Wednesday, January 22, 2014

Testicular Cancer

Testicular Cancer: Pure Seminoma Stage One

Today we met with the Dr. Tran, the urologist, who did Jacob's orchiectomy surgery last week. The pathology came back and it is, in fact, testicular cancer and is classified as "pure seminoma" in stage one. 

When staging testicular cancer, they look at four areas, TNMS. 
T: Primary tumor. They staged Jacob's tumor at a pT1. We also found out the tumor was 5.2 cm, which is a little over 2 inches. 
N:  Regional lymph nodes. Jacob's stage..."N0" (N-zero): No regional lymph node metastasis. 
M: Distant metastasis. Jacob's stage..."M0" (M-zero): No distant metastasis. 
S: Serum tumor markers. This one is a little tricky. We are waiting to get results back from blood work performed today to find out the staging on this one. For this category they check three different tumor markers in the blood.  Before surgery, one of Jacob's levels, the LDH (lactic dehydrogenase), was more than three times the normal level. We are hoping that the levels are back to normal, or on their way back down now that the tumor is removed. We should know the results of this blood work in a few days and the results will impact the treatment we choose. 

The three options in treating testicular cancer are surveillance, radiation and chemotherapy. 
1. Surveillance. As long as the "S" from above shows the LDH tumor marker is going down, then this will be an option. This would require having chest x-rays, Cat scans, and blood work every three months for a few years and annually for up to 10 years. In this form of treatment, about 80% of people never have any more occurrence of cancer and 20% do, typically in the first 1-3 years after surgery. 
2. Radiation. If Jacob's LDH levels have not gone down, radiation or chemotherapy will be necessary.  This is pretty self explanatory. Radiation would require us to do sperm banking for future children and has about a 3% re-occurrence rate. 
3. Chemotherapy. This also would require us to do sperm banking and also has a 3% re-occurrence rate. 

We will be meeting with an oncologist in the next few weeks to discuss the LDH levels and the recommended treatment plan. 

Overall, Dr. Tran said to take away from the appointment that "the cancer has favorable pathology and stage." So, although it is still kind of unbelievable to us everything that has unfolded over the last week, we are feeling thankful for these results. 

Thank you for all of the prayers, calls, texts, etc... and for following along on the latest Higgins Medical Saga.... (We think we're getting a little too good at these very heavy, serious medical posts.....) 

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