Two TC Questions

[italian_tc]

...when the doc told me that i need i/o I asked him if was possible to make a "half" orchiectomy...he said "it is possible but it's very difficoult, it's not safe for the spread of tumor, could be a long surgery and the anestesyologic risk is different...plus you can live normally with only one.
I can think about this surgey only for bilateral cancer in young man who accept the risk of spreading...preferable for seminoma"
ciao
da

[Fed]

AGAIN:
We are not specialists but we could help each other to formulate good questions to our doctors.
We should not apply the other’s prescription. That is the worst thing.
Knowing and asking makes TC even more curable.
Am I wrong?

Point well taken. My response is entirely based on my knowledge of cancer biology, and it is, in no regard, a substitute for the sound advice of an oncologist.

[Fed]

Good post, have you come across why partial I/Os arnt primarily used or why its not a simple orchidectomy rather than inguinal?
Isnt that metastasis from operations debate still up in the air?

Partial I/Os are surgically demanding. Apart from the potential of an unintended spread, it is much harder to define a surgical margin that is free of tumor -this is usually done by doing histopathology, and the naked eye is not sufficiently good to tell the difference. That said, there are a few cases in which they do work, and I believe there are some Forum members that have seen success with a partial I/O.
I don't know what is the surgical technique for a partial orchiectomy is, but I would gather it would still have to be inguinal since transscrotal is always considered suboptimal in cases where a neoplasm is suspected.

[oscar666]

Thanks

Fed,
Thank you for your detailed information.

I have seen people here still considering the CT scan as a tool good enough for scrotal tests. Obviously not CT but Ultrasound of the other (survival) testicle should be used for long-term check-ups after successful TC treatment.

Regarding the second question, thank you again for the clarification.

AGAIN:
We are not specialists but we could help each other to formulate good questions to our doctors.
We should not apply the other’s prescription. That is the worst thing.
Knowing and asking makes TC even more curable.
Am I wrong?

[Michael112]

It can, but the masses are better resolved in an ultrasound. Also, an ultrasound is capable of detecting blood flow to the mass whereas a CT cannot.

When there is a solid mass inside the testis confirmed by an ultrasound, 95% of the times (yes, 95%), the mass is malignant, hence the need for the I/O. Localized radiation may be feasible, but the consequences are that it will undoubtedly result in sterility. Chemo doesn't work because, just like the brain has a blood-brain barrier, the testis has a blood-testis barrier that does not allow for the transport of several compounds. There is a biological reason for this. The testis produces sperm, all of which contain DNA that is, by definition, different from your own. If there were direct access to a blood supply, your immune system would recoginze the sperm as an invader and would begin to mount an immune response -hence the need for the barrier. I always marvel at the wonderful design of the human body. Too bad it fails us sometimes.

Good post, have you come across why partial I/Os arnt primarily used or why its not a simple orchidectomy rather than inguinal?
Isnt that metastasis from operations debate still up in the air?

[Fed]

1.Does anybody know if CT scan really could detect something in testicle?

It can, but the masses are better resolved in an ultrasound. Also, an ultrasound is capable of detecting blood flow to the mass whereas a CT cannot.

2.Does anybody know other treatment than I/O when tumor is found there? (say, the ultrasound confirmed a “mass”)

When there is a solid mass inside the testis confirmed by an ultrasound, 95% of the times (yes, 95%), the mass is malignant, hence the need for the I/O. Localized radiation may be feasible, but the consequences are that it will undoubtedly result in sterility. Chemo doesn't work because, just like the brain has a blood-brain barrier, the testis has a blood-testis barrier that does not allow for the transport of several compounds. There is a biological reason for this. The testis produces sperm, all of which contain DNA that is, by definition, different from your own. If there were direct access to a blood supply, your immune system would recoginze the sperm as an invader and would begin to mount an immune response -hence the need for the barrier. I always marvel at the wonderful design of the human body. Too bad it fails us sometimes.

[fuse929]

An ultrasound is the best diagnostic tool for discovering testicular abnormalities. I've never heard of a CT scan being used as a tool for looking at a potentially problematic testicle. If somthing funny was seen on a CT scan, I would have them do a full scrotal ultrasound to get a better idea of what they were seeing.

I don't know enough about your second question to give a good answer, except to say that 95% of solid testicular masses are cancerous, and therefore need to come out. I believe there is a type of organ-sparing operation, but I know very little about it. I'm sure others in here have much more knowledge about it.

Bobby

[oscar666]

Two TC Questions

1.Does anybody know if CT scan really could detect something in testicle?
2.Does anybody know other treatment than I/O when tumor is found there? (say, the ultrasound confirmed a “mass”)