TC recurrence in other testicle after 3 years

[Apache]

I have come in contact with a young man who had a right I/O in 2003 and did not have chemo and went on surveillance. Now this summer he had some back pain and has been diagnosed with a recurrence in the left testicle, AFP =400, HCG = 13,000. All I know is that the original pathology from 2003 was mostly chloriocarcinoma.

For the recurrence, the doctors told him to do chemo and then see if the tumor shrinks and then maybe they can save the testicle. I do not know if it is only confined to the testicle but I would have trouble believing, with markers that high, that would be true.

Hey Fish and others, what do you think about this?

[Krokar]

I think it is important to say he has not "recurrence", but he has second TC. Recurrence would be if cancer would appear from first testicle which was removed 3 years ago.

[Fish]

I agree with Krokar, this sounds like a new primary case of TC. I would hope he goes for a second opinion. My personal opinion is that the testicle should come out if there is a tumor there, otherwise, they have no way of knowing what the pathology is.

When I found my second lump, I couldn't get the testicle out fast enough! My urologist was being cautious and even ran an MRI after the ultrasound just to be sure it was really a tumor, because it was very small when I found it. I kept telling him JUST TAKE IT OUT.

Also, if TC that is in the testicle could be treated successfully, why would any guy have one removed?

I think there are issues with the ability of chemo drugs to cross the "blood-testis" barrier. Maybe some of the folks who have had more experience with chemo can give you additional info on this.

Again, personally, there is no way I would leave the testicle in and try to treat it, to me it would not be worth the risk.

BTW, I always have difficulty explaining to the folks who do my CT scans that I had a second primary TC and not a recurrence.

[Apache]

ok thanks guys thanks for sharing your input. sorry about my terminology........oops! you are absolutely right. probably not a recurrence.

[petep]

apache,

when I visited with einhorn, he did mention to me that I should always monitor my remaining testicle - that was the undescended one brought down when I was 5 years old. He indicated I had an increased risk in that remaining one.

He did mention, I believe, that they have a procedure to remove the lump and not the whole testicle, if it was appropriate...perhaps a tiny mass....he said if I did get a new primary ever, to contact them...he went on to say that may alleviate the need for testosterone supplements etc.

I may have misunderstood him, but it would be worth getting a 2nd opinion.