Is Orchiectomy advised

[gmk]

On 7/19/06 my boyfriend went to ER experiencing severe back pain. After CT scan it was discovered that he had a left retroperitoneal mass of which a biopsy showed a malignant spindle cell neoplasm, not attached to any organ and with an inflamed lymph node. On 8/29 the lymph node was biopsied and the day before his birthday on 9/1 was told that he had testicular cancer. The biposy was showing pure seminoma. On 9/15 the oncologist referred him to a urologist to have the testicle removed, however on 9/20 the urolgist said that this was not necessary because there was no mass in the testicle. On 10/2/06 he began his chemo treatments as an inpatient. He had a port inserted and went through 3 cycles of chemo- each cycle was 1 week inpatient and Bleo 1 time each week as an outpt. He tolerated the chemo real well however the last week of inpatient treatment the port became infected and had to be removed. A pic line was inserted to complete the last 3 weeks of treatment. He had IV antibiotics at home and developed bloodclots in his arm, then had to be admitted to hospital for 2 blood transfusions. As a result of these blood clots he is now on coumadin for about 1 year as per his oncologist. In middle of Dec he began experiencing back pain and 12/27 had a MRI and bone scan and this showed that his left retroperitoneal mass had shrunk to half the original size and the lymph node was completely resolved and showed no new lymph node enlargement. The bone scan showed he has hemangioma on L-3 and that there was something showing on the T11 and T12. A biopsy of the T11 and T12 showed no cancer. This was followed by a PET scan and CT scan on 3/1/07 and what appears on the T-11 and 12 is osteomylitis with probable heart valve inflamation which they say is a likely result of the port infection. He will have a heart study this week to verify and will then be put on antibiotics for the infection. These tests also showed that the retroperitoneal mass had shrunk even smaller so hopefully it will disappear in time. The oncologist is very satisfied with the results. Now my big question is ...on 2/8/07 he went back to urologist to see about having the testicle removed and again the dr is saying no because there is no mass. He also had an ultrasound to confirm this. However,both of us believe it should be removed. When he questions the oncologist she says that it is up to the urologist as to whether this procedure is necessary. He has been through so much and we want to do the right thing. It was my belief that anytime that the cancer is seminoma the testicle was to be removed regardless of a mass. Who do we believe?? Hope you can advise us...we are very confused.

[Scott]

If there's no sign of a mass in the testicle, perhaps what he had was an extragonadal germ cell cancer (EGC). See this page at the Testicular Cancer Resource Center.

[dadmo]

It's not common but it seems that your boyfriend has a form of testicular cancer that does not involve the testicle. I know it seems weird but have a testicle removed will not help his situation. This may sound odd but your doctor should be thanked for not doing an operation that to us laymen seems necessary but really isn't.

[gmk]

If there's no sign of a mass in the testicle, perhaps what he had was an extragonadal germ cell cancer (EGC). See this page at the Testicular Cancer Resource Center.

Thank you so much Scott and Dadmo. It makes us feel better that the right decison was made. I have been using this website since last August when my boyfriend was diagnosed but never signed on until recently. It is easier for me to understand when I am able to read actual stories from people who had experienced TC or are experiencing TC. I guess unless you never have actually gone through it...you can only imagine what it is really like. Bruce had just retired at the age of 58 when he was diagnosed and it hit us like a freight train. I spent lots of time on this website and it helped me get through the bad times and understand better as to what he was going through. It helped me to see what he could be faced with next and I wouldn't be so surprised when he had to take a few steps back knowing that it was only like a detour and would soon be back on the main street again, after of course a bit of strength and courage. I will keep you informed as to Bruces' progress. He is a fighter and I know he will overcome all of this. Thanks again for this great website.

[Michael112]

I think he should have an MRI, they is more accurate then an U/S although not neccesary under usual circumstances.