Light to all of you, and all on this site.



            • #7
              I think surveillence is a reasonable choice -- just keep ALL your appointments. You can save the chemo in case there's a recurrence and your odds of a cure are the same no matter which you choose.

              Best of luck.
              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.


              • #8
                either option is ok. if you are someone that absolutely much take some action and undergo treatment for peace of mind, then probably 2xBEP. if not, just do the surveillance schedule (that's what I would do and did until recurrence but I had vascular invasion) but I echo the sentiments of others....stick to the schedule. good luck.
                Age 33, Right I/O Mar '05, 90% embryonal, 10% teratocarcinoma, Surv until 4 mo CT (+), 3 x BEP Aug/Sep '05, CT 10/05 ok, CT 2/06 ok, CT 3/06 ok, CT 6/06 ok, X-Ray, Blood 8/06 ok, Sperm Count 09/06: Low but active, CT 10/06 ok, X-ray 12/06 ok, CT 02/07 ok, X-ray/blood 4/07 ok, CT 6/07 ok, X-ray/blood 09/07, CT 10/07 ok, CT 4/08 ok, CT 10/08 ok

                LAST NIGHT I DREAMT 1000 LIES
                I CAN SEE THE DAWN


                • #9
                  see the attched link, and related link embedded...I was in the same situation as you...chose surveillance..

                  Coping with radiation, chemotherapy, RPLND, or surveillance: treatment issues, test results, surveillance reports. Talk about what's going on with you!
                  - lump first noticed 11/20/2005
                  - I/O right Dec 8, 2005
                  - 95% embryonal / 5% seminoma
                  - normal markers PRE surgery
                  - no vascular invasion, tunica free of cancer, epididymis free of cancer, lungs free, lymph free
                  - Stage I diagnosis
                  - surveillance
                  - mid feb '06, beta hcg slightly elevated = 4.6...small enlarged lower node seen on CT scan...
                  - 3BEP began feb 20, 2006
                  - finished 3 BEP, last bleo, april 17, 2006
                  - CT scan, blood markers, chest..all clear
                  - back on surveillance