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Chemo for pT1a? Also two independent (primary) cancers

Posted by janar @janar, Aug 6, 2024

I am 38 year old male. 2 years ago my right testicle was removed and received diagnosis for "adenocarcinoma of rete testis". Since then I was on surveillance with CT scan every 3 months. For 21 months they found nothing.

On my last CT they found a nodule that had grown slowly over the 21 months from 2mm to 6mm. Two weeks ago I received VATS surgery at private hospital because my primary oncologists told me that the nodule is "too small" and "we dont even know what it is".

I received pathologists report yesterday which says the nodule isn't rete testis adenocarcinoma and that the nodule was a primary. So until proven othetwise, I have two completely independent cancers. The pathologist stage is pT1a, but they didnt resect any lymph nodes so node staging is Nx. There was minor lymphatic carcinosis at the site but otherwise it was resected with healthy margins.

I have already studied a bit on T1 stage adjuvant treatments and most say that it doesnt actually give any benefit.

My question is that is this true? I imagine that if someone of advanced age would get diagnosis for T1, there might not be benefit from adjuvant treatment like chemo, but what about younger patient? I would very much like this thing to be nuked out of my body, side effects be damned.

Also has anyone any idea how two independent cancers affect treatment options?

Interested in more discussions like this? Go to the Lung Cancer Support Group.

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rcerwin3 | @rcerwin3 | Nov 22 11:46am
In reply to @janar "I am back and I am worried that so is my cancer. FDGPET showed one hilar..." + (show)
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I am back and I am worried that so is my cancer. FDGPET showed one hilar node SUVmax 3,9, CEA was 20 but somehow came down to 16. Could be unrelated, could be gastrointestinal problems, could be anything. There is possibility the node is entirely benign.

I have been advised to do bronchoscopy + biopsy and if malignancy, to surgery. Alternative is I go directly to surgery, intraoperatively check nodes for malignancy and if positive, proceed with open lobectomy.

Asked my surgeon that am I making the right decision and is this the best option? Answer: He would not advise me to do this and he would not be doing the surgery if he didn't think so.

Last time was VATS and recovery was easy. I am terrified that this will be completely different, unimaginably worse pain, for much longer duration and much longer recovery time. I have been trying to look for ways to manage pain. I hope there are means to do so.

Does anyone have experience with open lobectomy? Does anyone have experience with epidural for managing pain from open lobectomy?

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@janar You sound so much like me. I cannot stop the worry. I had a robotic lobectomy-not sure what an open lobectomy is. But my pain was very minimal. The worst part was having the chest tube in and mine was in four days. They did give me an epidural sometime during surgery so I suppose that helped with pain the first day. As I was groggy, I don't really remember much about the first day. While I was in the hospital (three more days) they gave me tramadol every so often but once home, I took Extra Strength Tylenol and that only for a few days. Never took any of the Tramadol they sent me home with. I know open is different.

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Colleen Young, Connect Director | @colleenyoung | 13 hours ago
In reply to @janar "@lls8000 I am now recovering in my room. Time passes so incredibly slowly (been counting minutes..." + (show)
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@lls8000 I am now recovering in my room. Time passes so incredibly slowly (been counting minutes for over 3 hours now).

I must say that painwise, I am actually better than after VATS. Immediately after surgery I was nauseous but pain was 0 or 1, less than after VATS.

Upper lobe hilus was positive and so was at least one mediastinal node.

They brought too much food for me. My burps are way louder than before and I wonder if its because of mediastinal node removal.

Wishing time passed faster. Its 9:30 PM and im not sleepy. Tired but not sleepy.

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@janar, how is recovery going? Are you home now? How are you doing?

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