danny's surveillance update

[LindaM]

Eight months since his i/o and all cat scans , x-rays and tumor markers are normal !!!!!! I read all the posts twice a day and think about what some of you are going thru and my thoughts are with you all the time. Happy and Healthy New Year to everyone and their families. Thank you, Scott, you have done a wonderful job with this site . I don't know what I'd do without it.

[Scott]

That's a great way to end the year! Congratulations!!

[Chris'Mom]

Wonderful news LInda and Danny, glad to hear it...Chris has his post RPLND and chemo cat scan scheduled this Thursday and then slides will be sent to Dr. Sheinfeld to review...wondering how long that will take to get results...I am a nervous wreck...but happy for your positive news....Mary Ellen

[LindaM]

I know just how you feel. Every time Danny goes to Sloan for cat scans or x-rays and blood work up I feel like jumping out of my skin. If you don't mind me asking, being as your son had the surgery what exactly are they looking for in the cat scans since the lymph nodes were all removed ??

[Chris'Mom]

Not really sure Linda, but that is standard protocol after RPLND from what I read...but all swollen nodes were removed and had teratoma....maybe just for final confirmation...but I think chris will always need a yearly or every two year cat scan...Mary Ellen

[dadmo]

Not all lymph nodes are removed during surgery. The nodes are like string of pearls and theY only remove the affected ones and then several on either side of that. The yearly scans are to check the remaining nodes for signs of growth due to cancer.

[LindaM]

It was my understanding that they normally remove about 40 nodes during surgery. So what happens when after the i/o a person who has a clear cat scan but chooses the surgery instead of surveillance. none of the nodes are affected so how do they choose and how many are there in that area over and above the forty that they remove. Patients with one or two swollen nodes have chemo first then surgery and still they remove 40 or so nodes. So whay you are saying that the cat scans are to observe the remaining nodes??? I guess I don't have a clear understanding of the lymphatic system and this surveillance option my son chose is driving me crazy.

[Scott]

The TCRC "After Treatment" section states that after RPLND, CT scans generally aren't necessary, with this caveat: "Please note that this protocol is appropriate if you had a good RPLND where all the lymph nodes in the template were removed as a single package. If your RPLND was not done in this manner, you might want to discuss a protocol that uses an occasional CT scan in addition to the tests listed here." It also says, "An abdominal CT should be done twice a year for those patients who had large volume teratoma."

[Chris'Mom]

Linda, Chris had a total of 23 nodes removed, not 40....I don't believe he had a large volume of teratoma in his original tumor...but if Sloan says a cat scan that is what we will have....Mary Ellen

[LindaM]

thanks for clearing that up for me , scott. I'm still trying to learn all that I can and I'm grateful for the info. Mary Ellen , I'm with you , whatever Sloan says to do we do. Thanks again, Linda

[Kman99]

LindaM..

I am glad to see that Danny's tests remain clear! And your in good hands at MSKCC!