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4xEP finished looking to RPLND for seminoma

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  • 4xEP finished looking to RPLND for seminoma

    I just finished my chemo now!, yuppie

    bad part is just before 3 cycle CT is performed and my mass of 6,5 cm didnt shrink at mymph node, also still have calcification which is a-typical of seminoma

    so theory from the center here is maybe the mass was not tumor but adenopathy from something else which was already there so they want to wait for PET-CT scan due on 12 Jan before deciding on surgery

    I asked to Dr.Einhorn and he recommended RPLND even without the result of PET-CT for presumed teratoma

    I found that even in the case of 100 percent seminoma test result there is possibility to overlook some cells of other types;
    in SK 40perc. necrosis, 40perc.teratoma and 20perc. active cancer found after operation of mass >3cm in post chemo mass of seminoma

    Now I look for another center to direct me a urologic oncologist because there is urology surgent here only, and I think he didnt do post chemo surgery before although he is very qualified for urology;

    Now I want to ask for opinions and experiences if there are
    Thanks

    sorry for typing mistakes this is azerty keyboard
    diagnose 18 Aug 06
    Orchiectomy 24 Aug 06
    pure Seminoma, markers normal, PALP positive
    CT 35x45x60 mm at L3
    EPx4 cycle from 6 Oct 2006
    CT no shrinkage after 4 cycle, PET negative 12 Jan 07
    Post chemo mass resection 14 Feb 07
    Found mature teratoma (unusual for seminoma)
    Surveillance !

  • #2
    I would opt for getting the RPLND. That mass has to be removed regardless of what the PET scan shows.
    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.

    Comment


    • #3
      stage

      and a small info my stag was T1
      so there is no big invasion yet

      is it possible to jump to lymph node and grove there even more than the testicle growth

      i dont like to have surger but if it is necessary there is no option of course
      diagnose 18 Aug 06
      Orchiectomy 24 Aug 06
      pure Seminoma, markers normal, PALP positive
      CT 35x45x60 mm at L3
      EPx4 cycle from 6 Oct 2006
      CT no shrinkage after 4 cycle, PET negative 12 Jan 07
      Post chemo mass resection 14 Feb 07
      Found mature teratoma (unusual for seminoma)
      Surveillance !

      Comment


      • #4
        The primary tumor stage is no longer relevant, since you did have metastasis that required chemotherapy. That remaining mass isn't hypothetical; it's really there and needs to be removed.
        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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        • #5
          thank you

          I guess so, but my doctor here explained this as an item
          due to atypical nature

          I'll go for a second opinon anyway
          diagnose 18 Aug 06
          Orchiectomy 24 Aug 06
          pure Seminoma, markers normal, PALP positive
          CT 35x45x60 mm at L3
          EPx4 cycle from 6 Oct 2006
          CT no shrinkage after 4 cycle, PET negative 12 Jan 07
          Post chemo mass resection 14 Feb 07
          Found mature teratoma (unusual for seminoma)
          Surveillance !

          Comment


          • #6
            Be sure to read what Karen just posted in the Research Library, at this link.
            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


            Your donation funds Livestrong services for people facing cancer now. Please sponsor my ride!

            Comment


            • #7
              Yes I didn't miss this one
              this is very valuable for people like me, but I have additional no shrinkage in 2 cycles and calcification therefore risk of teratoma or NSGT is higher

              also Dr Einhorn himself recommending RPLND although he is contraversial here
              so depending on test result I may need surgery and I'm preparing myself for it

              here NK response to similar issue
              they recommend RPLND to cure 20% who may recur although in vein for 80%

              Journal of Clinical Oncology, Vol 24, No 16 (June 1), 2006: pp. 2598-2599
              © 2006 American Society of Clinical Oncology.
              DOI: 10.1200/JCO.2006.05.6523

              what would I do without these recent articles and internet
              these are help me think and releasing my mind

              Thanks Scott, Dadmo

              ps. I got information that my insurance doesnot cover planned operation in US, therefore I have to find somewhere in EU (or pay myself)
              diagnose 18 Aug 06
              Orchiectomy 24 Aug 06
              pure Seminoma, markers normal, PALP positive
              CT 35x45x60 mm at L3
              EPx4 cycle from 6 Oct 2006
              CT no shrinkage after 4 cycle, PET negative 12 Jan 07
              Post chemo mass resection 14 Feb 07
              Found mature teratoma (unusual for seminoma)
              Surveillance !

              Comment


              • #8
                I am looking for, I got appointment with a cancer institute in Paris
                due to their papers on the internet I think they are ok
                of course I will confirm their experience

                one point I didnt mention about Dr. Einhorn's recommendation is to complete the 4th cycle, that is the reason I am waiting
                and I read on the net that best time for surgery is 4-6 weeks after chemotherapy to let body recover

                until 6th week we will have CT+PET for confirmation

                If you have any recommendation I will be happy to hear

                links

                diagnose 18 Aug 06
                Orchiectomy 24 Aug 06
                pure Seminoma, markers normal, PALP positive
                CT 35x45x60 mm at L3
                EPx4 cycle from 6 Oct 2006
                CT no shrinkage after 4 cycle, PET negative 12 Jan 07
                Post chemo mass resection 14 Feb 07
                Found mature teratoma (unusual for seminoma)
                Surveillance !

                Comment

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