Got my post I/O results

[daniel.s]

Hello everyone.

Got my results back. It's a stage 1 seminoma. I'm just waiting on an appointment to see the Oncologist. In addition to that, I need to think about whether I'm going to go on surveillance, or go with some treatment.

I'm leaning towards surveillance at the moment.

If anyone's interested, I scanned in the pathology report:

CLINICAL DETAILS
(L) testicular tumour.

MACROSCOPIC DESCRIPTION
LABELLED 'LEFT TESTICLE'. A testis, 60 x 45 x 20mm, 43g. The spermatic cord is 45mm long and
15mm in diameter. A well demarcated pale tan tumour 20 x 12 x IOmm is noted in the lower portion of the
testis. No necrosis or haemorrhage is seen. The remaining testicular tissue appears unremarkable. The
tumour does not appear to involve the tunica, hilum, epididymis or spermatic cord. Block 1A & 1B tumour
with tunica, 1C tumour with tunica and uninvolved testis, ID hilum, IE uninvolved testis, IF epididymis, 1G
spermatic cord.

MICROSCOPIC REPORT
The sections show a classic seminoma of the testis. The tumour cells show abundant clear cytoplasm, large,
rounded nuclei and prominent nucleoli. Small areas of necrosis are seen. Mitoses are readily found (about
4/hpf in some fields). There are scattered lymphocytes in the fibrous septa between nests of tumour cells.
Intratubular germ cell neoplasia and pagetoid spread into the rete testis are noted.

No other types of germ cell tumour are found in representative sections.

SPECIAL INVESTIGATIONS
Abundant glycogen granules are seen in the tumour cells, including intratubular component, confirmed by a
PAS stain with diastase predigestion.
Immunohistochemistry shows no expression of EMA and CD30 antigens in the tumour cells. PLAP and ckit
are positive in the tumour cells.

SUMMARY
Left testis: Classic seminoma.

[MRMRSU]

Hi Daniel: Looks like you caught this early which is a good thing. Keeping positive thoughts for you and hoping that your oncologist will be able to see you soon. BTW, Sydney has got to be one of the prettiest places in the world. My husband and I always say that if we could pack up and move somewhere else, it would be Sydney. Best wishes for continued recovery.

[fuse929]

That is an extremely promising report daniel! Once you have your post-op CT scan, X-rays and bloodwork, you will have a much better idea of what to expect for treatment. It looks to me like you may be well on your way to surveillance!

Bobby

[Scott]

Looks good! As you've undoubtedly read, 80% of men with stage I seminoma are cured by the orchiectomy alone.

[Fed]

Daniel,

The path report you show here looks very promising. Surveillance is an excellent choice as long as you are good about follow-ups and can handle the pre-lab anxiety. Like Scott said, with the I/O alone, you have an 80-85% chance of already having been cured. Hopefully you'll be able to settle on a path once you see your doc. Cheers,

[daniel.s]

Cheers guys. We'll wait and see what the next couple of weeks hold.

How long do you normally go on surveillance for?

[Fed]

How long do you normally go on surveillance for?

Surveillance is a lifetime thing, dude. For stage I seminoma treated with surveillance, the usual schedule goes CT scans, markers, and chest X-rays every 4 months during years 1-3, twice a year for years 4-6, and once a year for year 7 and beyond. In the case of seminoma, the relapse window is 5 years due to its slow growth rate, so it is crucial you stick to the schedule.

[Scott]

Surveillance is a lifetime thing, dude.

...and that's true even if you choose other treatment now. Checks would be further apart and even less likely to find anything, but they'd still be at least annually for life.

[daniel.s]

Fair enough. I understand the long-term part of it. I was just wondering how the first 6 or so months would be. I was under the impression that the checkups would be more regular to start with.

[CharlieFL]

My surveillance is also in that 4 month cycle that Fed mentioned, but for the first year, my Doc wants to see me every month. I think he wants to make sure I stick to the plan. I actually don't mind seeing him, not only because he's good and I like him, but because it gives me peace of mind.......

[MDdad]

Daniel: Sent you a PM. Your biopsy results are near identical to mine. Looks like we both caught it early. Best of luck to you!

[donnie]

i did and would go with surveilance, seems less of a risk to me. Down side is there will be more reason to worry in the future.