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One dose of chemo or surveliance?

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  • One dose of chemo or surveliance?

    My hubby just had his appointment on Friday with the Onc Specialist and I would like to hear other opinions.

    He has had surgery and had the left teste removed on Sep 22. The pathology stated classic seminoma stage 1 with no spread. Typical, I cant lay my hands on the report to be exact in the wording... So the Dr recommended that he go on surveliance. He said that the one dose chemo has not been around long enough to be sure of side effects. My gut thinks that he should have the chemo. I know it is his decision and have told him that. I will support him whatever he decides. I just think he is taking more of a risk not doing anything iykwim?

    So what do you all think? I really need to hear others advice here. I know I am going to be bloody stressed every ten weeks waiting for the results of his scans.....

  • #2
    Eight out of ten men diagnosed with stage I seminoma are cured by the orchiectomy alone, so surveillance can be a good choice. Radiation therapy or chemotherapy will still be there in case of recurrence. The important thing is to stick to the surveillance schedule so that if cancer does recur, you catch it early.
    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


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    • #3
      With stage I seminoma confirmed it's very likely that your husband is cancer free already. Surviellance is a good option for your husband but he must stick to a strick schedule of follow ups.
      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.

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      • #4
        Hi,

        It's an issue of nerves as well. Please be confident that he is cured, otherwise both of you will drive yourselves nuts. I was just diagnosed with exactly the same thing and the doc recommended surveillance as well.

        Be rest assured that docs only recommend surveillance if they feel that the patient will comply with the follow-ups. It is nerve racking for me, but I know that I will be there every 4 months drinking that foul barium crap (actually I kinda like it ).

        So chances are he is cured, but don't lull yourselves into a false sense of security, and in the slight chance he isn't, radiation or chemo will cure him then.

        Oh, one more thing... I don't have children but I want to soon, naturally. That played a big role in my decision for surveillance. If I had children already, I may have gone with radiation for the peace of mind. Still, with radiation I would worry about secondary tumors.

        And as far as chemo? Carboplatin sounds good, but there just isn't enough numbers out there to determine that it isn't worse than radiation.

        Good luck! And remember, horrible things happen to people every day, car accidents, lightning strikes, falls, slips, etc. My philosophy now is that while I know I have a higher chance than someone else to have testicular cancer in my lymph nodes in the future, I will plan my life as if that isn't a concern (but I will prepare for the possibility.) Otherwise, I feel as if I can't go on and be productive.

        Again, best of luck!

        djm
        Detected mass 10-6-06, Radical left I/O 10-10-06, Stage I seminoma, 1.5 cm primary, No LV invasion, No Rete Testis Invasion... Currently on Surveillance.

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        • #5
          Snap

          Hiya,

          I'm in you husbands boat, stage 1 seminoma. I had my op in September and am due for my second check up on Tuesday.

          I've gone for the survelance option and have made my decision on the following basis -

          a) 85% + chance its gone.
          b) Radiotherepy/Chemo can cause secondary cancers - why take the risk.
          c) If cancer does return there is little or no difference in cure rates if caught early.
          d) Radiotherepy or single cycle Chemo don't always work.

          and most importantly

          e) I'm going to be monitored closely for the rest of my life. Whether I have chemo (this would be my prefered treatment) or not I'm going to be stressed every time I go for a checkup anyway.

          This is just my rational, we're all wired differently but given the statistics I'm just going to assume I'm cured until someone tells me otherwise.

          Wish your husband good luck for me.

          All the best P.

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          • #6
            Thanks again for all your replies.

            I think I just have to get in the right mind-set. I need to get my mind thinking he is cured, and that the scans will just prove it every 10 weeks

            Cheers Sheryn

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            • #7
              Single dose Carboplatin

              My other half has just had a single dose of carboplatin for stage 1 seminoma, he is 24 and we don't have any kids yet. He was treated at the Bristol Royal Infirmary and they have been doing some studies and suggested that carboplatin would be his best bet, they told him that there was a big chance he was completely cured with the surgery but that the chemo would "mop up" any stray cells in his body.
              The chemo its self is actually very low dose and the only side effects he had was tiredness for a couple of days. I asked the doctors about surveillance but they both suggested that it's much harder with seminoma because there are no tumors markers and the CT scan can be sensitive causing un-nessesary worry if something is seen. Good luck with whichever course you choose x
              Ceri

              Boyfriend left testicle removed 24/08/06, diagnosed 24/08/06. Stage 1 Seminoma, single dose Carboplatin 12/10/06.

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              • #8
                Single Dose or surveillance - I am deciding today

                This is a great thread for me. I just saw the specialist this AM. Am also in the UK. Have a stage 1 seminoma. The guy I saw, whilst being a TC specialist, is also the Clinical Director for the regional cancer centre overall and seems to know his stuff.

                The issues I'm weighing up are:

                Regular CT scans carry radiation too - so regular scans are not without any downside. And scans are more important than blood markers for seminoma.

                If I am one of the 20-25% in whom it comes back, I then get a heavier dose of chemo / radiotherapy than the single shot done pre-emptively.

                The 20-30 year survival rates from radiotherapy do show some risk - although practice has changed a lot since the 80s and there are (obviously) no long term stats on the lower doses of radiotherapy that are now used.

                The effects of the single shot are not fully known long term yet as it hasnt been around for long - however, the immediate effects - smaller risk of hair fall out - shorter period of lower immune system (1 month) - and not so much the ongoing fatigue - make it worth thinking about.

                Be interested in what others who had the single shot have found.

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                • #9
                  Chemo effects

                  Single dose carboplatin hasn't really had an effect on my other half, who is an otherwise healthy 24yrs chap. The actual chemo took an hour and was painless. The only side effect he has had was tiredness about 3 days after the chemo this lasted 2 days, he didn't go off his food and didn't feel sick. He was back to work after 7 days, although he felt that he could have gone back earlier. He hasn't lost any hair and is back up to full speed only 10 days after Chemo.

                  He might have had a easy ride but the nurses said that the single dose chemo doesn't seem to negativly effect anyone they've treated.

                  Although the long term effects are known, this chemo has been used for many other cancers for years in much higher doeses.
                  Ceri

                  Boyfriend left testicle removed 24/08/06, diagnosed 24/08/06. Stage 1 Seminoma, single dose Carboplatin 12/10/06.

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                  • #10
                    So what's next for him?

                    Useful info - thanks. I'm due to start a new job at the same time as I would be having the chemo so it's reassuring to think I wouldn't be wiped out.

                    How often does he need a check up / bloods / CT scan after the carboplatin?

                    I am trying to compare to surveilance without the chemo to the follow up after the single dose chemo


                    Pilgrim

                    P.S. Tried to send you a message direct but not sure if it worked.

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                    • #11
                      I am not one to push chemo and I believe that he is cured with the surgery. I thought there was a study that just finished up with the one shot chemo where they followed them for a few years(this was a study outside the USA). If I remember right it did have 99% plus cure rate. I can't remember if it was sem or non sem that they looked at or both. I will look for the study.
                      Brian
                      5-1-2006 Right IO - Stage 1 Nonseminoma Embryonal and Yolk sac - Surveillance Baby on the way Born 7-20-07

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                      • #12
                        something to think about

                        the 85 % number comes from those who chose survl only, so if 85% made it with no treatment, I would be willing to bet the 85% is a lot higher being that the teated folk may not have needed treatment.

                        Also My ONC told me she would be ording a PET scan vs a CT scan being that smaller tumors are harder to see with a CT. If you Insurance covers a PET go fo it, it is the better way.
                        10/09/06 -- pT1-pNx-Mx-S0

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