deciding between RPLND or Surveillance

[Alucard]

RPLND is only for abdominal masses, and is not for lung mets. Thoraic surgery is for lung masses resulting from lung mets.

If a patients normalises his tumour markers after primary chemotherapy, an RPLND will be undertaken, typically to remove any residual mass over 1cm.

If a patients tumour markers do not normalise after primary chemotherapy, further chemotherapy will be prescribed rather than an RPLND.

Davie

Thanks Davie, you're always very helpful.

[Davie]

RPLND is only for abdominal masses, and is not for lung mets. Thoraic surgery is for lung masses resulting from lung mets.

If a patients normalises his tumour markers after primary chemotherapy, an RPLND will be undertaken, typically to remove any residual mass over 1cm.

If a patients tumour markers do not normalise after primary chemotherapy, further chemotherapy will be prescribed rather than an RPLND.

Davie

[Alucard]

Hi,

In case you choose surveillance and you have already done 4xBEP, can you still get more chemo to kill remaining cells instead of RPLND? I'm not sure I get this right, RPLND is also for lung mets isn't it?

[clyde_on]

here is some math on your question

http://www.webtie.org/SOTS/Meetings/Genitourinary/SUO_12_13_14_2002/transcripts/32/transcript.htm

[Scott]

What have you decided to do?

[mikeygti]

You may already be cured by the I/O,so surviellance sounds like a good option for you.

As Dadmo mentioned,the "weed-killer" provides a good safety-net.......just in case !

Best Wishes

[dadmo]

If you can deal with the stress of surveillance it is a very good option. As Brian said you can save the big guns for later use if they are needed.

[IowaBrian]

I went with sureveillance that is a big surgery and why do it now if it isn't needed. I had VI and still went for surv with 50/50 odds yours are much better 70/30.
Good Luck both are good choices, but it is a personal choice.
Brian

[immaa]

Just found this board. Struggling with whether or not I should move ahead with RPLND scheduled for this Tuesday because yesterday we met with DR. Steven Williams, head of the Cancer Instit.at Indiana Univ, and he "slightly leaned toward sureveillance.". Our original Doctor, who also trained at Indiana but is in Dallas now, leaned toward RPLND.

Orchiectomy 9/14/06 showed 95% embryonal, 5% seminoma with no VI. Cat scans were all neg. and tumor markers were always normal. Dr. Williams told us that either surveillance or RPLND had close to a 99% cure rate and that given all the facts he " leaned toward surveillance" rather than RPLND because occassionaly the cancer skips the nodes and goes to the lungs. Right now my RPLND is scheduled for this Tuesday so obviosuly we are at our last chance of making a decision.

I guess the confusing thing is that there are two vastly different options for me, and both seem to ulitimatly produce the same cure rate. Dr. W put it this way, without the surgery I have a 35% chance of later needing chemo and with the surgery, a 15 % chance of later needing chemo. Any opinions or thoughts would be appreciated.