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Diagnosis; Embryonal Carcinoma, now what?

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  • #1

    Diagnosis; Embryonal Carcinoma, now what?

    Well, it has taken a while after my IO (seems like forever) however i now have my pathology report back.

    Embryonal Carcinoma: as well there was a name Carritoma (SP) which I can't find anything on. Anyone heard of this?

    My markers pre-surgery 5/23/06;
    HCG 451
    ASP 863

    these to me seem really low comparitevly. so My question while I wait to hear about when I can get in is this. Anyone else gone/going through this with similar levels? Any recomendations as to how this could progress? RPLND then chemo? visa versa? Is there a chance to survey this for a while with such low markers?

    I am in the Atlanta area and next steps are to see Dr. Jeff Carney at Emory. Anyone else have a possible better recommendation in the Atlanta area. Should I be looking outside Atlanta as well?

    Of course I am wanting to hear from others to help put my mind at ease and btw thank you all for such a wonderful and supportive community!

    peace and love,
    ken;
    Diagnosed 5/5/2006
    RT IO 5/26/2006
    Pathologic report 6/12/2006;
    90% Teratoma / 10% Embryonal Carcinoma / 2% yolk sac
    Pre surgery levels; ASP/HCG 863/451
    6/26/2006; ASP/HCG 17/1
    7/27/2006; ASP/HCG 5/<1
    8/17/2006 Modified rt RPLND 26 nodes removed
    8/22/2006 26 nodes reported cancer free

    click to follow my personal TC blog entries
    Tags: None
  • #2
    ken:
    If the scans show spread it will be chemo for you. Embryonal can skip the nodes and go right to the lungs so an RPLND first may not be a cure. Let's hope your markers normalize and you can avoid any treatment other then surviellance.
    Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

    Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

    Comment

    • #3
      Thank you dadmo,

      If by scans you are talking of the CT scans. They did a set pre surgery along with chest xrays and nothing showed up. I went through a CT with and without contrast. As well on my RT IO it appeared to be confined inside the testicle with nothing showing up in the cord, at least that was the urologists assesment post surgery.

      ken;
      Diagnosed 5/5/2006
      RT IO 5/26/2006
      Pathologic report 6/12/2006;
      90% Teratoma / 10% Embryonal Carcinoma / 2% yolk sac
      Pre surgery levels; ASP/HCG 863/451
      6/26/2006; ASP/HCG 17/1
      7/27/2006; ASP/HCG 5/<1
      8/17/2006 Modified rt RPLND 26 nodes removed
      8/22/2006 26 nodes reported cancer free

      click to follow my personal TC blog entries

      Comment

      • #4
        Well, then you have a great chance of the doc wanting to put you on close surveillance. You may be done with treatment. Holy cow wouldn't that be nice.
        Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

        Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

        Comment

        • #5
          I can selfishly say though I haven't gone through what others have here, I would love to get a bit of good news during this! And now I wait a bit longer i'm sure...

          ken;
          Diagnosed 5/5/2006
          RT IO 5/26/2006
          Pathologic report 6/12/2006;
          90% Teratoma / 10% Embryonal Carcinoma / 2% yolk sac
          Pre surgery levels; ASP/HCG 863/451
          6/26/2006; ASP/HCG 17/1
          7/27/2006; ASP/HCG 5/<1
          8/17/2006 Modified rt RPLND 26 nodes removed
          8/22/2006 26 nodes reported cancer free

          click to follow my personal TC blog entries

          Comment

          • #6
            Ken:
            This is the time to be selfish. In this you do come first. Don't ever feel guilty about wishing good for yourself.
            Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

            Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

            Comment

            • #7
              Ken,

              Did your pathology report mention if there was any vascular or lymphatic invasion by the tumor? Also,what was the percentage of E/C in your tumor?
              This info, along with your post I/O markers ,will help "steer" you into the next step of your treatment. As Dadmo mentioned, it MAY just end up being surviellance !

              Best Wishes
              Dec/04-Right I/O-nonseminoma (95%E/C),Stage 1, surveillance
              Nov/05- 2.2 cm lymph node= Stage II A
              Nov/05 -Jan/06-3 x BEP
              Jan/06 -Surveillance



              ___________________________________________

              Comment

              • #8
                carritoma = teratoma?

                my only comment is that your marker levels seem a bit high for everything to be confined to the testicle. may want to double check them?
                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
                THROUGH A DIFFERENT SET OF EYES

                Comment

                • #9
                  Originally posted by mikeygti
                  Ken,

                  Did your pathology report mention if there was any vascular or lymphatic invasion by the tumor? Also,what was the percentage of E/C in your tumor?
                  This info, along with your post I/O markers ,will help "steer" you into the next step of your treatment. As Dadmo mentioned, it MAY just end up being surviellance !

                  Best Wishes
                  Good question! I only got the name from the nurse there since it was a phone call. I have yet to sit down and go over it yet. hopefully today or tomorrow.

                  ken;
                  Diagnosed 5/5/2006
                  RT IO 5/26/2006
                  Pathologic report 6/12/2006;
                  90% Teratoma / 10% Embryonal Carcinoma / 2% yolk sac
                  Pre surgery levels; ASP/HCG 863/451
                  6/26/2006; ASP/HCG 17/1
                  7/27/2006; ASP/HCG 5/<1
                  8/17/2006 Modified rt RPLND 26 nodes removed
                  8/22/2006 26 nodes reported cancer free

                  click to follow my personal TC blog entries

                  Comment

                  • #10
                    Originally posted by Apache
                    carritoma = teratoma?
                    You got me, I have a call in to the nurse again to find out the spelling as well as some of the other questions posed here. I unfortunately do not have the answers handy. I am also going to ask for a copy
                    Originally posted by Apache
                    my only comment is that your marker levels seem a bit high for everything to be confined to the testicle. may want to double check them?
                    thanks for the insight, those were the numbers read to me and it was urologist that handled the IO. perhaps he was mistaken in his observation, doctors never make a mistake right? All in jest.

                    thanks again,
                    ken;
                    Diagnosed 5/5/2006
                    RT IO 5/26/2006
                    Pathologic report 6/12/2006;
                    90% Teratoma / 10% Embryonal Carcinoma / 2% yolk sac
                    Pre surgery levels; ASP/HCG 863/451
                    6/26/2006; ASP/HCG 17/1
                    7/27/2006; ASP/HCG 5/<1
                    8/17/2006 Modified rt RPLND 26 nodes removed
                    8/22/2006 26 nodes reported cancer free

                    click to follow my personal TC blog entries

                    Comment

                    • #11
                      let us know if we can help.

                      ~A
                      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
                      THROUGH A DIFFERENT SET OF EYES

                      Comment

                      • #12
                        Originally posted by Apache
                        carritoma = teratoma?
                        Teratoma is the word of the day!

                        I got a fax of the diagnositic report and it is;

                        90% Teratoma
                        10% Embrional Carcinoma
                        along w/ scattered syncytiotrophoblastic(WOW what a word!) giant cells.
                        Spermatic cord margin is negative for tumor.
                        Intratubular germ cell neoplasia (ITGCN) is identified (I have no idea what this is supposed to mean)

                        there is a note on the ITGCN that reads;
                        There is a small detatched fragment of teratoma on slide 3. It is difficult to determine if this is a contaminant or extension of the tumor into the cord. Correlation with gross specimen, additional sections from the cord, and where this section was submitted may help to resolve the issue.

                        gotta love that one! At any rate there is what I have to go on so far. I'll do some more digging to see what the %'s mean in relation to the treatment path. If anyone has any insight I would love to hear it!

                        peace and love,
                        ken;
                        Diagnosed 5/5/2006
                        RT IO 5/26/2006
                        Pathologic report 6/12/2006;
                        90% Teratoma / 10% Embryonal Carcinoma / 2% yolk sac
                        Pre surgery levels; ASP/HCG 863/451
                        6/26/2006; ASP/HCG 17/1
                        7/27/2006; ASP/HCG 5/<1
                        8/17/2006 Modified rt RPLND 26 nodes removed
                        8/22/2006 26 nodes reported cancer free

                        click to follow my personal TC blog entries

                        Comment

                        • #13
                          Originally posted by Apache
                          ...
                          my only comment is that your marker levels seem a bit high for everything to be confined to the testicle. may want to double check them?
                          Those levels seem high to me also. My HCG never went over 90, and I wound up with Stage IIa (see below). Mine was 100% EC (see below), so it might be different.

                          What are you markers now? HGC should be back to normal (less than 5) by now if there is no more cancer in your body. If it is over 5 now, there might be something hiding somewhere. I would suspect if the numbers were still high, they would have you do chemo just in case.
                          ________
                          Buy Silversurfer Vaporizer
                          Last edited by BeachTech; 08-11-11, 11:20 PM.
                          BeachTech
                          Diagnosis
                          Diagnosed May 2005
                          Stage IIa
                          Pure Embryonic Carcinoma
                          One 2.0cm tumor in testicle
                          One 1.0cm tumor in lymph node

                          Treatment
                          Radical orchiectomy
                          Two cycles of BEP
                          Two cycles of EP (the Bleo was causing lung issues)

                          Complications
                          Pulmonary Embolism (Almost died)
                          Extremely low red blood count (Required 4 blood transfusion)

                          Status
                          In remission since August 2005
                          July 2011-tumor markers clean!

                          Favorite Question
                          "Which testicle did they remove?"

                          Comment

                          • #14
                            doctor recomendation in Atlanta

                            We are in Atlanta area and my husband was diagnosed with TC in October of last year. He sees Dr. Wayne Harris at Emory. He has been great and my husband has been very happy with his treatment he has recieved. Feel free to e-mail me with any questions about him.

                            Erin
                            Erin (caregiver)
                            Hubby Stage IIIC Diagnosed 10/27/05,
                            HCG 512,000 AFP 636 LDH 1012, I&O 10/28/05
                            1 x EP, 2 x VIP, then 2 x BEP (10/31/05-1/06)
                            Sterotactic Radiation to two brain tumors 12/05
                            Sterotactic Radiation to new brain tumor 4/4/06
                            Whole brain radiation 4/15 -5/18/06
                            Tandem High dose chemo and stem cell 6/5/06-7/31/06 - markers normalized
                            RPLND with 9cm x 24 cm abd mass removal 9/14/06 - Only teratoma and necrotic tissue removed
                            Currently on surveillance

                            Comment

                            • #15
                              Ken, keep piecing all the facts together. Once you get those marker test levels back, then I would suggest seeing at least two qualified experts and discuss your options - which are always numerous.

                              HYPOTHETICALLY:

                              If the pathology is as such and the markers were as high as they were, I would be inclined to take some action. Given the pathology, an RPLND maybe the wise choice with close surveillance thereafter, chemo if the embryonal component jumps to the lungs. RPLND's post-chemo are always a bit more tricky due to scar tissues etc. I thought long and hard about the RPLND and if I would have did it, it might have saved me from chemo Rx (my recurrence was in the para-aortic lymph node).

                              anyway, I'll keep reading your story and if I can shed any light, I'll put in my thoughts.
                              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
                              THROUGH A DIFFERENT SET OF EYES

                              Comment

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