New Member

[Andy D]

I have been on this website quite a few times now since being diagnosed with T/C, and I would like to say how much of a help it has been reading all the other peoples threads.
I found a painless, hard right testical by accident in the shower, I have had a series of blood tests and have undergone an orchidectomy on the 16th August 06 and the histology came back as a classical seminoma. The LDH came back at 638 with the upper limit of 600 and the alpha feta protein at 5.2 wtih the upper limit of 5 and a total HCG at 16 international units with the upperlimit of 5 - Can someone please shed some light on what exactly this all means ? I live in the UK and know that the USA have different systems to how we work but any help would be much appreciated. This will be explained to me in more detail when I get the appointment through to see my Clinical Oncologist at Christie Hospital, Manchester but as you are probably aware I am rather anxious.

[Karen]

Andy,
Welcome!

Cleck out this site for UK info. http://www.cancerhelp.org.uk/help/default.asp?page=2665

The terminology and treatment preferences are a bit different between the UK and US. My favorite site is http://tcrc.acor.org/ It explains in greater detail the terms and treatments.

A word of caution....raised AFP is NEVER seen in a pure seminoma...so even though you only have a tiny elevation you may want to get a second opinion on the pathology (from an expert Institution) and repeat blood tests. If you have even a small non-seminoma component to the tumor the treatment will be different. Your outcome will still be fine, and I don't want to cause you added concern, but you need the right diagnosis and treatment from the beginning.

[Ras Joe]

A word of caution....raised AFP is NEVER seen in a pure seminoma...so even though you only have a tiny elevation you may want to get a second opinion on the pathology (from an expert Institution) and repeat blood tests. If you have even a small non-seminoma component to the tumor the treatment will be different. Your outcome will still be fine, and I don't want to cause you added concern, but you need the right diagnosis and treatment from the beginning.

Listen to Karen, she knows her stuff. You should probably get a second look at the pathology with your blood test like they are. I also fully agree with her assurance that your outcome will still be the same-- you will beat this. Anyways, are you a City or United man? I saw you were from Manchester and thought I'd ask, I love the Premiership-- best football on the planet!!

[Scott]

Andy, Karen already gave you great advice, so let me just add my welcome to the forums. Have you had a CT scan yet to check for signs of spread?

[Andy D]

Keep smiling

Went to chrities hospital yesterday for another blood test and chest x-ray. they have booked me in for a scan on the 27th and an mri for the 29th of this month, they also have provisionally booked me for radiotherapy for the 6th october for 8 sessions depending the outcome of the scans and blood tests.
I did not know what to expect yesterday, but i came out feeling a lot better than i went in

http://www.christie.nhs.uk/

[Karen]

Andy,
Sounds like you're moving along on things! Please let us know your results!

[cbuysse]

Andy with the raised levels of your initial blood work I would definately get a second opinion on the pathology report just to make sure your course of treatment is the correct one from day one of treatment. Check out the abstract attached below which talks about the error rate on pathology reports for TC. Like all the others have said before me you are going to be fine just make sure they get it right, remember no one cares as much about you as you do.

Urological Cancer Research Unit, Royal Prince Alfred Hospital, Camperdown, Australia.

Accurate histological diagnosis and staging are critically important in determining the optimal management of patients with testicular cancer. We have assessed the importance of histological review of "outside" pathology reports from 87 patients referred to the Urological Cancer Research Unit. In 28 patients (32%), the reviewed pathology report differed from the outside report. In 10 of these patients (11%), the pathology review resulted in a change of treatment or prognosis from that which would have obtained in the absence of such histological review. Pathology review at a major cancer centre with a subspecialist interest in tumour pathology and a large experience in the management of germ cell malignancy is an essential first step in the treatment of testicular cancer.

[Karen]

you are going to be fine just make sure they get it right, remember no one cares as much about you as you do.

Amen! You really do need to get the path confirmed by an expert, regardless of your post I/O bloodwork, If you have a non-seminoma component the zaps are not going to be effective. As much as we trusted the doctor and the path lab, we still went to Sloan with slides and scans in hand for a second read on the slides. And don't worry about offending your docs by telling them you want another opinion....it's your life.

[Lori]

We went to both Sloan and Indiana for a second/third opinion. Our local oncologist was very supportive. Please get a second opinion.