new here, kind of unusual case

[bravnot]

i'm 28, was diagnosed in september of last year. had a classic stage 1 seminoma. after surgery blood and ct scans came back good. urologist said i could do close observation, so that's what i did. i've been good about all my appointments. during a physical with my general doc, he noticed some atypical moles. i've been through 4 punch biopsies and two excisions on one that showed possible stage 0 melanoma.

told the urologist all this, and he's said that maybe i should go ahead with the radiation to ease both our minds. i've done some reaidng on these boards, and have found some material talking about radiation vs chemo in stage 1 seminoma.

my question is has anyone been in this situation? i'm really not keen to a lot of the possible long term side effects of radiation. if i can feel better about long term even if it means i'll be worse in the short term with regards to chemo, i'd want to go that route.

i have an appointment with an oncologist tomorrow, but i'd like to go into these things as informed as a i can be.

thanks for reading.

edit: also, anyone who's had any melanoma issues after tc would be nice to talk to as well. i have AMS (atypical mole syndrome), which heightens probability of developing melanoma at some point. there have also been studies that show a link between tc and AMS, thereby a relationship between tc and melanoma. my huge worry was that i was hit by this stage 0 only 7 months after surgery. i know it's extremely rare for tc to metastisize to skin, but i'm going out of my head trying to figure out how to pull all this together.

[Mikey_Mike]

Hi,

I was in the same situation in March (06) I was diagnosed with stage 1 Seminoma, and was offered radio, chemo (single dose Carboplatin) or surveillance. I was told the chances of it returning was about 20% if I did nothing dropping to 4% if I had radiotherapy. I was told radiotherapy was falling out of favour now though due to an increased incidence of cancers due to the radiotherapy. Carboplatin so far has proved to have the same cure rate of radio but the long term effects probably aren't known as it's not been used so long in treating this type of cancer (although it has in others).

I chose the chemo.... couldn't do nothing, and although the chemo has most impact on my situation now (26, just married, no kids but sperm banked) the thought of getting a secondary cancer due to the treatment for this one didn't seem right. the chemo wasn't bad at all (although everyone is different), just a few days of reslessness and nausea.

hope his helps..

Mike.

[Karen]

A melanoma is not a metastesized seminoma. Two different cell types, no relation. What did your detmatologist say after the punch biopsies? Were the margins clean? Melanoma stage 0 is "in situ", the earliest stage, the cells are confined to the outer layer of the skin. Check out this site:

http://www.melanomacenter.org/index.html

Stage 0 (Melanoma in Situ) Treatment
Treatment involves generally outpatient surgery to remove the tumor and a limited surgical margin, a surrounding area of normal-appearing skin. When the tumor is removed with a surgical margin of 0.5 centimeters (less than 1/4"), the likelihood of local recurrence of the disease is extremely small.

My thoughts are you should set up regualr appts with a dermatologist and touch base with your oncologist. GPs are great for lots of things, as are urologists, but skin cancer is not a speciality for either. Let us know what your oncologist says.

[Mom]

The only thing I can associate between melanoma and TC is hormones. I have dysplastic nevus syndrome (in fact I have stitches in my foot right now from a biopsy). My first mole turned dysplastic when I was pregnant. Twenty-five years later, when I went on hormone replacement therapy, my freckles turned black and I had three moles change, almost overnight. The first thing the dermatologist asked was if I was taking estrogen. I had to stop taking it immediately. Moles show up during puberty, another sign that their growth is hormone related. So, I am certainly not an expert, but if you are prone to this syndrome and have TC, a fluctuation in hormones might be part of the problem. I have been told to "stay out of the sun" and quite frankly, where I have had these moles, they never saw the sun! I am not sure I would want to be radiated. Dianne

[TimsWife]

My husband was the same as Mikey Mike- he had stage I A Seminoma and chose to do 2 doses of Carboplatin. He completed his last dose about 6 weeks ago. Best of luck, decisions are tough!

[Fish]

I'm not sure what benefit radiation therapy (or chemo) would provide 9 months into your surveillence if you have no evidence of recurrence. I think getting a second opinion from the oncologist is a very good idea. Also was the link between TC and AMS found in patients who had already received radiation/chemo, or in patients who recieved no treatment or both groups? With these types of studies, it is often difficult to eliminate unrelated confounding factors (eg: amount of sun exposure, family history, etc.) from the data analysis, so I generally read them with a healthy dose of skepticism. Also, Mom makes a good point about the possible interactions of hormones.

Best wishes -- let us know what the oncologist tells you.

[Scott]

I wouldn't let precancerous moles change the treatment decisions you made for your testicular cancer. I'd keep going with surveillance.