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  • Risk of Recurrence?

    I was diagnosed with TC and had right IO on Oct 20. Tumor was 80% embryonal carcinoma, 15% teratoma, 5% yolk sac. There was no lymphatic or vascular invasion.

    The first doctor I went to, who is the head of urology-oncology at UT Southwestern in Dallas, said that my risk of recurrence was about 25% and that surveillance was an option. He said if there had been lymphatic or vascular invasion, my risk was 40% and surveillance would be a bad idea.

    I went to MD Anderson in Houston for a second opinion. The doctor there - who agrees there is no invasion - says my risk of recurrence is 40% and surveillance is a bad idea. He says that embryonal carcinoma puts me in the 40% risk category. He wants me to do 2 rounds of adjuvant chemo.

    I've searched some online and can't find anything that directly supports the second doctor's estimate of 40% risk of recurrence for embryonal carcinoma without lymphatic/vascular invasion. Can anyone shed some light on this?

    Thanks,
    Robert
    Oct 2006 - Right I/O - Stage I - 80% embryonal, 15% teratoma, 5% yolk sac - No lymphatic or vascular invasion.
    Dec 2006 / Jan 2007 - 2x adjuvant BEP
    Feb 2007 - 4th child (first daughter!) born
    Nov 2008 - 5th child (second daughter!) born

    "When you go through a trial, the sovereignty of God is the pillow upon which you lay your head." - Charles Spurgeon

  • #2
    Did you ask him to explain why surveillance is a bad idea? If you stick to the schedule, you'll catch a recurrence early and have chemotherapy only if and when you know you need it. Even if the 40% statistic is accurate, I'd take a 60% chance of not needing chemotherapy over a 40% chance of needing one more round than you're being offered as adjuvant therapy.
    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
      robert:
      I know it won't be easy but focus on the fact that you have a 60% chance of being cured. I agree with Scott, save the chemo for when your sure it's needed. Wheather you get the chemo now or a bit later the cure rate will be the same.
      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
        Both doctors indicated that 3 - 4 rounds of chemo was significantly worse than 2, in terms of short and long-term side effects. I am not too worried about the short term effects, but the long term ones (like heart trouble - I have a family history) worry me.

        Considering there's a fair amount of teratoma, would relapse be likely to mean RPLND as well as chemo?
        Oct 2006 - Right I/O - Stage I - 80% embryonal, 15% teratoma, 5% yolk sac - No lymphatic or vascular invasion.
        Dec 2006 / Jan 2007 - 2x adjuvant BEP
        Feb 2007 - 4th child (first daughter!) born
        Nov 2008 - 5th child (second daughter!) born

        "When you go through a trial, the sovereignty of God is the pillow upon which you lay your head." - Charles Spurgeon

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        • #5
          Short term side effects are no walk in the park either. Neuropathy can be pretty debilitating. Make sure you consider all of the variables of this.
          I Love My Pack!

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          • #6
            Teratoma won't cause a relapse. But you're correct it might very well mean chemo and RPLND if it spreads. The RPLND is a nasty operation but it's the chemo that causes long term problems.
            Last edited by dadmo; 11-29-06, 11:46 AM.
            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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            • #7
              With 95% E/C,and no V/I or L/I,I was told I had a 40 % chance of relapse during my original surviellance. I was also told that most relapses (85 % I think he said) of E/C occur within the first year. Taa-Daa !......pretty well spot-on what happened to me.

              Save the chemo for when you really need it !

              Best Wishes
              Dec/04-Right I/O-nonseminoma (95%E/C),Stage 1, surveillance
              Nov/05- 2.2 cm lymph node= Stage II A
              Nov/05 -Jan/06-3 x BEP
              Jan/06 -Surveillance



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