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  • Surveillance / general / prosthesis questions

    Im 28 and had a seminoma that was 3cm's with no elevated tumour markers. I think i noticed it fairly quickly and didnt hesitate going to the doctor.i had my orchietomy on july 5th and met up with my oncologist a week later. I chose surveillance rather then rediation. My ct scans were clear and the various markers were still not elevated. Im wondering that if i do get some sort of a recurrence are my markers likely to rise, given that they never did in the first place? Is it a good sign they hadnt, or does it mean anything really? Also for anyone that got a prosthetic was yours positioned comfortably from the get go. Mine is very high, so high that when i have an errection it sits along side rather then hanging down. Doc says to pull it reguraly and hopefully as scar tissue heals it will go to a more comfortable position but i reckon he didnt seem too hopeful about that. Any advice or general words of wisdom would be greeatly appreciated. Oh and is 3cm big?

  • #2
    Hey donnie,

    Although I cannot help you with your questions about the prosthesis, I can give you some input on the other questions you asked.

    If your original tumor did not show markers, it is unlikely that the bloodwork would indicate a recurrence. The fact that there are no markers doesn't tell you anything because there are other germ cell tumors that don't produce markers either. If anything detectable were to increase, it would be the LDH because it is sometimes used as an indicator of tumor burden; however, LDH is the most imprecise of all of the markers because it is also produced by normal cells. In the case of seminoma treated with surveillance, the radiology will be the best indicator of a relapse.

    As far as the tumor size is concerned, it really has little bearing on the likelihood of a relapse. The important issue is the extent of invasion. For example, if the tumor is big, but it doesn't invade the rete testis and there's no L/V invasion, then the chances of a recurrence go down.

    Hope this helps with your questions. Fire away if anything else is unclear.
    "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.

    Comment


    • #3
      Thanks for replying. I was told that the cancer was confined inside the testicle. What is L/V invasion?
      Cheers

      Comment


      • #4
        This refers to microscopic invasion by tumor cells of the blood vessels or lymphatic vessels of the testicle.

        When I was doing research after my seminoma diagnosis, I found at least one study that correlated tumor size with risk of recurrence, but only if the tumor was bigger than 4 cm. I don't know if there has been any additional work done on this subject.
        Fish
        TC1
        Right I/O 4/22/1988
        RPLND 6/20/1988
        TC2
        Left I/O 9/17/2003
        Surveillance

        Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

        Comment


        • #5
          thanks for that, i was a bit worried that 3 cm seemed a bit large even though i didnt think it was likely that i had it for long.

          Comment


          • #6
            Originally posted by Fish
            When I was doing research after my seminoma diagnosis, I found at least one study that correlated tumor size with risk of recurrence, but only if the tumor was bigger than 4 cm. I don't know if there has been any additional work done on this subject.
            Yes, I read this study, as well (and I believe it's referenced in the library and resources part of the Forum). All the docs I talked to during my trials and tribulations were more concerned with invasion into other structures more than size, which makes sense, since invasion of the stroma or vascular structures correlates with spread. Then again, the bigger the tumor, the greater the likelihood of invasion.
            "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.

            Comment


            • #7
              My doctor said there were no signs of it spreading so i presume that would mean there were no sigs of invasion. Thanks for all the help

              Comment


              • #8
                i have read an article which says if the tumor is bigger than 6 cm surveillance is not recommended. i dont know it is true or not but it says 6
                Last edited by TC Destroyer; 06-28-11, 10:48 AM. Reason: spam
                -------------------------------------------------------------------------
                27/07/07 diagnosed
                30/07/07 Right I/O
                path: 5.00 cm mass with EC %40 / Imm. ter. %30 / semin %20 / YS %10
                no vaslucar inv./ no lymphatic inv/no metastis
                Stage I-A
                surveillance
                24/10/07 CT showed 2 enlarged nodes
                Stage II-B
                markers:
                27/07/07 B-hcg:202 /AFP:260
                13/08/07 B-hcg:0.306 /AFP:32/ LHD:293
                20/08/07 AFP:13.25
                05/09/07 AFP:3.7
                05/10/07 AFP:2.7 B-hcg:6.01
                30/10/07 AFP:6.0 B-hcg:17

                Comment


                • #9
                  Originally posted by Fed
                  Then again, the bigger the tumor, the greater the likelihood of invasion.
                  I agree, that's the likely reason for the observed correlation, it would be interesting to see a correlation of tumor size with L/V invasion.
                  Fish
                  TC1
                  Right I/O 4/22/1988
                  RPLND 6/20/1988
                  TC2
                  Left I/O 9/17/2003
                  Surveillance

                  Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

                  Comment

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