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Biopsy Concerns

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  • Biopsy Concerns

    As per my previous threads, after my Testicular Cancer I had an RPLND followed by 2 rounds of BEP. At the time there was a big debate on whether I needed the chemo as only they very slightest of cancer cellers were founf in 2 nodes removed.

    I am now approximately 5 months from the end of chemo and my recent CT scan showed 2 enlarged nodes. My oncologist beleives there is a 66% chance this could be teratoma with a 35% chance of the return of cancer. His view is that if it is a return of the cancer the prognosis is a 50/50 chance of survival at best.

    After a consultation with both my Oncologist and Urologist, they want to biopsy the enlarged nodes on the basis they hope it is teratoma, my questions are as follows:

    1) Is this a sensible move, recognizing the percentages above?

    2) How painful is a Biopsy?

    3) finally if it is Teratoma, and I need a second RPLND does anybody know if it is as invasive as the first op?

    Thanks for any advise.


  • #2
    Hey Dave...what were your most recent tumor markers? Were they normal or elevated at all. My cancer came back about 7 months after my last round of BEP...and like you it was because of a few lymph nodes that had grown in size from the previous CT scan. The main difference was I never had an RPLND before I had a bi-lateral one done and they were able to biopsy the nodes that way.

    When I was initially diagnosed...both left and right lymph nodes in the retroperitoneal region were swollen. They biopsied one node via a needle-scope biopsy through the back. It wasn't painful at all and they drug you up enough that it seems like it lasted 5 minutes (it really took a lot longer). They all shrank from the chemo. I'm not a doc...but the needle-scope biopsy sounds like the way they would do it for you.
    Brett, Stage IIIB Non-Seminoma Extra-Gonadal Germ Cell Tumor 7/12/06, 4xBEP 7/31/06 - 10/17/06, enlarged retroperitoneal lymph nodes found 5/22/07, bi-lateral RPLND and Left I/O 6/05/07, 2xVIP 7/16/07 - 8/11/07, spot on spleen found 9/13/07 - DOH!, PET scan sked 10/29/07


    • #3
      Navy, thanks for the response.

      My Tumor markers are good, AFP 2.0 and HCG less than 5. However, even with the original cancer they were not that elevated, I think my AFP was around 7.