I'm writing regarding my brother's testicular cancer. He had an orchiectomy two weeks ago and he has spoken to two different oncologists. He has got a different treatment recommendation from each. I've read so much about and I just can't come to grips with which route is the best. His tumor is primarily embryonal carcinoma with some seminoma, but CT scan was clear and no tumor markers. My brother is leaning toward RPLND surgery because he is so fearful that the cancer will return and I've read about a lot of people having chemo and then getting the RPLND. What is the likelihood that he will have to have chemo after the RPLND surgery? I need advice.
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The good news is that testicular cancer cure rates are excellent, even when it does recur. I'm still not sure whether surveillance has been discussed as an option. As I know if they do the RPLND surgery, he could still need chemotherapy depending on what they find while operating. Sometimes after chemotherapy, there's residual teratoma that needs to be surgically removed too. I have read recently that embryonal carcinoma may spread beyond the retroperitoneal lymph nodes. So RPLND may not be curative, however, if you're already dealing with one of the experts, I'd trust his opinion. He’s going to get through this whatever choice your brother makes.
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Best advice I can give is to listen to the doctors and if you feel unsure about something they say then ask them about it. Tell them, well you say to do this and so and so says to do this...what are the benefits etc. to doing your way or the other way. Make sure to look up their backgroung info and also find out how many people they treat with TC. Make sure you have a doctor that has delt with TC on a regular basis and is up to date with the ways to handle it now. They are always finding new ways to help so they need to be on top of the latest technology.
The chances of having RPLND before or after chemo are 50/50 I would say. It all depends on how his blood tests come back and how the CT's and/or PET scans look. Either way people get through it and go on to live great lives. I think your brother will do fine with the RPLND and it's great that you are so willing to help him through this!
BTW, make sure he is eating lots of protien to keep his weight on in case chemo is a suggestion.
I hope this helps you and if you have any other questions please feel free to ask!
The chances of having RPLND before or after chemo are 50/50 I would say. It all depends on how his blood tests come back and how the CT's and/or PET scans look. Either way people get through it and go on to live great lives. I think your brother will do fine with the RPLND and it's great that you are so willing to help him through this!
BTW, make sure he is eating lots of protien to keep his weight on in case chemo is a suggestion.
I hope this helps you and if you have any other questions please feel free to ask!
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