4xEP finished looking to RPLND for seminoma

[wannalive]

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

[dadmo]

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

[wannalive]

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

[Scott]

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.

[wannalive]

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

[Scott]

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

[wannalive]

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)

[wannalive]

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

http://www.igr.fr/brochure_recherche/eng/germinal-tumours.shtml

http://www.igr.fr/brochure_recherche/eng/intro.shtml