Any advice on Carboplatin

[jeremyb]

Hi,

Have just had results of pathology, ct scan, xrays and bloods. It appears I have been VERY lucky to have found my seminoma tuma very early indeed.

My bloods showed no raised markers, and my scans and xray were clear. My cancer was shown to be seminoma and no vascular or lymphatic invasion.

Ultrasound on remaining testical showed some "background changes" which oncologist didnt seem too worried about.

Consultant said that chances of it coming back are 1/6 without any treatment and 1/50 if I have either radiotherapy or a single dose of carboplatin chemotherapy. Now my wife and I have already decided that the 1/6 odds are too small and have decided to have the treatment, but not which one. I also know that the research into carboplatin is good but hasnt been around that long. We are also wishing to have a second child soon and are not sure which option is best from fertility, outcome and treatment side effects point of view.

Would be very grateful for any advice, opinions etc from anyone who knows about this stuff.

All the best

Jeremy

[Jens]

Hi Jeremy.

Carboplatin is not that new, but using it instead of RT on seminoma, is a new thing. The results I have seen published are quite promising and it appers that the sideeffects may be less than from RT.
One issue is kidney function and if the rays hit the kidneys, there may be a decrease in efficincy 2-3-4 years after radiation. With chemo the effect is immidiate, if any. And carboplatin is supposedly a milder reagent than cisplatin, so all in all (imho) it might be worth at serious discussion with your oncolgist.

Some pros and cons...
http://annonc.oxfordjournals.org/cgi...tract/mdj039v1
http://www.medscape.com/viewarticle/508882
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract


Best wishes

[Lunge]

Hi jeremyb
Welcome to the club

Maybe you want to read the posts of me "Lunge" and "Krokar".
We both did the Carboplatin treatment. Just use the forum search.

Greetz
Lunge

[Scott]

The usual TC-NET advice is to consider participating in a clinical trial for two-dose carboplatin and to avoid single-dose carboplatin. While radiation therapy is well-proven treatment, less long-term data is available for treatment with carboplatin.

[Krokar]

I can not avoid TC-NET argument against Carboplatin from TC-NET administrator, that Carboplatin is in use in Europe because doctors are corrupted This was most unprofessional answer I ever read on that forum.

....with all respect to TC-NET anyway...

[Scott]

Hmmm, I don't think anyone said European doctors are corrupt. I think the claim was that there is a systemic bias toward less expensive treatment.

(I'm just reporting what I read. I don't have enough information to judge whether it's true.)

[Ken A]

Is surviellance cheaper than RT for for a sampling of stage one seminoma people? I think it is clearly not and this is a European protocol not an American one.

[Scott]

Some studies have shown that adjuvant radiation therapy is less expensive than surveillance. See this link, for example.

However, why do you say that surveillance is "a European protocol not an American one"?

[Ken A]

My doctor told me surviellance is more accepted in Canada and Europe and it is a newer tren here in the States. My reading seems to support this as well.

Is interesting as I agree RT is likely cheaper so was a bit surprised. Seems if surviellance is more expensive and it is being used by the more cost constrained societies than that sure is an endorsement,

[Scott]

The National Comprehensive Cancer Network guidelines say there is "non-uniform consensus (but no major disagreement)" that surveillance is appropriate for stage I seminoma "if T1 or T2 histology in selected patients committed to long-term follow-up."

[Ken A]

Thanks yet again Scott. I suspect some of the old guard feel strongly about RT.

[jeremyb]

Sorry guys for raising something that seems to have created some "healthy debate".

Anyway, back to the point and my consultant is adamant that 1 dose of carboplatin is equivalent to radiotherapy, so am going to trust him - still some anxiety about this given the strength of opinion on this, but have to make decicion by today. Hope am right to go for this - only time will tell I guess. But there is no evidence except some small background changes in lefty that i will have any further problems - so here goes!!!

Cheers

Jeremy

[Jens]

Best of luck Jeremy!

Jens

[Krokar]

Good luck.

[jeremyb]

ok, I have my one dose of carboplatin this friday (9th dec).

Cheers for advice etc

jeremy