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[italian_tc]

hey!!! I make a decision!
I've booked my rplnd! Probably will be at the end of march at Istituto Nazionale dei Tumori, Milano. A very good surgical equipe, they did 3000 of this.
I spoke a lot with many doctors and erveryone, bot one, suggest me to do the surgery.
First they want to read again my cells...just to be shure...
I will have a toraco-abdominal ct scan in the first week of march, and i'm choosing to make a total body pet in add...in your opinion is useless? (this make me more relaxed...)
If everithig will be ok I will have the rplnd, otherwise chemio.

If they will find microscopic positive lynph in rplnd they don't don't give me chemio, if the ct are false negative, with bigger lynph 2 peb...statistically 80% of people with clinic stage1 and positive lynph at rplnd don't need chemio...
thank again!!!!

yes...I'm scared from rplnd!!!

[italian_tc]

Hi again...and thank again.
I'm very close to take my decision and probably will be sourveillance. I give myself some more days...just to be (i don't know the right word in english..may be) relaxed...shure...in the future i will never want to tell...if i did something different...I need only to promise this to myself...and this need some days...
all the people here give me a real and great help in this strange moment of my life...

thank you thank you thank you...and good luck! I will pray for all of you!

[dadmo]

If you can stand the anxiety surveillance is a great option. Just be sure you never ever miss an appointment.

[italian_tc]

I posted a mail to the hospital where Doc Sternberg work but i don't have a reply yet...the third option is by young oncologist that work in a small hospital...she's not specialized...and I hope a little paranoic...but she's friend of mine...
tks Scott....I like this way of thinking!

[Marco1975]

Davide, Doc. Sternberg suggested last treatment?

[Scott]

If it were me, I would choose surveillance now and chemotherapy if and when you have a confirmed recurrence.

[italian_tc]

hi guys...i'm very confused at the moment.
I spoke with three different oncologist and theese are the opinion:
- rplnd, stadiant (to make better stage) and curative, if needed chemio...but the goal is to avoid chemio.
- pet/tc scan, if clear sourveillance
- 3 bep + rplnd + ather chemio if needed...(this seems crazy!)

I have to decide! The first seems to be an expert (very good surgey team! they make 2900 rplnd in the last 20 year!!of course nerve sparing or half rplnd)
The second is a very good oncologist but not specialized in tc...the third is crazy...
help me in making a choice!
tks

[italian_tc]

ciao Marco, i've asked for laparoscopic but they avoid for high risk cases like mine... they want to wait to make a tc scan in march, if the scan will be ok we will make the rplnd, if not the chemio. I didn't ask what they will do if there will be active cancer in the nodes but if they do chemio the stats they show me doesn't work...50% of the cases make chemio and rplnd is useless. I will ask when i call for scheduling the surgey!

Marco you have a pm!

tks

[Marco1975]

Ciao Davide,

if you're deciding for the RPLND, consider tha Laparoscopic procedure. I was treated by Dr Sternberg (the other specialist listed on TCRC page) and her husband (Prof. Pansadoro) is The Doc for L-RPLND: I had stage IIb and had both chemo and surgery (and survided to both). Regarding side effects yes, better the surgery (even if I had the less invasive Laparoscopic procedure, so maybe a "real" RPLND survivor should answer...). Chemo tends to be... fastidiosa.

Glad you made it here in this forum, you've come to the right place for tips and answers.

Se vuoi fare due chiacchere, contattami!
In bocca al lupo,
Marco.

[dadmo]

italian_tc:
The doctor is right in wanting to avoid chemo. He has a reasoned approach to your treatment and you seem comfortable with it, and that is important. I do have a question for your doctor. If he should find active cancer in the lymph nodes what is his plan. In the U.S. the standard is two rounds of chemo.

[italian_tc]

...here what my oncologist say:
"you are high risk patient, 50% in your situation have relapse and 70% of this are in the linph, embrional can skip and 30% are in the chest. I can't know if you will and where but if i make rpnld tho everyone in this situation only 30% on 50% of the total will need chemio. This is my goal in terms of quality of life for your future. Only 15 on 100 will need chemio...this 15 make a rplnd they don't need but this is better than make 50 chemio not needed. After a month the surgery effect disappear, for the side effect of chemio is different"
He can make rpnld unilateral very fast without problem (in about 2 1/2 hour) and they assure they make a lot of this surgery....
i'm thinking on this...

[Rover]

I should add, my oncologist was leaning toward adjuvant chemo and understands it is more common in Europe. In fact he was looking at 1xBEP he said they were beginning to use 1x for adjuvant rather than the more typical 2x. We consulted with IU and they said they would not do adjuvant. So, even the experts have their preference.

-christoforo (for this post, I love Italy)

[Rover]

Welcome to the board,
To go on surveillance versus adjuvant chemo is a difficult and personal choice. We are fortunate to have options and the the cure rate is the same. There is no wrong decision. I have chosen surveillance for a tumor that is better than 50% embryonal with invasion. I prefer to not have chemo unless it is really needed but that is just my preference.

Good luck in your decision. Milano? Not too far from Genova. Man am I craving some focaccia.

-chris

[italian_tc]

sorry...i realize that i'm writing a lot of post.
I can't find doc that say: embrional carcinoma can skip linph node...
it make a huge difference... i'm confused but i'll see the oncologist in 4 hour...
bye

[italian_tc]

yeah! sounds very good! now i understand something!!!
and i find this (it seems to be a very useful doc) http://www.uroweb.nl/files/uploaded_...ularCancer.pdf
..and wow...one of the oncologist who wrote is the boss of my oncologist...if i understand they will give me 2 bep...we will see!
tks again
davide