Announcement

Collapse
No announcement yet.

Newly diagnosed, need advice

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Newly diagnosed, need advice

    Hi everyone. I have just been diagnosed with TC and I am looking for some advice on treatment options.

    I started having some pain in my right testicle about 6 months ago. It lasted for about 2 days and then went away. The end of March I went to have my annual physical for work and the pain had returned. I also had elevated white blood cell count. I went to my GP and he started treating me with antibiotics for epiditymitis. I noticed a small knot on my testicle about 2 weeks later. It was kind of soft and the GP thought it was just a hydrocele and continued to treat me with antibiotics. After 3 weeks of antibiotics the knot had grown to cover most of the inside of the testicle. My GP referred me to the Urologist who ordered an ultrasound and confirmed that there was a mass. My tumor markers and chest X-ray were normal (I don't know the numbers). He said the only way he could tell for sure was to do the I/O and take a look at it. I had the surgery on 5/18/07 and the Urologist told me after the surgery that it looked like cancer to him. I saw the doctor on 5/29/07 and the pathology confirmed that it was cancer.

    [I]Histopathologic Diagnosis:

    Right Testicle, Radical Orchiectomy: Non-Seminomatous Germ Cell Tumor Consistent with Embryonal Carcinoma.

    Focality: Unifocal

    Pathological Stage: pT2, pN0, pMX

    Tumor Size: 2.8 cm (Gross Dimension)

    Spermatic Cord Margin: Univolved

    Lymphovascular Invasion: Present

    Extra testicular spread: Absent (Tumor confined to testis).

    Comment:
    Sections show a tumor which is largely subcapsular in location. The tumor cells are fairly large with very large pleomorphic nuclei having frequent prominent nucleoli. A few poorly formed gland like structures are noted. Mitotic figures are fairly frequent and there is hemorrage and necrosis within the tumor. There are several foci where there are nest of tumor cells in thin walled apparent vessels which most likely represent lymphatics. In one focus there is a cluster of tumor cells within a muscular vessel. It is felt that this represents true lymphovascular invasion. A PAS stain shows strong cytoplasmic staining which is eradicated by diastase indication significant glycogen in the tumor cells. An immunostain for human chorionic gonadotropin is performed and shows virtual absence of staining in tumor cells. An immunostain for alpha fetoprotein is performed and shows only rare positive cells. The histologic appearance and immunostain characteristics of this tumor are most consistent with a choriocarcinoma (choriocarcinoma is marked out and initialed, the Urologist sais that he discussed it with the Pathologist and he said it was a typo).

    I got an infection after the I/O and I still have my staples. The Urologist is going to remove the staples on Monday and then schedule the CT. I live in East Tennessee and I am thinking about going to Vanderbilt-Ingram Cancer Center at Vanderbilt University to get a second opinion. The Urologist is handling everything on his own and has not even mentioned reffering me to an Oncologist. The Urologist said that my options were to watch it, RPLND, or Chemo. He is recommending the RPLND because he says that the 10 year recurrance with chemo is very high and there is a 20-25% chance that the cancer will come back if we just watch it. Could someone help me to understand the staging? I thought I understood the Urologist to say that it was stage I but I am beginning to wonder if its not stage II due to the lymphovascular invasion. Any advice that you can give me will be appreciated. Sorry for such a long post.

  • #2
    Hi

    Hi spcrice,

    The people here are the best!
    You are in good hands!
    The most important for you is to try to relax somehow.
    Your body offered some change – You have to change your life a little bit, that’s all.
    Think that, this is just one challenge. For all of us is the same.

    You will find some opinions and some meaning of all medical secret words, but don’t try to analyse what is good and what is not so good.
    Every case is unique.

    The dice is played (sorry for my English ), and the only important things now are: to not get crazy, to keep you mind – you are as normal as everybody, this is not a disease.
    And the most important – timing!
    Usually the dealys are given "in weeks", so is not question of seconds.
    But for the begining is important.
    Check the time /frequency recommendations here about your next blood tests, X-rays, CT-scans, doctor’s appointments and so on.

    Comment


    • #3
      spcrice:
      Your urologist might be a nice guy but you really need to meet with an oncologist and Vanderbilt would certainly be worth the trip. To get the proper staging you will need both scans and xrays. If you do have lymphatic involvement surveillance would not be a good choice. Of course this is just my opinion an oncologist is the person to sit with.
      Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

      Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

      Comment


      • #4
        Originally posted by spcrice
        ...I am thinking about going to Vanderbilt-Ingram Cancer Center at Vanderbilt University to get a second opinion. The Urologist is handling everything on his own and has not even mentioned reffering me to an Oncologist. The Urologist said that my options were to watch it, RPLND, or Chemo. He is recommending the RPLND because he says that the 10 year recurrance with chemo is very high and there is a 20-25% chance that the cancer will come back if we just watch it. Could someone help me to understand the staging? I thought I understood the Urologist to say that it was stage I but I am beginning to wonder if its not stage II due to the lymphovascular invasion. Any advice that you can give me will be appreciated. Sorry for such a long post.
        The "pT2" part of your pathology report covers the invasion, which increases the risk of metastasis but doesn't mean that it has occurred. You won't have complete staging information until your CT scan and new blood test results. You should certainly consult with a medical oncologist about all your treatment options. Hang in there, and keep us in the loop!
        Scott, [email protected]
        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!

        Comment


        • #5
          Spcrice, these guys have got you on the right track for sure. I can't offer much in the way of medical help, but I wanted to offer my support and prayers. It sounds like you are headed in the right direction. Let us know if we can do anything to help, I know this can be a stressful time in your life.

          Margaret
          Co-survivor with husband Boyce, Diagnosed 7-11-06, orchiectomy right testicle on 7-12-06- Stage 3A: Mixed germ cell tumor with inguinal seminomatous and kartotypic carcinoma. One tumor over 10 cm, second tumor 4 cm, Chemo 4xBEP: Bi-lateral RPLND Dec 2006, nerve sparing but left sterile.
          Current DVT
          Current testosterone replacement therapy, Testim.

          "You must abandon the life you planned, to live the life that was meant for you" ~wisdom I have learned from my family on this forum

          Comment


          • #6
            take roberts advice - get a 2nd opinion from an expert...its a very curable cancer...but somewhat rare and relatively few experts....

            you'll do fine...if I can say it this way...the best thing about this type cancer is there is so much data, very standard protocols, with a very high cure rate....that you will find when you consult with the experts all of the data points to a fairly standard treatment path(s) and the cure rate differences between the possible options are negligible....

            point is, you will not be in a situation where you are 2nd guessing your choice.

            keep us posted.

            pete
            - lump first noticed 11/20/2005
            - I/O right Dec 8, 2005
            - 95% embryonal / 5% seminoma
            - normal markers PRE surgery
            - no vascular invasion, tunica free of cancer, epididymis free of cancer, lungs free, lymph free
            - Stage I diagnosis
            - surveillance
            - mid feb '06, beta hcg slightly elevated = 4.6...small enlarged lower node seen on CT scan...
            - 3BEP began feb 20, 2006
            - finished 3 BEP, last bleo, april 17, 2006
            - CT scan, blood markers, chest..all clear
            - back on surveillance

            Comment


            • #7
              Originally posted by Margaret
              Spcrice, these guys have got you on the right track for sure. I can't offer much in the way of medical help, but I wanted to offer my support and prayers. It sounds like you are headed in the right direction. Let us know if we can do anything to help, I know this can be a stressful time in your life.

              Margaret
              Hi Sprice,

              Firstly, sorry you had to visit this site; Secondly I have found this site to be my lifeline of Faith; Hope; Reality Check; Knowledge and Love.....couldn't ask for much more hey But wait...There IS more.....they are also the most empathetic.....as they have been or going thru similar circumstances......My heart and thoughts are with you.....Keep strong.....Think strong......Live Strong

              Margaret,
              I wanted to thank you and Boyce for getting Michael to tell us his story; because of that I have spoken to Dr Schwartz and even tho he said that Gerrard doesn't seem to fit the criteria, he has sent his info on to the specialists at sloan and he assured me that they would be in contact with Gerrard's Doctors.....so Thankyou from the bottom of my heart.......See Sprice this is why they are such a great group

              Take care
              Jenny

              Comment

              Working...
              X