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Surveillance with pT2 tumor?

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  • Surveillance with pT2 tumor?

    Hello everyone! This is my first "real" post (I've already introduced myself in the Ballroom) ... I had my I/O 15 days ago now and I'm having my first meeting with the radiologist tomorrow, 8/17.

    I had a pT2 tumor (due to vascular invasion) and of course the recommended treatment is going to be radiation. However, I'm just trying to play devil's advocate and starting to test the waters to see if there are any noted cases of surveillance being recommended despite the presence of vascular invasion. My main concern is that I've already had skin cancer in the past (morpheaform basal cell carcinoma) and wonder if I'm at any greater skin cancer risk due to the radiation.

    I also wanted to bring up something that stood out when I read it: In reading the Lance Armstrong Story on the American Cancer Society's website, it mentioned that despite his advanced condition, he did not have radiation therapy "because of the concern that it also would affect his balance or coordination." Well, as a career musician, I can safely say that I would like to retain my balance and especially my coordination. Are they implying that radiation can permanently (or otherwise) affect balance and coordination? Any clarification would be very, very appreciated ...

    Have a wonderful day -- !
    Right I/O 8/1/06
    Stage I Seminoma -pT2 (Size 4.2 x 3 x 3 cm) w/vascular invasion
    Adjuvant Therapy: RT 9/18/06 - 10/5/06
    All Clear #1: 5/15/07
    New CD available on CD Baby and iTunes! (Visit for more info)

  • #2

    Welcome to the site and I look forward to hearing some of your music.

    It seems we may have a little in common. We're both 35, we both have TC and we both love music. I'm a little further along in my TC process and things are looking up.

    Radiation wasn't an option for me (non-seminomas don't respond to it) so I just finished about 3 months of chemo.

    Good luck with your treatments (if any) and the music!

    TC diagnosed 4/3/06, AFP@3300; Left I/O 4/10/06; Stage IIa Non-Seminoma, 100% Yolk Sac; Started 4xEP 5/22/06 with AFP@135; Finshed 4xEP 8/11, AFP normal, CT scans clear! Now on surveillance


    • #3
      Quantum - -

      Yours is similar to mine - pT2 due to vascular invasion and 4.2 cm. Surveillence was presented as an alternative along with single dose chemo. The odds of a reoccurence seemed a little more than I felt I could comfortably deal with without being a worrywart over every little ache and pain. It seemed there was not enough data yet on the single dose, so I chose the RT. You'll have to do your own homework and make your own choice, but I think they are all reasonable. If you choose surveillence, you'll have to do more frequent followups including CT's - which gives you quite a bit of radiation over time too - and you need to evaluate whether you will indeed keep current on your followups and have the emotional state to deal with those kind of odds (I was told close to 30% reoccurence rate for pT2, but others have quoted it closer to 20%). And if there is a reoccurence it is quite treatable, usually by RT or chemo.

      I finished my RT about 2-1/2 months ago. It was not too bad. Inconvenient to have it every day, and I was tired and a bit queasy the entire time, but functioned close to normal. Took a few weeks to feel close to normal after it ended. I don't think I have any lasting physical effects - certainly nothing relating to balance or coordination.

      I am not sure exactly what kind of TC Lance Armstrong had, but it is publicized as the most aggressive form - which means it is not seminoma. Seminoma is very responsive to RT, while the other forms are not - so RT is not used for those. So, I am not sure if the LAF article is exactly accurate, but it makes for good reading I guess.

      You might ask your radiation oncologist about the concern about skin cancer. I am very fair and have had pre-cancerous spots removed (grew up in California before we knew about sunsceen) and have lots of moles and spots on torso, and when I asked about that issue I was told the benefit outweighed any risk - that it looked like the RT pattern I would be exposed to would miss all but one of the spots on my torso we are watching - but at the same time be sure to mention it to your dermatologist next time you see him.

      Lots to consider, but the good news is you are on the road to being cured.

      Here is a link to treatment and followup protocol that I have found very useful:

      Last edited by Sans rt1; 08-16-06, 06:17 PM. Reason: wanted to add a link to a useful reference
      Right I/O 4/17/06, Seminoma Stage Ib
      RT (15 days) completed 6/1/06
      All clear as of 5/8/09


      • #4
        The best thing you can do is write down all of your questions so you don't forget any and take someone with you to the visit. My first visit with the onc was about 3 hours give or take a few minutes. They go over a lot of information as to your options. Make sure to click on the at the top left of the page there are many links that have questions to ask the doctor.
        Others will post soon too.
        here is the link
        5-1-2006 Right IO - Stage 1 Nonseminoma Embryonal and Yolk sac - Surveillance Baby on the way Born 7-20-07


        • #5
          I believe the balance or coordination concerns with Lance came into play when they had to consider radiation on the tumors in his brain. The RT that you may be subjected to should not cause those problems.
          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.