And another...

Say hello to Reese and Cara. Reese was on surveillance but recently started 3xBEP after a CT showed activity in his retroperitoneal lymph nodes.

Another member of the club!

Please welcome David, from Atlanta, to the TC family! He starts 4xBEP on Monday.

the low down diagnosis

Here's what we found out on Wednesday Jan 12, 2005 (from Frank's email to Schmink)

the nitty gritty:

--
The pathology report says the tumor was mixed germ cell, 95% embryonal,
less than 5% mature teratoma, focal seminona.
It was classed pT2 (tumor extends through tunica albuginea with vascular/lymphatic invasion).

CT scan shows: "There is a large inhomogeneous mass seen in the left periaortic area that
measures 6 cm x 5 cm in size.  This displaces the left renal vein anteriorly and extends over
routine 7 mm images anterior to the left psoas into the region of the left common iliac artery."
(the orchicetomy was on the left side)  N.B - the onc thinks the size is underestimated by
at least 2 cm (in the head-to-toe measurement).

Bloodwork on 12/27 (10 days before the orchiectomy):
LDH 258, AFP 9897, B-HCG 372

Bloodwork on 1/10 (5 days after the orchiectomy):
LDH 216, AFP 9464, B-HCG 451

So it's non-seminoma that has metastatized into the retroperitoneal lymph system,
with a big frickin mass sitting on my aorta.
The urologist suggests chemo first and maybe surgery later after the mass has shrunk.
The oncologist/hematologist suggests the same, except he will probably insist on
surgery after chemo.

The urologist isn't big into staging; the oncologist said pT2, N3, S2; or stage IIC.

Here's the plan: I go get a port-a-cath next week, then start chemo on the 24th.
3 rounds of BEP (maybe a fourth if the tumor markers don't fall like they should) with Neupogen
between rounds; 12 weeks total (more if 4 rounds).
Intermediate CT scans, with the likelihood of surgery after the chemo is done.