Between two choices

[warev]

I have been hanging around the forum since beginning of the month. First week of August had pain in my left testicle - went to my General Practioner(Wednesday) , thought it was an infection, but also wanted an ultra sound on Thursday. Friday he called me in to tell me he thought I had t/c and had scheduled an appt. with an urologist on Tuesday. Tuesday say the Dr. had me do a c/t and blood work up and sceduled me for surgery Wednesday morning for the removal of the testicle.

Initial reports from pathology were a benign tumor, however went today (Fri) for a followup visit and my Dr. stated that they sent for a second on the pathology and came back 95% tetoma (sp?) and 5% embryonal carcinoma.

Now c/t scan "all clear" and blood markers normal. There was no spread or detection of cancer in any other place around the testicle but the 5%. tumor was 2.6 cm. My dr. feels we caught real early but.....

My dr. has left the decision to me if I desire the wait and see (c/t and blood work every three months) or go for the Lymph surgery. Would like some advice on how to proceed, input or suggestions. With no detection anywhere, is the surgery the best course of action? What is the chances it will return? Thank you in advance for your responses

[Scott]

Welcome, warev. There's at least a 70% chance the orchiectomy cured you. As long as you will keep to the surveillance routine, you should be able to save further treatment until it's known to be necessary -- and it very likely never will be.

[Dave40306]

From the sounds of things, I would choose surveillance. Even if something shows up later, you still have several options at that point. Why go through a major surgery if you don't need it and still have the option for it later if you do at some point?

[DianeE]

It's a tough decision to make. My son's path report indicated
"possible lymphatic invasion" which I guess is like saying
"there's a possibility of rain!" He chose to get the RPLND
which was the right thing for him as there were traces of
cancer in five of his removed nodes, and then he had another
choice of whether or not to get two rounds of chemo, which
he opted for.

After his testicle was removed, my son had a 70% chance of
being cured. He wasn't. After the RPLND, he had a 70% chance
of being cured. He wasn't.

A month or two ago, I had brunch with "Mom" who is a member
of this forum. We were discussing statistics and percentages,
and she told me her husband's doctor, years ago,
put it pretty straight forward when he said,

"You've either got it or you don't."

My son didn't want the uncertainty of surveillance. A lot of the
guys on this forum have done great with surveillance.
Do what you can deal with.

Diane

[QuantumSheep]

Diane,

What you write makes such sense. I've been following this thread and applying it to my own situation although mine is different (Stage 1 seminoma with possible vascular invasion, trying to choose between surveillance and radiation therapy) ... since no one responded to my similar post a few topics down ...

I will never really have the benefit of knowing whether I had any remaining cancer after my RT but with the vascular invasion, the chances are a lot higher. My 2 biggest concerns are a reoccurence of skin cancer (which I've already gone through once before) and the possibility of infertility.

Such wonderful choices available to me! (Sarcasm alert!)

It's funny how we make so many decisions based on statistics. A 70% chance sounds great but like you said, if you're in the other 30%, then you're 100% in the other 30% !!

Or, as Paul Rudd said in Anchorman, "Sixty percent of the time, it works every time!"

[IowaBrian]

Welcome
I am on surveillance right now and can tell you if you can make it the first 3 months it seems to get easier you get in a groove you go to the doctor once a month for a x ray and blood work and every 3 to 4 months you get a ct scan and bloodwork. The hardest part is waiting for the results seems to take about 3 days for everything to come back and I think it is harder on family then me at times. Everyone does get stressed out waiting for results. I have about a 50-50 chance of being cured yours sounds like 70-30 which is darn good, but if the stress of the monthly xrays and bloodwork isn't something that you want to do then other options might be best for you. If you do the surveillance you must be willing to go to the doctor every month for the testing or you will be playing with fire. Good luck this is a great place to get information if you have any questions ask away.
Brian

[dadmo]

warev:
I’m fairly aggressive when it comes to treatment but in your case with normal markers and no evidence of invasion, I would certainly choose surveillance. Just make sure you don’t miss even one follow up appointment.

[warev]

I would like to thank you all for your input - after much reading and discussion with my wife, we have decided to go the surveliance route. We are going to speak with the dr. to get some clarifications before the final decision.

Here is another question, I am two weeks post-op from my i/o. So now that the swelling has gone down and the itching has begun, I was taking a closer look at my scrotum, and while feeling around I noticed a knobby thing on my left side that if I remember used to be at the bottom of the scrotum. So he is the question, when doing the check up what are we looking for on the empty side of the scrotum? Any help greatly appreciated from a overly sensitive and aware guy.

[dadmo]

Good luck with the Dr's appointment. The empty side may take a while to truly become empty. What your feeling may be a blood clot that overtime will disappear.