Looking at RPLND

[Jstat]

I'm in QLD, Aus, and was diagnosed with TC in May 06. I had the orchidectomy (L) and the biop revealed it to be an embryonal carcinoma (pure). The biop did not suggest any vascular invasion, yet the followup CT revealed 2 retroperitonal lymph nodes enlarged to 19mm and 12mm. I had 3 rounds of BEP, although the bleo was stopped after 3 doses due to fibosis of the lungs. My dilemma is that the BEP ended in Aug 06 and there is still a 11mm mass in the lymph nodes. The urologist who preforms the RPLND in Brisbane suggested a followup CT and this CT did show a 7.8mm mass, although the PET did show activity. He is suggesting RPLND on the following basises: 1.) the inital mass was found to be pure embryonal carcinoma, 2.) there was definate local invasion, 3.) i have been marker negative since day one, and 4.) with the embryonal carcinoma he feels that there is higher risk of relapse. he does state that if the tumour shrinks they could watch it, but the minor difference in size (2.2mm) would most likely be due to where the slice was taken for the CT, not due to any significant shrinkage. My question is, is the urologist right? Will this be worse than the chemo? Will I have to have chemo following? What is the recovery time? Any diets I need to be on before the surgery?
The only other thing of significance is the fact that the tumour markers were the highest that they have ever been (3.9) right before the CT.
Thanks in advance for your help!

[dadmo]

I'm not going to give statistics here but with a mass that size and a PET scan that shows some activity I would want it out. I saw my son go through an RPLND and it was tough but not nearly as bad as the 3 months of chemo. You will be up and walking the next day and home in about a week. The big plus with this operation is that it can give your doctors a clear path in which to continue your treatment. You will be told that if they find active cancer it means two more rounds of chemo, that's standard treatment, and when that's finished you should be cured. As to the diet, it not a big deal simply stay no fat for a few weeks. If you like pasta and salad you'll be thrilled.

[Scott]

Welcome, Jstat. It sounds as though RPLND to remove the residual mass is the right thing to do, though you may want to get a second opinion. It's major surgery, but the experience will only make you stronger.

[Jstat]

RPLND Confirmed

RPLND has been confirmed for 16 Feb. I dont know whether to be worried or glad...

[dadmo]

I dont know whether to be worried or glad...

It's quite normal to be both. Where are you having the RPLND done?

[Jstat]

Princess Alexandra Hospital, Brisbane, Australia. Surgery is on the 16th of Feb, but they admit me on the 15th. Dr. David Nichols is performing the surgery.

[Margaret]

I wish you all the best. You will be walking laps and feeling better in no time!

Margaret