Surveillance plan

[tc2006]

Is there a recommended surveillance plan for stage I seminoma ? I am currently on surveillance, but found that there seems to be a large variety of plans in terms of the frequency of CTs, x-rays and blood work, in particular the first 3 years. Does anybody know what some of the top TC specialists in the U.S. (Sloan-Kettering, Dr. Einhorn, etc.) suggest? Thanks.

[Scott]

You'll find recommended surveillance schedules posted at the bottom of this TCRC page.

[tc2006]

Scott: Thanks. I did find these two recommendations, and already they differ. So do the recommendations I got from my urologist and my oncologist. That's why I was wondering whether anybody knows what Sloan-Kettering, etc. are suggesting ? Thanks.

[MRM]

I think Sloan-Kettering uses the National Comprehensive Cancer Network guidelines, which are more conservative-- i.e. frequent-- than the TCRC's, which are based on Indiana University's.

A lot of Sloan Kettering doctors are on the NCCN's testicular cancer panel.

The guidelines are here:

http://www.nccn.org/professionals/physician_gls/PDF/testicular.pdf#search=%22NCCN%20testicular%22

[IowaBrian]

I like to fall to the side of caution but if the extra test are not needed then no need to do them I would think both groups have their research that backs up the plan I think it goes to what does your doctor believe is right for you. I know my answer sucks no real answer but I am sure both scools of thought are good.

[matthias]

Let me infuse a data point by throwing in my own schedule; this is for non-seminoma, no chemo, no RPLND. Note though that my onc is IU-trained, hence there might be a bias:

1st year, every 30d, CXR, markers; every 60d CT;
2nd year, every 60d CXR, markers; every 90d CT;

3rd year and out, who knows...I am not there yet

Is there a recommended surveillance plan for stage I seminoma ? I am currently on surveillance, but found that there seems to be a large variety of plans in terms of the frequency of CTs, x-rays and blood work, in particular the first 3 years. Does anybody know what some of the top TC specialists in the U.S. (Sloan-Kettering, Dr. Einhorn, etc.) suggest? Thanks.

[tc2006]

Thanks, everybody. By the way, does anyone know why the NCCN guidelines suggest the chest x-ray only at every alternate visit, i.e. every 6 months in year 1-3, while the abdominal/pelvic CTs are at every visit every 3-4 months? Is there a reason why chest X-rays should be less frequent than the CTs? I think I read somewhere on this forum that TC has the ability to actually bypass the abdominal lymph nodes and go directly to the lungs, so wouldn't that suggest more frequent rather than less frequent chest X-rays ?

[Scott]

I think I read somewhere on this forum that TC has the ability to actually bypass the abdominal lymph nodes and go directly to the lungs...

That's embryonal carcinoma. Seminoma typically follows a predictable path of spread to retroperitoneal lymph nodes first.

[tc2006]

I see. Thanks, Scott.