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Seminoma, radiotherapy and markers - help

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  • Seminoma, radiotherapy and markers - help

    left i/o June 2nd seminoma, scans clear, just started radio on mid abdomen
    AFP and HCG normal (- as expected in pure seminoma??)

    No other markers were tested for at any time.
    Am I right in thinking that HCG-beta and possibly PLAP (if available) would be useful? No marker baseline exists on which to judge the effects of my radiotherapy - is this normal? Anyone have any advice here?
    I do have other blood test results (not markers) but none of these have been explained to me at any time as the doctors, although committed, are massively overworked and the concept of explaining anything to patients is unheard of in the country where I am being treated. There is no option of a second opinion, and querying anything could result in delays to treatment due to a doctor feeling "peeved". I tentatively raised the issue of markers with a consultant radiologist and he told me to get stuffed.
    Eastern Europe by the way - at least it's all free of charge ...

  • #2
    Your confusion is understandable, as I have struggled with the whole marker issue too. My doctor (urologist) really played up the whole clear bloodwork as huge good news, but that was pre-surgery and we did not know it was seminoma - so I think it was good news because it indicated my tumor was most likely seminoma - meaning it very treatable and less aggressive than most. But going forward, since most seminoma patients do not show blood markers, it really does not mean a whole lot. What is important is to go through your treatment and then a reasonable long-term follow-up plan to check for any future reoccurrence.

    Yesterday in the TC Survivorship Discussion, in a thread titled First Checkup, a link was shared that had some good information (Thanks Karen!) on testicular cancer and specifically on current recommended follow-up for seminoma treated with RT.

    I found it extremely helpful as I plan my first follow-up and discussions with my oncologist about long term followup. Hopefully it has some information that will be helpful to you as well. Good luck.
    Right I/O 4/17/06, Seminoma Stage Ib
    RT (15 days) completed 6/1/06
    All clear as of 5/8/09


    • #3
      Follow-up questions

      Thanks for the information!
      I don't know what stage I've been put at.
      On my marker results (thrust into my wife's hands in a corridor by a passing doctor in a 30 second conversation) only "AFP" and "hCG" appear. I assume "hCG" couldn't possibly mean "beta-hCG" ... or could it??
      Did you have AFP, beta-hCG and LDH tests done on you? And were any other markers tested for? Were these done before and after radiotherapy? (As I had AFP and hCG before and after surgery.)
      Sorry for the battery of questions here, but I've been left completely in the dark, and nothing has been explained to me. I also got given blood test results without explanantion - utterly meaningless to me.
      At least the speed of treatment here is fast (and free of charge) - the first visit to the doctors (who would have been unable to detect TC without ultrasound) was followed by i/o within 30 hours.
      One more thing - in RT I saw mention of "Gy" as a measurement of radiation dose. How does this relate to "rads"? My full dose in 12 fractions is 200 rads - I asked a friendly looking clinical assistant.
      How does this compare with your (others') experience of prophylactic treatment? I must admit I was happy/relieved they were zapping me just below my breastbone and no lower - I understand this is to minimize organ damage and enable later RT in that area for any secondary/new cancers.


      • #4
        According to the Health Physics Society

        "1 gray = 1 Joule/kilogram = 100 rad"

        200 rad seems low, the NCCN guidelines (
        recommend 20-30Gy total dose, that would be 2000-3000 rad. Perhaps they meant 200 rad per visit which would give 2400 rad or 24 Gy which is right in the range.

        Best wishes.
        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.