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Life after Chemo and RPLND

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  • Life after Chemo and RPLND

    My name is Kevin and this is my first time posting to the site. I am 46 years old and I was diagnosed in February with non-seminomous testicular cancer. (Footnote, I had a vasectomy 16 years ago. Ever since the vasectomy, I have had extreme sensitivity and slight swelling of the left testicle. Doctors say this was a coincidence.) I am interested in your responses to some of the concerns I have since my treatment.

    A brief synopsis; I had a left radical orchiectomy in February this year. AJCC staging IIIB (PT3, N2, Mx, S2). My AFP was 3800 and BHCG was 1200. The pathology report indicated 50% embryonal carcinoma, 30% Teratoma and a mix of choriocarcinoma and yolk sac tumor. The subsequent CAT scan revealed 2 tumors in my abdominal lymph nodes.

    I went through 4 rounds of BEP. After chemo, both AFP and BHCG were 2. Unfortunately, the CAT scan after chemo revealed that the tumors had actually grown slightly. I went to Inidana U for a consultation with Dr. Williams. I was very impressed. He said non-nerve sparing RPLND is needed for my survival. We had the RPLND performed at Henry Ford Hospital in Detroit on August 7th. I was on the table for 9 hours! Apparently it was a challenging surgery as one tumor (12cm x 5cm x 5cm) was on the left side very near the Aorta and the other tumor in the left pelvis area (5cm x 5cm x 4cm) had elements wrapped around my siatic (sp?) nerve running to my left leg. The pathology report from the RPLND revealed pure teratoma. Therefore, we are in surveillance mode! YEAH!!!! I am making slow but steady progress recovering and hope to be back to work later this month.

    I am interested in your impressions of my case. I also have a couple of symptoms and I would appreciate your feedback. 1. Neuropathy (numbness and pain) in both feet and to a lesser extent in my hands. Does it ever go away? 2. My right testicle is now extremely sensitive.

    At one time, before we got the RPLND pathology back, my Oncologist discussed salvage chemo and stem cell transplant may be required. This did not sound very good. Has anyone had this type of treatment.

    Sorry for the long thread, quite a story. I am a very optimistic and relatively healthy guy. I am so pleased that treatment is done... for now... Thank you!
    Kevin Ricks (46 years old)
    Diagnosed 2-2006, AFP = 3800, BHCG = 1226. Left I/O 3-2006, Stage 2 Nonseminomous (50% embryonal carcinoma, 30% teratoma), 4XBEP, two tumors in lymph nodes, (12cm x 5cm left periaortic region and 5cm x 5cm left pelvic region) RPLND 8-2006, Pathology is negative, tumor markers negative, surveilance beginning 9-2006.

  • #2
    Kevin, first congratulations! You seem to be doing awesome!

    My husband is in the middle of high dose chemo with stem cell transplant. We expected the worst, but he has faired well. He was very tired throughout the first round but wasn't sick at all. We start the next round on Friday. If you have any specific questions, let me know.

    Lori
    Lori and Jon
    Diagnosed 5/22/2006
    I/O 5/26/2006, Stage 3, Good
    Teratoma (Majority), Seminoma (10%), Yolk Sac
    3xEP then determined not working
    HDC w/stem cell transplant 8/16/06 to 9/25/06
    Chest and Neck surgery 10/9/06 - immature teratoma
    RPLND 11/16/06 - immature Teratoma
    2/29/2008 - markers continue to be normal!
    9/16/2008 - released from Dr. Einhorn's care

    Comment


    • #3
      Kevin:
      First I want to congratulate on being cured. With the path report showing nothing but teratome you should have this thing beat. As bad as your case may sound it really won't seem that odd to the people on this forum. Post chemo RPLND's can often take a long time, the chemo makes to organs soft and harder to work with. My son had a post chemo RPLND with some teratoma at the aeortal biforcation and he was on the table around 8 hours. The most important thing is that it was all teratoma, that's great news. Several people on the forum suffer from neuropathy and it does get better with time. Your oncologist should be asking about this and if he isn't mention it to him, they do have some medication that can help with this. I would think that the idea of salvage chemo ( I prefer second line) has been scraped because of the good path report. As to the tumors growing during chemo, teratoma is nonresponsive to chemo and can double in size every 10 days. I have no idea why the other testicle would hurt, sorry. As question come up just keep asking.
      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.

      Comment


      • #4
        Kevin:

        Congratulations on getting all that behind you. RPLND is a very invasive surgery, and you might notice all kinds of odd pains and sensations in your abdomen and groin for a while. It's possible this could be the cause of your testicular pain, but a lot of guys report increased sensitivity in the remaining testicle. Make sure your doc checks it out and ask for an ultrasound if it will give you some peace of mind.

        Don't rush the recovery from the RPLND, especially since it was post-chemo. It probably put a lot more stress on your body. Give yourself time, lots of time to recover. I had only the RPLND (no chemo) and it was about 6 months until I felt completely normal. Be extremely careful lifting things, you can tear your incision and end up needing a repair.

        Best wishes
        Fish
        TC1
        Right I/O 4/22/1988
        RPLND 6/20/1988
        TC2
        Left I/O 9/17/2003
        Surveillance

        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.

        Comment


        • #5
          Thank you so much for the support

          Fish / Dadmo and Lori, Thank you for the responses. Information from those experienced is certainly valued and appreciated. There is so much to learn. It sounds that from your responses that my case is fairly typical and I am just going through the healing process. It is comforting to know these things. I saw my Dr. today and he checked out my feet. Good circulation and pulse in the feet. Most likely some after effects of the surgery as the tumor in the pelvis was entwined with nerves.

          The rest of it is just a 46 year old guy recovering from something that normally occurs in men 20 years younger than myself. My Oncologist calls me the senior citizen of this group. Thank you all, I admire your strength and courage. By keeping up on the support group, you continue to provide comfort and guidance to others.
          Kevin Ricks (46 years old)
          Diagnosed 2-2006, AFP = 3800, BHCG = 1226. Left I/O 3-2006, Stage 2 Nonseminomous (50% embryonal carcinoma, 30% teratoma), 4XBEP, two tumors in lymph nodes, (12cm x 5cm left periaortic region and 5cm x 5cm left pelvic region) RPLND 8-2006, Pathology is negative, tumor markers negative, surveilance beginning 9-2006.

          Comment


          • #6
            Kevin:
            Yes your case is fairly normal for this type of cancer. Who would ever think I could use normal and cancer in the same sentance?
            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.

            Comment


            • #7
              Kevin, I just wanted to add my welcome. You've certainly been through it all, and I've no doubt you're stronger for it.
              Scott, [email protected]
              right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since


              Your donation funds Livestrong services for people facing cancer now. Please sponsor my ride!

              Comment


              • #8
                me too

                12 years ago I was on varicocello surgery on left testicle. After that, my left testicle had becomed very sensitive and sometimes painful. So, after 12 years I was diagnosed with TC in the save testicle. Conincidence ??? I think not. Really I'm convinced that the V surgery was the main cause of later TC.

                The life after 3xBEP is a very normal life. Sometimes I feel unexplained tired but this pass away very quicly. It's very very important to get enough sleep. Do some exercise and everything will be just fine.
                Buy the way - FORGET SMOCKING

                Best regards
                Last edited by AdrianB1971; 09-07-06, 07:07 AM.
                2005-03
                Stage III EC 85% + Sem 15%
                AFP=2.6; HCG=10, 20,28 and rising
                FULL CAT scan:
                -abdominal lymph clear
                -subpleural lungs metastasis [bipulmonary lesions with diam <= 1cm]
                4 x BEP changed to 3 x BEP at my request
                from 2005-05....Surveillance

                Comment


                • #9
                  Just happy to be here

                  Adrian / Scott, Again, thanks for your comments. I plan to continue to monitor this site as time goes on so that others may benefit from my experiences as I have from yours.

                  In my own mind, I believe that my experience with the sensitivity and pain after the vasectomy and the TC are related. The doctors say this is not the case however. I am just happy to be here!
                  Kevin Ricks (46 years old)
                  Diagnosed 2-2006, AFP = 3800, BHCG = 1226. Left I/O 3-2006, Stage 2 Nonseminomous (50% embryonal carcinoma, 30% teratoma), 4XBEP, two tumors in lymph nodes, (12cm x 5cm left periaortic region and 5cm x 5cm left pelvic region) RPLND 8-2006, Pathology is negative, tumor markers negative, surveilance beginning 9-2006.

                  Comment

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