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It doesn't always turn out that way. For example, I had elevated markers from my yolk sac and embryonal carcinoma elements, but my recurrence produced no markers and turned out to be seminoma.
You may recall that several weeks ago I had my path re-read (for a third time) by the pathologist that works in my lab at Dana-Farber. This was done in my presence with the assistance of the GU pathologist on call. When we were going through my slides, I asked him whether it was possible that one cell type would be mistaken for another. He stated that embryonal carcinoma has very similar morphology to seminoma because they derive from the same precursor ITGCN: under the scope, both cell types look like fried eggs with big nuclei. In that instance, the blood markers may help tilt an assessment into one direction, and EC will not necessarily show markers. Under these circumstances, knowledge of blood marker levels could potentially impair the impartial pathological determination of a tumor sample.
I should place a disclaimer, though, that I am not fully qualified (yet; I may go to a cancer pathobiology workshop this summer that will train me on these sort of things) to make assessments of this sort.
"Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
11.22.06 -Dx the day before Thanksgiving
12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.
The pathologist will (should) test the immunohistochemistry.
Indeed. Then the evidence would be incontrovertible because one would be seeing the actual markers stain on the slide.
"Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
11.22.06 -Dx the day before Thanksgiving
12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.
Anthony had his MRI this morning, now we have to wait until next week to have a doc. read them and let us know how everything is.
I am now concerned about something else.
Before anthony started chemo he was having low back pain from the enlarged node.
After he started chemo that all went away.
He got up this morning and has that same back pain again.
Should I not wait? Should I take him to the ER?
Tammy
Son Anthony DX 12/11/06
L/O 12/20/06 Stage IIIA, 95% EC, 5% Yolk Sac
4XEP 1/29-4/6/ 07
AFP started increasing3 wks later
Residual abdominal mass found on CT
RPLND 6/8/07
Cancer in pathology-
80% mature teratoma, 20% Yolk Sac. --
No adjuvent chemo and
AFP normalised
Can you think of some other possible cause for the back pain today? I wouldn't think an emergency room visit is needed, but if it's really concerning you, it may be worth a call to your oncologist.
Scott right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since
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Tammy,
I agree with Scott. There are a LOT of things that can cause back pain. You have to do what your heart tells you, but you may want to wait a couple of days and see if hot showers and Motrin hekp it out. If not, definatley mention it to the oncologist.
Retired moderator. Husband, left I/O 16Dec2005, stage I seminoma with elevated b-HCG, no LVI, RTx15 (25Gy). All clear ever since.
Can you think of some other possible cause for the back pain today? I wouldn't think an emergency room visit is needed, but if it's really concerning you, it may be worth a call to your oncologist.
Well all I can say is that he is only 21 yrs old and has never had back pain until he got cancer; and the pain is in the same place as it was before. Remember that they found a mass on his scan that he just had after chemo...
The largest part of the mass was 4.5 cm BEFORE chemo .. and on his scan AFTER chemo it is 4.7cm. I am assuming it is the same enlarged node that they found before chemo.
Could it still be growing?
If he was chemo refractory, would the markers return to normal during chemo, and then begin rising after?
Im really worried and Im not sure what to think ...
If it is cancer again, can it wait until I call the dr. monday, or is it more dangerous to wait since he has already had chemo? Will it grow too fast?
Son Anthony DX 12/11/06
L/O 12/20/06 Stage IIIA, 95% EC, 5% Yolk Sac
4XEP 1/29-4/6/ 07
AFP started increasing3 wks later
Residual abdominal mass found on CT
RPLND 6/8/07
Cancer in pathology-
80% mature teratoma, 20% Yolk Sac. --
No adjuvent chemo and
AFP normalised
Tammy, is Anthony's RPLND surgery scheduled, and if so, how soon? If the mass is teratoma, chemotherapy wouldn't have had much effect on it, but surgery should be curative.
Scott right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since
Your donation funds Livestrong services for people facing cancer now. Please sponsor my ride!
Tammy, is Anthony's RPLND surgery scheduled, and if so, how soon? If the mass is teratoma, chemotherapy wouldn't have had much effect on it, but surgery should be curative.
Scott, no it has not been scheduled yet but when I spoke with Dorrie on friday she said everything had been faxed to U of M, and they were working on it.
I know the oncologist said they wait for 6 weeks to recover from chemo.
Anthonys last week of chemo was April 2 through April 6. So it has been 3 weeks.
Also, the original pathology did not show anything about teratoma. The oncologist just told me that he thinks it might be teratoma, when they found the mass on his after chemo scan.
Son Anthony DX 12/11/06
L/O 12/20/06 Stage IIIA, 95% EC, 5% Yolk Sac
4XEP 1/29-4/6/ 07
AFP started increasing3 wks later
Residual abdominal mass found on CT
RPLND 6/8/07
Cancer in pathology-
80% mature teratoma, 20% Yolk Sac. --
No adjuvent chemo and
AFP normalised
Hi Tammy,
Have been reading your posts, have been in a whirl wind myself. If you make a move, don't "offer" to pay. Just let it work it's way through if it come up. I believe every hospital has charity money and they have to document charitable funds so they want to give....at least sometimes. Don't ask me the logic.
I believe your concerns are valid. They are also very confusing. I am glad for people like Dorree. She has to be working with someone, because she could not place that order without a physician. Do you know who is supporting her? That might be a direction to go for someone with an undersatnding ear. When I read the quote from the onc MD "that his markers will not go up," I had a huge reaction. Maybe he is educated and experienced and the best in the world, but that kind of attitude and statement usually comes from the mouth of person who carries personal ego infront of compassion. Very often, they are excellent at outcomes and you don't have a thing to worry about, but it is the same arrogant attitude that got us into the situation that we are in. Should have been simple, went to advanced. I can hear in your words the confusion and stress. it will be impossible for you to diagnose this. It is difficult even for the MDs. Your son will be sensing your stress right now and he needs a Mom. If you are not his Mom, no one else can be. I am not saying to let go or slow down, just fire your arrow to the people that will be there for you. Find your balance so your son can feel secure. This is advice giving, but there were times people looked me in the eye and I am thank-ful for the efforts that helped me get my train back on the track. The stress is huge....distance runners, bikers, pace themselves! Hang on, we are with you!!!!!!! Russell's Mom, Sharon
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