A new member

[mjc8185]

Hi,

I was diagnosed with TC two weeks ago and underwent the orchiectomy 9 days ago. Blood markers were negative. Pathology report showed contained classic seminoma (4.4cm) with negative lymphovascular and perineural invasion. However, the CT scan showed two small spots (less than 1.5cm each) in the abdominal area and two very small spots (less than 0.5cm each)in the lungs. The urologist is referring me to medical oncologist for further evaluation of readings but it sounds like I'm in for chemotherapy. Anyone else experienced a similar situation?

[Scott]

Welcome, mjc. The good news is that seminoma responds very well to chemotherapy, and you'll come through just fine. Hang in there.

[mjc8185]

Thanks Scott.

My faith is strong and I'm ready to do whatever's necessary to beat this thing.

[dadmo]

mjc:
Sorry about your situation but you'll come thru this just fine. If you havent been there yet check out this site tcrc. Learn all you can it will make the treatment less frightning.

[huckchef]

Be knowledgable....it helps with the anxiety. My thoughts and prayers are with you!

[mjc8185]

timeframe and protocol for chemo

With pure seminoma Stage 2 or 3, what kind of timeframe should I expect if chemo is the recommended treatment? Also, what is the typical protocol for chemo and seminoma cancers? Most of what I find is chemo related to non-seminoma. Is the chemo regimen similar for seminoma? What should I expect regarding being able to work during the chemo cycles? I am an IT manager so it's primarily desk duty anyway - nothing very physical.

[Scott]

You'll find all the treatment guidelines in this publication. Stage IIA or IIB seminoma is generally treated with radiation therapy. Stage IIC or III is generally treated with three of four cycles of BEP, as with non-seminoma.

[mjc8185]

Thanks Scott. Very useful document.

[mjc8185]

Waiting....

The waiting is the worst part. After the CT scan results my urlogist wanted to send me to an oncologist that just completed her studies so wife and I decided it was time to self-refer to MD Anderson in Houston. Now waiting to hear from them on when I can see an oncologist. Given that something showed up in the lungs my urgency has increased. Seems to me the sooner we can start treatment the better. Appreciate any reassurance.

[Fish]

Believe me I know how stressful the waiting is. I will tell you - don't automatically assume the spots in the lungs are TC. They MIGHT be, but CT scans are notorious for picking up small nodules in the lungs that turn out to be nothing. I've had one for about 2.5 years now, it initially got smaller then stabilized and has been the same size since. Hopefully, they'll be able to better evaluate your lung nodules and determine if they are TC.

Hang in there.

Best wishes.

[mjc8185]

Thanks Fish.

We're certainly praying that the spots in the lungs are not TC. Still, I'm mentally preparing myself for the possibility of chemo rather than radiation.

[mjc8185]

latest update

We met with the medical oncologist at MD Anderson today and he didn't see anything that concerned him on the CT scans but is deferring to the radiologist to review the scans before deciding any next steps. Latest blood work shows all normal levels. Will meet again with oncologist 9/25 after radiologist has a chance to review the scans. So we wait some more before getting a final stage diagnosis.

[MRM]

A had a scare with a few lung nodules earlier this summer. They turned out to be nothing-- in fact, they weren't even visible on the last chest CT I had.

I'd expect that they'd monitor you for a few weeks and check for growth before sending you to chemo, especially if your blood work is OK. That's what they did with me. They might also biposy the spots before doing anything else if there was growth.

[mjc8185]

Report from radiology

Met with oncologist again today following review of CT scans by radiologist. Enlarged lymph nodes indeterminate so he wants to do a biopsy of the one on the left side to determine if it's malignant. So we still don't have a final staging until after the biopsy results. Either stage 1 if benign or stage 2b if malignant. Lung spot is being identified as "possible post inflammatory scar" so it doesn't look like stage 3.

CT Abdomen & Pelvis results:
Unfortunately no preoperative CT scans are available for comparison, therefore, an enlarged lymph node between aorta and carva just above the bifurcation measuring 1.9cm x 1.9cm is indeterminate. While this may be a reactive postoperative process, and rather unusual location for metastatic disease, however, re-evaluation by a short-term follow-up CT is recommended. There is alsi a fatty lymph node posterior and lateral to aorta at the same level which measures 2.1cm x 1.6cm. No retroperitoneal, retrocrural or upper abdominal lymphadenopathy is detected.

Both kidneys show normal function and no obstruction. The liver, gallbladder, adrenal glands, pancreas and spleen are normal. There is a 6cm x 5cm seroma or hematoma in the left inguinal region from previous surgery.

CT Chest results:
There is a quite nonspecific density in left lower lobe that measures less than 0.8cm x 0.4cm. The margin characteristic is not quite typical for metastatic disease and may represent a post inflammatory scar, however, comparison with any prior chest CT scans or otherwise, attention to this area in follow-up examinations are recommended. There is no hilar, mediastinal or axillary lymphadenopathy.

Sorry for the long post but wanted to see if any of this was familiar to other members.

[Scott]

I saw you had advice over on TC-NET, which I would summarize as:

1. Get an expert opinion from Indiana University.
2. Skip the biopsy, stick with surveillance for now, but be prepared for the likelihood of additional treatment.