non-seminoma--just diagnosed

[w4lucy]

Would really appreciate some input from ya'll...

My DH just found out yesterday the mass they removed was non-seminomatous, 95% immature teratoma and 5% yolk sac, and stage 1. The size of the tumor was 3.1 cm. The pathological stage is PT1 NX MX. (is there a difference between NX and N0 and MX and M0?) We've been referred to an oncologist to dicuss chemo and such. The dr said it wasn't a necessity, but more precautionary.

Just wondering if any of ya'll have any insight for us. I know the oncoloist will talk with us about this, but is chemo or suveillance probably the best way to go? Also, I know stage 1 is good, but since it's non-seminomatous instead of just sminomatous, does that make much of a difference in the treatment we choose (i.e. chemo or not.)?

This was all a huge surprise to us--DH noticed about two weeks ago his left testicle was hard and went to prompt care just to check things out. Next thing I know, I get a call at work that he's going into emergency surgery to have his left testicle removed. We're both just pretty shocked by the whole thing, yet thankful it is only stage one.

ANyway, any thoughts or comments would be greatly appreciated. You can also email me at [email protected]

Thanks so much...

[Scott]

The pathological stage is PT1 NX MX. (is there a difference between NX and N0 and MX and M0?)

The 'X' means "not assessed," while '0' means "no evidence." You need an abdominal CT scan and chest x-ray to fill in the Xs. Have those happened yet? Was AFP elevated from the yolk sac, and has it returned to normal?

Unless there is evidence of metastasis, I suspect that surveillance will be the best choice.

Hang in there, everything will be OK!

[tlh]

The 'X' means "not assessed," while '0' means "no evidence." You need an abdominal CT scan and chest x-ray to fill in the Xs.

Scott,

I had my path report say pT1, Nx, Mx (AJCC Stage 1A). Tumor is limited to Testis. Epididymis and tunica albuginea are free of neoplasm. No angiolympahtic invasion identified. the spermatic cord margin is free of neoplasm. I had follow up chest x-rays (lungs clear and expanded) and abdominal CT scan ( No evidence of enlarged lymph nodes) done. Shouldn't the path report have stated pT1, N0, M0 because of the findings of the ct scan and chest x-ray, or are they only basing the T, N and M off of the path from the testicle/surgery itself? I'm a little confused about this. Any info would help. thanls.

[Scott]

...or are they only basing the T, N and M off of the path from the testicle/surgery itself?

You got it.

[tonytigre]

Pretty much the same

Hi there w4lucy,
My diagnoses was pretty much the same as DH's. I was 90 percent immature teratoma and 10 percent yolk sac. My tumor was a little smaller only being 1.6, but everything else is the same. My tumor markers were pretty low before surgery. I think my afp was 36 and everything returned to normal and has stayed that way. I am about to comple month 16 on surviellence and so far so good. If everything checks out for him I think surviellence would be the way to go. Good luck

[Fed]

I had my path report say pT1, Nx, Mx (AJCC Stage 1A).

There is also an important item here. The "p" before the "T1" indicates pathological stage. Pathological stage means that they basically did a biopsy and they have direct evidence from the source. If there is no "p", then the evidence is "clinical".

For the sake of argument, if you had had lymph node dissection and nothing was found there, then you would see pN0 rather than just simply N0.

[w4lucy]

Thanks for the input.

They did a CT scan after the surgery and it came back good (nothing in his lymph nodes or anywhere that they see.) I'm not sure about the mestasis...umm, where would that be on the report?

I think we're both anxious to get bloodword done again to see if the counts go down. I'm guessing that will big a big factor in whether or not he does chemo or surveillance. We're anxious to see what the oncologist has to say, but I still haven't heard when that appt is--we're calling the office tomorrow to find out what's going on with that.

A main concern right now is fertility. We're both young and have been TTC for some time now. This answers a lot of questions on why that hasn't happened yet though. I know there are many options for that as well though, chemo or not.

Anyway, thanks again for ya'll's comments.

[Scott]

I'm not sure about the mestasis...umm, where would that be on the report?

Metastasis just means spread to other parts of the body, which would show up in a chest x-ray or abdominal CT scan. The pathology report should also note whether there is vascular or lymphatic invasion, which gives the cancer a route to spread.