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Hi everyone,
I need your help. Now that the pathology of my tumor was confirmed by a second opinion from Dr Peter Drew from Shands, I had two visits with oncologists this week - and two very different opinions. FYI, the pathology is Seminoma with Syncytial Trophoblastic Cells, which caused my HCG to elevate to 33 before surgery. About a week after surgery, it fell back to normal (<2). All other bloodwork was normal. CT Scans were all normal. The pathologist noted that the tumor was entirely contained within the testicular parenchyma (which I understand means no spread).
So here's the conflict:
My urologist, Robert Bradford, who admits he sees no more than 5 cases of TC per year, sent me to Radiation oncologist, Philip Sharp (who see's about the same amount). When I questioned Bradford about the RT, his answer was that RT was the standard treatment. When I saw Dr. Sharp, his only recommendation was RT, about 2000-2500 rads? over 20 visits.
Yesterday, I had a 2nd opinion consultation with Dr. Mayer Fishman, a Genito-Urinary Oncologist at Moffitt Clinic in Tampa. He told me there's a 95% chance I am already cured. He recommends Surveillance due to the size of the tumor, and no invasion or metastasis. Fishman also said the Syncytial Trophoblastic Cells would help identify a recurrence by the elevated HCG. He feels so confident of chemo, that if I do have a recurrence, it can be easily managed with what he described as a double dose of 4 rounds of EP. He truly described the recurrence as an "inconvenience".
At the end of the consult, I asked him about Sharp's recommendation of RT. He wouldn't discourage it - and even asked about the dosage - and said it was a "safe, low dose". I urged him to help me decide which way to go, and his response was "pick a path, either way, you're going to be fine".
Note: All three doctors talked about, and seemed to place significant weight on the NCCN guidelines - which seems to me like a "cookie cutter" type of treatment outline. Have any of you had similar experiences?
So now I've been put in a position of making my own decision, and even after all I've read - I am undecided. I am leaning toward Surveillance due to the size of the tumor alone. I am not convinced that in a recurrence, the HCG will be automatically elevated.
Please comment. Thanks! CW
I need your help. Now that the pathology of my tumor was confirmed by a second opinion from Dr Peter Drew from Shands, I had two visits with oncologists this week - and two very different opinions. FYI, the pathology is Seminoma with Syncytial Trophoblastic Cells, which caused my HCG to elevate to 33 before surgery. About a week after surgery, it fell back to normal (<2). All other bloodwork was normal. CT Scans were all normal. The pathologist noted that the tumor was entirely contained within the testicular parenchyma (which I understand means no spread).
So here's the conflict:
My urologist, Robert Bradford, who admits he sees no more than 5 cases of TC per year, sent me to Radiation oncologist, Philip Sharp (who see's about the same amount). When I questioned Bradford about the RT, his answer was that RT was the standard treatment. When I saw Dr. Sharp, his only recommendation was RT, about 2000-2500 rads? over 20 visits.
Yesterday, I had a 2nd opinion consultation with Dr. Mayer Fishman, a Genito-Urinary Oncologist at Moffitt Clinic in Tampa. He told me there's a 95% chance I am already cured. He recommends Surveillance due to the size of the tumor, and no invasion or metastasis. Fishman also said the Syncytial Trophoblastic Cells would help identify a recurrence by the elevated HCG. He feels so confident of chemo, that if I do have a recurrence, it can be easily managed with what he described as a double dose of 4 rounds of EP. He truly described the recurrence as an "inconvenience".
At the end of the consult, I asked him about Sharp's recommendation of RT. He wouldn't discourage it - and even asked about the dosage - and said it was a "safe, low dose". I urged him to help me decide which way to go, and his response was "pick a path, either way, you're going to be fine".
Note: All three doctors talked about, and seemed to place significant weight on the NCCN guidelines - which seems to me like a "cookie cutter" type of treatment outline. Have any of you had similar experiences?
So now I've been put in a position of making my own decision, and even after all I've read - I am undecided. I am leaning toward Surveillance due to the size of the tumor alone. I am not convinced that in a recurrence, the HCG will be automatically elevated.
Please comment. Thanks! CW
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