Testicular Cancer Survivor Follow-Up



J

J C

Guest
I had my last treatment of chemo for my cancer on January 14, 2003. I have been having follow-up
CT's, bloodwork and chest Xrays. This last CT scan showed a enlarged lymph node of a little over
1cm. My blood work and Chest Xray all came back normal. My oncologist wants to do surgery if in a
month the lymph node has stayed the same or enlarged. I asked her about doing a pet scan to see it
was actually cancer and she responded that the pet scan probably would not pick something that small
up. I personally do not want to have the surgery if my marker levels are all normal. does anyone
know if lymph nodes can enlarge and be cancerous without the marker levels elevating? Also what else
could cause enlarged lymph nodes? Thanks, J Clark [email protected]
 
"J C" <[email protected]> wrote in message
news:[email protected]...
> I had my last treatment of chemo for my cancer on January 14, 2003. I have been having follow-up
> CT's, bloodwork and chest Xrays. This last CT scan showed a enlarged lymph node of a little over
> 1cm. My blood work and Chest Xray all came back normal. My oncologist wants to do surgery if in a
> month the lymph node has stayed the same or enlarged. I asked her about doing a pet scan to see it
> was actually cancer and she responded that the pet scan probably would not pick something that
> small up. I personally do not want to have the surgery if my marker levels are all normal. does
> anyone know if lymph nodes can enlarge and be cancerous without the marker levels elevating? Also
> what else could cause enlarged lymph nodes? Thanks, J Clark [email protected]

Testicular cancer can certainly grow without the markers elevating. But the likeliest thing is that
the repeat scan will not show any growth, in which case surgery is a judgement call
 
J C <[email protected]> wrote:

> I had my last treatment of chemo for my cancer on January 14, 2003. I have been having follow-up
> CT's, bloodwork and chest Xrays. This last CT scan showed a enlarged lymph node of a little over
> 1cm. My blood work and Chest Xray all came back normal. My oncologist wants to do surgery if in a
> month the lymph node has stayed the same or enlarged. I asked her about doing a pet scan to see it
> was actually cancer and she responded that the pet scan probably would not pick something that
> small up. I personally do not want to have the surgery if my marker levels are all normal. does
> anyone know if lymph nodes can enlarge and be cancerous without the marker levels elevating? Also
> what else could cause enlarged lymph nodes? Thanks, J Clark [email protected]
Lymph nodes can also be enlarged due to infection or inflammation, experienced radiologists can
sometimes tell the diff between large metastatic and inflamed nodes. A 1cm node (depending where
its located) is borderline, a repeat scan is sensible -perhaps a month or two later. If it keeps
growing and you can rule out an infection at or below that level then surgery is the way to go. As
Steph says, markers aren't too reliable in testicular cancer. Were they were raised before
treatment began?

--
madiba
 
JC,

Here is my real life experience with your situation:

I had the exact same scenario 12 years ago, but back then my doc wanted to remove all my lymph nodes
throughout my whole torso. I refused. My cancer just came back 2 years ago and I'm still fighting
it. My doc this time was getting advice from Dr. Lawrence Einhorn, Lance Armstrong's saving doc, who
now is exclusively my doc. Anyway, the tumor grew back in the original lymph node and I went through
7 1/2 months of chemo when they decided to do surgery. But now they are able to do a more precise
removal of only the key lymph nodes associated with network the caner is in. I had my surgery at U
of M by a very good urologist and things were looking pretty good. He was a specialist in this type
of surgery and that is all he does, so he was very experienced at this type of surgery. But despite
all that my cancer persists. Believe-you-me, I wish I had that lymph node removed 12 years ago!

My advice to you would be to go see Dr. Einhorn at Indiana University Cancer Center and get his
opinion, after all, he is THE top testicular cancer doctor in the world. He has the best reputation
for pulling people from the grave! I just hope he can save me!

PTC

"J C" <[email protected]> wrote in message news:[email protected]...
> I had my last treatment of chemo for my cancer on January 14, 2003. I have been having follow-up
> CT's, bloodwork and chest Xrays. This last CT scan showed a enlarged lymph node of a little over
> 1cm. My blood work and Chest Xray all came back normal. My oncologist wants to do surgery if in a
> month the lymph node has stayed the same or enlarged. I asked her about doing a pet scan to see it
> was actually cancer and she responded that the pet scan probably would not pick something that
> small up. I personally do not want to have the surgery if my marker levels are all normal. does
> anyone know if lymph nodes can enlarge and be cancerous without the marker levels elevating? Also
> what else could cause enlarged lymph nodes? Thanks, J Clark [email protected]
 
"madiba" <[email protected]> wrote in message
news:1g9s2dt.1nl6io014zht5qN%[email protected]...
> J C <[email protected]> wrote:
>
> > I had my last treatment of chemo for my cancer on January 14, 2003. I have been having follow-up
> > CT's, bloodwork and chest Xrays. This last CT scan showed a enlarged lymph node of a little over
> > 1cm. My blood work and Chest Xray all came back normal. My oncologist wants to do surgery if in
> > a month the lymph node has stayed the same or enlarged. I asked her about doing a pet scan to
> > see it was actually cancer and she responded that the pet scan probably would not pick something
> > that small up. I personally do not want to have the surgery if my marker levels are all normal.
> > does anyone know if lymph nodes can enlarge and be cancerous without the marker levels
> > elevating? Also what else could cause enlarged lymph nodes? Thanks, J Clark [email protected]
> Lymph nodes can also be enlarged due to infection or inflammation, experienced radiologists can
> sometimes tell the diff between large metastatic and inflamed nodes. A 1cm node (depending where
> its located) is borderline, a repeat scan is sensible -perhaps a month or two later. If it keeps
> growing and you can rule out an infection at or below that level then surgery is the way to go. As
> Steph says, markers aren't too reliable in testicular cancer. Were they were raised before
> treatment began?
>
> --
> madiba

My markers were elevated before the treatment began. after the first cycle they went back to normal.
I continued on with 2 more cycles of chemo. The enlarged lymph node is in the same spot that was
cancerous before. Thanks for the followups.

J Clark
 
"J C" <[email protected]> wrote in message
news:[email protected]...
>
> "madiba" <[email protected]> wrote in message news:1g9s2dt.1nl6io014zht5qN%[email protected]...
> > J C <[email protected]> wrote:
> >
> > > I had my last treatment of chemo for my cancer on January 14, 2003. I have been having follow-
> > > up CT's, bloodwork and chest Xrays. This last CT scan showed a enlarged lymph node of a little
> > > over 1cm. My blood work and Chest Xray all came back normal. My oncologist wants to do surgery
> > > if in a month the lymph node has stayed the same or enlarged. I asked her about doing a pet
> > > scan to see it was actually cancer and she responded that the pet scan probably would not pick
> > > something that small up. I personally do not want to have the surgery if my marker levels are
> > > all normal. does anyone know if lymph nodes can enlarge and be cancerous without the marker
> > > levels elevating? Also what else could cause enlarged lymph nodes? Thanks, J Clark
> > > [email protected]
> > Lymph nodes can also be enlarged due to infection or inflammation, experienced radiologists can
> > sometimes tell the diff between large metastatic and inflamed nodes. A 1cm node (depending where
> > its located) is borderline, a repeat scan is sensible -perhaps a month or two later. If it keeps
> > growing and you can rule out an infection at or below that level then surgery is the way to go.
> > As Steph says, markers aren't too reliable in testicular cancer. Were they were raised before
> > treatment began?
> >
> > --
> > madiba
>
> My markers were elevated before the treatment began. after the first cycle they went back to
> normal. I continued on with 2 more cycles of chemo. The enlarged lymph node is in the same spot
> that was cancerous before. Thanks for the followups.
>
> J Clark
>
>

If disease is recurrent after treatment, it sometimes becomes marker neg even though it was
initially marker pos. Nonetheless, the likeliest thing is that yours is NOT recurrent.....
 
Paul Collins wrote:

> JC,
>
> Here is my real life experience with your situation:
>
> I had the exact same scenario 12 years ago, but back then my doc wanted to remove all my lymph
> nodes throughout my whole torso.

I'm not a doctor but knowing where all the lymph nodes are in the torso, that's physically and
practically impossible to do. The patient would have to be cut open from the neck down to the pelvis
and even under the armpits. (perhaps a misunderstanding?)

> I refused. My cancer just came back 2 years ago and I'm still fighting it.

best wishes with your treatment. J
 
"J" <[email protected]> wrote in message
news:[email protected]...
> Paul Collins wrote:
>
> > JC,
> >
> > Here is my real life experience with your situation:
> >
> > I had the exact same scenario 12 years ago, but back then my doc wanted
to
> > remove all my lymph nodes throughout my whole torso.
>
> I'm not a doctor but knowing where all the lymph nodes are in the torso,
that's
> physically and practically impossible to do. The patient would have to be
cut
> open from the neck down to the pelvis and even under the armpits. (perhaps
a
> misunderstanding?)
>
> > I refused. My cancer just came back 2 years ago and I'm still fighting it.
>
> best wishes with your treatment. J
>

Retroperitoneal lymph node dissection is a pretty extensive surgery, with quite significant
side-effects.
 
Well, what the doctor "exactly" said to me was all the lymph nodes were to be removed throughout my
chest and abdomen. Much like the procedure for Hodgkins Disease.

"J" <[email protected]> wrote in message news:[email protected]...
> Paul Collins wrote:
>
> > JC,
> >
> > Here is my real life experience with your situation:
> >
> > I had the exact same scenario 12 years ago, but back then my doc wanted
to
> > remove all my lymph nodes throughout my whole torso.
>
> I'm not a doctor but knowing where all the lymph nodes are in the torso,
that's
> physically and practically impossible to do. The patient would have to be
cut
> open from the neck down to the pelvis and even under the armpits. (perhaps
a
> misunderstanding?)
>
> > I refused. My cancer just came back 2 years ago and I'm still fighting it.
>
> best wishes with your treatment. J
 
Steph wrote:

> "J" <[email protected]> wrote in message
> > Paul Collins wrote:
> >
> > > JC,
> > >
> > > Here is my real life experience with your situation:
> > >
> > > I had the exact same scenario 12 years ago, but back then my doc wanted to
>
> > > remove all my lymph nodes throughout my whole torso.
> >
> > I'm not a doctor but knowing where all the lymph nodes are in the
> torso,that's
> > physically and practically impossible to do. The patient would have to be
> cut
> > open from the neck down to the pelvis and even under the armpits. (perhaps a
>
> > misunderstanding?)
> >
> > > I refused. My cancer just came back 2 years ago and I'm still fighting it.
> >
> Retroperitoneal lymph node dissection is a pretty extensive surgery, with quite significant side-
> effects.

Yes, I see that, thank you. http://urology.jhu.edu/MIS/RPLND.html

J
 
"Paul Collins" <[email protected]> wrote in message
news:[email protected]...
> Well, what the doctor "exactly" said to me was all the lymph nodes were to be removed throughout
> my chest and abdomen. Much like the procedure for Hodgkins Disease.
>

That certainly is NOT done for Hodgkin's disease