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kathryn1 said:

Hi
Hi,
My son was recently diagnosed. I have a lot of concerns and questions. One being why the incision is so long? Did you have chemo and surgery? Or do you have a choice?
I would appreciate any info.
Thanks, Kathryn

Testicular Cancer Resource Center
Katheryn,
There is a comprehensive website all about TC:

http://tcrc.acor.org/index.html

You can probably find the answer to just about any questions you might have regarding TC on that site.

Now, to answer your questions as best I can, I need to find out: Which incision do you think is so long? The orchiectomy, or is he getting a Retro Peritoneal Lymph Node Dissection (RPLND)?
The orchiectomy is just a 4" incision, normally.
The RPLND is a major surgery where they temporarily remove the intestines for the abdominal cavity to access the lymph node behind them. They generally open from breastbone to pubic bone to do that.

You doctor will recommend surgery, chemo & or radiation, depending on the types of cells discovered in the pathology report, & other tests that indicate if there was any spread to the lymph system. Some cells respond well to radiation, others respond best to chemo.

Rather than repeat my personal story with TC here, check out my profile page for details, but I've had TC twice, 35 years apart, & I'm more than happy to answer any questions I can.

Dave

kathryn1 said:

Dave
Thank you for replying.
My son had the surgery for removing the testicle. He had a prosthetic put in. Two weeks after surgery they did a catscan and told him he has embryonal carcinoma, with spots in lower abdomen. They are doing another catscan today of chest area.

I have been going thru ovarian cancer and the staging ect. is very different. I can see why the incision is so long if they have to get behind the intestines.

I don't know why they didn't do the catscans before the first surgery. I am in TN and he is in IA. So I haven't been there to hear everything the doctors have been saying. Getting info from my son second hand isn't the same. He's scared and stressed, which I more than understand.

If he has surgery I will be going to stay with him and his wife to help take care of him till he's back on his feet. I've been trying to get as much info as possible and I think the website you gave will be a big help!

If there is anything you think I should know or be asking about, please let me know!

Thanks again,
Kathryn

Well, generally the first
Well, generally the first step is the orchiectomy & biopsy to determine 1-if there are cancer cells present & 2- What types of cells they are. They can also get some indication of whether cells have spread into the blood or lymph systems.

Cat scans are pretty limited, although they can tell you if it is likely that you've had cells spreading they cannot rule out all spread. In other words, a negative cat scan may not be a clean bill of health. A positive one tells them more treatment is definitely needed.

My cat scan was ambiguous enough that my oncologist ordered a PET scan ( 2-4 X the cost of a CAT scan, I believe), which showed I have one lymph node that is "almost certainly" cancerous. The oncologist decided chemo would offer the best results & I'm in my second week right now.

My tumor was mixed 65% seminoma & 35% embryonal. In mixed tumors they treat the whole thing as if it was embryonal. Hence the chemo & no radiation. (seminomas, respond well to radiation, non-seminomas do not)

I had the RPLND surgery for my first TC in 1975. Chemo therapies were still emerging back then, I believe & if your nodes came back clean, as mine did, they considered you cured.

Back then there was no "nerve sparing" technique, or they were not well known, I was left with retrograde ejaculation. I was told it would not be impossible to father children, but it would require some special harvesting techniques. I never looked into it.

If his doctor wants to do a RPLND, make sure he is satisfied with the reason for doing so, today's chemo is *highly* effective & it treats the entire body, so a few stray cells aren't likely to survive.

I can tell you that my recovery from RPLND was long & uncomfortable, partly do to getting a staph infection in a portion of my incision. Also, over the next 10 years I had 2 different bowl obstructions due to adhesions (scar tissue) in my abdomen. They required surgery to fix.

Don't let my problems scare you. I don't know how many folks have complications like mine, I suspect just a fraction. I just want you to know that it can happen. Your son's oncologist is the best person to guide you through this decision. Be aware that there are "Surgical Oncologists" (surgery) & "Medical Oncologists" (chemo). It might be a good idea to talk to one of each.

Dave